Australian National Enterovirus Reference Laboratory annual report, 2013

Area of Science:

• Public Health
• Virology
• Epidemiology

Background:

• Australia maintains polio-free status via acute flaccid paralysis (AFP) surveillance in children under 15, adhering to World Health Organization (WHO) guidelines.
• The Australian Paediatric Surveillance Unit and Paediatric Active Enhanced Disease Surveillance System collect AFP case data, with specimens sent to the National Enterovirus Reference Laboratory for analysis.

Observation:

• In 2013, Australia reported 1.4 non-polio AFP cases per 100,000 children, meeting WHO sensitivity criteria, with no poliomyelitis cases detected through clinical surveillance.
• Enterovirus A71 was identified in nine of 61 non-polio AFP cases in 2013, linked to a significant outbreak.
• A Sabin poliovirus strain was detected in an infant returning from Pakistan, who had received vaccination abroad.

Findings:

• Australia's surveillance system is sensitive, meeting WHO performance criteria for polio-free status monitoring.
• Non-polio enteroviruses, such as enterovirus A71, are significant causes of AFP and can be associated with outbreaks.
• Imported poliovirus cases, even in vaccinated individuals, pose a continued risk to polio eradication efforts.

Implications:

• Continued vigilance and sensitive surveillance are crucial for maintaining Australia's polio-free status.
• Understanding the epidemiology of non-polio enteroviruses is important for managing AFP cases and potential outbreaks.
• Global polio eradication requires ongoing international cooperation and measures, such as vaccination recommendations for travelers, to prevent reintroduction of the virus.