title: Surveillance of acute flaccid paralysis (AFP) in Lombardy, Northern Italy, from 1997 to 2011 in the context of the national AFP surveillance system.
abstract: An Acute Flaccid Paralysis (AFP) surveillance system was set up in Lombardy (Northern Italy) in 1997 in the framework of the national AFP surveillance system, as part of the polio eradication initiative by the World Health Organization (WHO). This surveillance system can now be used to detect Poliovirus (PV) reintroductions from endemic countries. This study aimed at describing the results of the AFP surveillance in Lombardy, from 1997 to 2011.   Overall, 131 AFP cases in Lombardy were reported with a mean annual incidence rate of 0.7/100 000 children &lt;15 years of age (range: 0.3/100 000-1.1/100 000). The sensitivity of the surveillance system was optimal from 2001-2003. The monthly distribution of AFP cases was typical with peaks in November, in January, and in March. The major clinical diagnoses associated with AFP were Guillain-Barré Syndrome (GBS, 40%) and encephalomyelitis/myelitis (13%). According to the virological results, no poliomyelitis cases were caused by wild PV infections, but two Vaccine-Associated Paralytic Paralysis (VAPP) cases were reported in 1997 when the Sabin oral polio vaccine (OPV) was still being administered in Italy. Since a surveillance system is deemed sensitive if at least one case of AFP per 100,000 children &lt;15 years of age is detected each year, our surveillance system needs some improvement and must be maintained until global poliovirus eradication will be declared.
authors.affiliation: a Department of Biomedical Sciences for Health; University of Milan; Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pellegrinelli
authors.forename: Valeria
authors.initials: V
authors.lastname: Primache
authors.forename: Lucia
authors.initials: L
authors.lastname: Fiore
authors.forename: Concetta
authors.initials: C
authors.lastname: Amato
authors.forename: Stefano
authors.initials: S
authors.lastname: Fiore
authors.forename: Laura
authors.initials: L
authors.lastname: Bubba
authors.forename: Elena
authors.initials: E
authors.lastname: Pariani
authors.forename: Antonella
authors.initials: A
authors.lastname: Amendola
authors.forename: Maria
authors.initials: M
authors.lastname: Barbi
authors.forename: Sandro
authors.initials: S
authors.lastname: Binda
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D009123:Muscle Hypotonia / Q000453:epidemiology; D010243:Paralysis / Q000453:epidemiology*; D012621:Seasons
keywords: Acute Flaccid Paralysis; Enterovirus; Polio Eradication Initiative; Poliovirus; Surveillance