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Australia's contribution to global polio eradication initiatives
R M D'Souza1, C Watson, M Kennett
1National Centre for Epidemiology and Population Health, Australian National University, Australian Capital Territory. Rennie.D'Souza@health.gov.au
Objective:
To provide evidence according to the requirements of the Global Commission for Certification of Poliomyelitis Eradication that poliomyelitis has been eliminated in Australia.
Methods:
Documentation of the surveillance of poliomyelitis, the presence of a comprehensive national immunisation program, and a network of laboratories for viral diagnosis. Active surveillance of acute flaccid paralysis (AFP) cases was initiated in 1995 to prove that poliovirus does not cause such paralysis. Australia is also evaluating the surveillance of AFP through a retrospective hospital based study.
Results:
The last case in Australia of polio due to wild poliovirus was seen in 1978 and the last case of vaccine-associated paralytic poliomyelitis detected by serology was in 1994. The latest immunisation coverage figures for OPV3 for children under one year of age is 85.6%. The Australian National Polio Reference Laboratory has tested 821 enteroviruses since 1994 and have not identified any wild poliovirus. The average rate of non-polio AFP based on 111 cases investigated for the period 1995-98 is 0.71 per 100,000 under the age of 15 years. Stool samples were collected from only 21% of cases.
Conclusion:
The process of certification of the eradication of poliomyelitis in Australia is almost complete. Although immunisation coverage is high, improvement in AFP surveillance and stool collection is vital for the certification process. The next challenge is the containment of polioviruses.
Implications:
Although Australia and other Western Pacific countries are likely to be certified as wild-polio free in 2000, a comprehensive immunisation program and surveillance must continue for three years after global certification (expected 2003-04).