title: Notification of patients with acute flaccid paralysis since certification of Australia as polio-free.
abstract: OBJECTIVE
  Surveillance of patients presenting with acute flaccid paralysis (AFP) is the World Health Organization (WHO) recommended method for the detection of incident cases of poliovirus infection. Australia was certified free of circulating poliovirus in 2000 but is required to continue AFP surveillance until global certification. Although Australia reached the WHO nominated surveillance target in 2000 and 2001, it was not reached in 2002. Notification rates between states have been variable. We aim to investigate the difference in notification rates by state to determine whether different rates reflect different patterns of disease or different approaches to reporting.
  
  
  METHODS
  Notification rates were reviewed by state for the years 1997-2002. The completeness of case ascertainment was reviewed from published studies. Key informants described differences in AFP reporting in states with consistent differences in notification rates.
  
  
  RESULTS
  Australia achieved 75% of the WHO surveillance target for AFP cases between 1997 and 1999 and 98% between 2000 and 2002. After 2000, Queensland achieved 150% of its target while Victoria achieved less than 50%. New South Wales reached its target over the entire 6 years but other states and territories were not as consistent. Although the formal process for AFP reporting is uniform throughout Australia, many differences in approach were identified between Victoria and Queensland.
  
  
  CONCLUSIONS
  Maintaining AFP surveillance at the required WHO standard will be more likely in Australia if the populous states are able to notify cases at the same rate as Queensland (since 2000) and New South Wales (in general).
authors.affiliation: School of Public Health, Latrobe University, Melbourne, Victoria, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Whitfield
authors.forename: H
authors.initials: H
authors.lastname: Kelly
mesh_terms: D000208:Acute Disease; D001315:Australia / Q000453:epidemiology; D003937:Diagnosis, Differential; D006801:Humans; D015994:Incidence; D010264:Paraplegia; D035622:Parental Notification; D011051:Poliomyelitis / Q000175:diagnosis / Q000453:epidemiology; D011793:Queensland / Q000453:epidemiology; D014739:Victoria / Q000453:epidemiology