title: Acute flaccid paralysis surveillance: A 6 years study, Isfahan, Iran.
abstract: BACKGROUND
  Poliomyelitis is still an endemic disease in many areas of the world including Africa and South Asia. Iran is polio free since 2001. However, due to endemicity of polio in neighboring countries of Iran, the risk of polio importation and re-emergence of wild polio virus is high. Case definition through surveillance system is a well-defined method for maintenance of polio eradication in polio free countries.
  
  
  METHODS
  In a cross-sectional survey from 2007 to 2013, we reviewed all the records of under 15 years old patients reported to Acute Flaccid Paralysis Committee (AFPC) in Isfahan province, Iran. All cases were visited by members of the AFPC. Three stool samples were collected from each reported case within 2 weeks of onset of paralysis and sent to National Polio Laboratory in Tehran, Iran, for poliovirus isolation. Data were analyzed by SSPS software (version 22). Student's t-test and Chi-square was used to compare variables. Statistical significance level was set at P < 0.05.
  
  
  RESULTS
  In this 6-year period 85 cases were analyzed, 54 patients were male (63.5%) and 31 were female (36.5%). The mean age of patients was 5.7 ± 3.9 years. The most common cause of paralysis among these patients was Guillian-Barré syndrome (83.5%). We did not found any poliomyelitis caused by wild polio virus. Only one case of vaccine associated poliomyelitis was reported.
  
  
  CONCLUSIONS
  Since 1992, Iran has a routine and high percent coverage of polio vaccination program for infants (>94%), with six doses of oral polio vaccine (OPV). Accurate surveillance for poliomyelitis is essential for continuing eradication.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Infectious Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Alireza Emami
authors.initials: AE
authors.lastname: Naeini
authors.affiliation: Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamadreza
authors.initials: M
authors.lastname: Ghazavi
authors.affiliation: Department of General Physician, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sharareh
authors.initials: S
authors.lastname: Moghim
authors.affiliation: Department of Virology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Amirhosein
authors.initials: A
authors.lastname: Sabaghi
authors.affiliation: Department of Infectious Diseases Specialist, Health Care Center, Isfahan, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Fadaei
keywords: Acute flaccid paralysis; poliomyelitis; surveillance