title: Enhanced surveillance of acute flaccid paralysis following importation of wild poliovirus in Xinjiang Uygur Autonomous Region, China.
abstract: BACKGROUND
  After being polio free for more than 10 years, an outbreak occurred in China in 2011 in Xinjiang Uygur Autonomous Region (Xinjiang) following the importation of wild poliovirus (WPV) originating from neighboring Pakistan.
  
  
  METHODS
  To strengthen acute flaccid paralysis (AFP) surveillance in Xinjiang, "zero case daily reporting" and retrospective searching of AFP cases were initiated after the confirmation of the WPV outbreak. To pinpoint all the polio cases in time, AFP surveillance system was expanded to include persons of all ages in the entire population in Xinjiang.
  
  
  RESULTS
  Totally, 578 AFP cases were reported in 2011 in Xinjiang, including 21 WPV cases, 23 clinical compatible polio cases and 534 non-polio AFP cases. Of the 44 polio cases, 27 (61.4%) cases were reported among adults aged 15-53 years. Strengthening AFP surveillance resulted in an increase in the number of non-polio AFP cases in 2011 (148 children < 15 years) compared with 76 cases < 15 years in 2010. The AFP surveillance system in Xinjiang was sensitive enough to detect polio cases, with the AFP incidence of 3.28/100,000 among children < 15 years of age.
  
  
  CONCLUSIONS
  Incorporating adult cases into the AFP surveillance system is of potential value to understand the overall characteristics of the epidemic and to guide emergency responses, especially in countries facing WPV outbreak following long-term polio free status. The AFP surveillance system in Xinjiang was satisfactory despite limitations in biological sample collection.
authors.forename: Ning
authors.initials: N
authors.lastname: Wen
authors.forename: Chun-Xiang
authors.initials: CX
authors.lastname: Fan
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Fu
authors.forename: Jing
authors.initials: J
authors.lastname: Ning
authors.forename: Yi-Xin
authors.initials: YX
authors.lastname: Ji
authors.forename: Hui-Ming
authors.initials: HM
authors.lastname: Luo
authors.forename: Hua-Qing
authors.initials: HQ
authors.lastname: Wang
authors.forename: Shuang-Li
authors.initials: SL
authors.lastname: Zhu
authors.forename: Wen-Zhou
authors.initials: WZ
authors.lastname: Yu
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Zhu
authors.forename: Fu-Qiang
authors.initials: FQ
authors.lastname: Cui
authors.forename: De-Xin
authors.initials: DX
authors.lastname: Li
authors.forename: Shi-Wen
authors.initials: SW
authors.lastname: Wang
authors.forename: Wen-Bo
authors.initials: WB
authors.lastname: Xu
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Hao
authors.forename: Ling-Sheng
authors.initials: LS
authors.lastname: Cao
authors.forename: Li
authors.initials: L
authors.lastname: Luo
authors.forename: Lu
authors.initials: L
authors.lastname: Han
authors.forename: Lei
authors.initials: L
authors.lastname: Cao
authors.forename: Wei
authors.initials: W
authors.lastname: Xia
authors.forename: Xin-Qi
authors.initials: XQ
authors.lastname: Wang
authors.forename: Kathleen H
authors.initials: KH
authors.lastname: Reilly
authors.forename: Fuerhati
authors.initials: F
authors.lastname: Wushouer
authors.forename: Sha-Sha
authors.initials: SS
authors.lastname: Mi
authors.affiliation: Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Xicheng District, Beijing 100050, PR China. yangwz@chinacdc.cn.
authors.forename: Wei-Zhong
authors.initials: WZ
authors.lastname: Yang
authors.forename: Li
authors.initials: L
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010243:Paralysis / Q000453:epidemiology / Q000821:virology*; D011051:Poliomyelitis / Q000453:epidemiology* / Q000821:virology; D017955:Poliovirus; D012189:Retrospective Studies; D055815:Young Adult