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Australian National Enterovirus Reference Laboratory annual report, 2023
Matthew B Kaye1, Linda K Hobday1, Aishah Ibrahim1
1National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia.
Insights
Australia maintained its polio-free status in 2023, with no poliomyelitis cases reported. Surveillance systems met World Health Organization (WHO) standards, detecting non-polio acute flaccid paralysis (AFP) cases and various enteroviruses.
Area of Science:
- Public Health
- Virology
- Epidemiology
Background:
- Australia maintains polio-free status through rigorous surveillance as per WHO guidelines.
- Acute flaccid paralysis (AFP) surveillance in children under 15 is crucial for detecting poliovirus.
Purpose of the Study:
- To report on Australia's polio surveillance data for 2023.
- To assess the sensitivity of Australia's AFP surveillance system against WHO performance criteria.
Main Methods:
- Clinical surveillance of acute flaccid paralysis (AFP) cases in children.
- Virological investigation of fecal specimens by the National Enterovirus Reference Laboratory.
- Enterovirus and wastewater surveillance to complement clinical data.
Main Results:
- No cases of poliomyelitis were reported in Australia in 2023.
- Australia reported 1.71 non-polio AFP cases per 100,000 children, meeting WHO sensitivity criteria.
- Several non-polio enteroviruses were identified in AFP cases, including coxsackievirus and echovirus strains.
Conclusions:
- Australia's surveillance systems effectively monitor for poliovirus and other enteroviruses.
- The system's sensitivity meets WHO standards, ensuring the detection of potential polio cases.
- Global poliovirus circulation continues in endemic countries and through vaccine-derived strains in other nations.
Abstract:
Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2023, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.71 non-polio AFP cases per 100,000 children, thereby meeting the WHO's performance criterion for a sensitive surveillance system. The non-polio enteroviruses coxsackievirus A9, coxsackievirus B5, echovirus 9, echovirus 30, enterovirus A71 and enterovirus C96 were identified from clinical specimens collected from AFP cases. Australia also performs enterovirus and wastewater surveillance to complement the clinical system focussed on children. In 2023, there were twelve cases of wild poliovirus reported from the last two remaining endemic countries: Afghanistan and Pakistan. Another 23 countries reported cases of poliomyelitis due to circulating vaccine-derived poliovirus.
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