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    Paediatric surveillance of Acute Flaccid Paralysis in the Netherlands in 1995 and 1996

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    Authors
    Conyn-van Spaendonck MAE
    Geubbels ELPE
    Suijkerbuijk AWM
    Type
    Report
    Language
    en
    
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    Title
    Paediatric surveillance of Acute Flaccid Paralysis in the Netherlands in 1995 and 1996
    Translated Title
    Kindergeneeskundige surveillance van acute slappe verlamming in Nederland in 1995 en 1996
    Publiekssamenvatting
    In Nederland wordt de surveillance van acute slappe verlamming (AFP acute flaccid paralysis) sinds oktober 1992 uitgevoerd via het Nederlands Signalerings-Centrum Kindergeneeskunde. Het betreft een vorm van actieve surveillance waarbij klinisch werkzame kinderartsen maandelijks een aantal zeldzame aandoeningen anoniem rapporteren. Na melding worden door de betreffende onderzoekers met behulp van een vragenlijst additionele gegevens over klinische presentatie, diagnostische bevindingen vaccinatiestatus nagevraagd. In 1995 werden 11 gevallen die aan de casus-definitie voldeden gerapporteerd, in 1996 15. Dit resulteert in een AFP-rate van 0,39 per 100.000 in 1995 en 0,53 per 100.000 in 1996. Er werden geen gevallen van AFP ten gevolge van een polio-infectie gesignaleerd. Bij ongeveer 50% van de gerapporteerde AFP-patienten werd de diagnose Guillain-Barre Syndroom gesteld. Tot op heden voldoet de AFP-surveillance in Nederland niet aan de criteria van WHO voor certificering als polio-vrij in het kader van het polio-eradicatie-initiatief. Een geobserveerde AFP-rate van 1 per 100.000 wordt daarbij gehanteerd als criterium voor voldoende sensitiviteit van het systeem. Behalve de tijdigheid van de meldingen baart het lage aantal adequate faeceskweken zorgen (58% een faecesmonster waarvan 51% binnen 14 dagen na de eerste ziektedag; 11% twee faecesmonsters). Aanbevelingen voor optimalisatie: telefonische rapportage (snellere melding en advisering over adequate diagnostiek); de kinderartsen via NSCK-nieuwsbrieven, presentaties en publicaties beter informeren en stimuleren; uitbreiding naar neurologen.<br>
    The surveillance of Acute Flaccid Paralysis (AFP) is included in the Dutch Paediatric Surveillance System (NSCK) since October 1992. Paediatricians in hospitals report a list of rare diseases on a monthly basis as part of an active surveillance scheme. After the initial report, additional information on clinical presentation, diagnostic results and vaccination history is collected through a questionnaire. In 1995 11 cases conforming to the case-definition were reported, and in 1996 15, resulting in an AFP-rate of 0.39 per 100,000 in 1995 and 0.53 per 100,000 in 1996. No cases of AFP caused by polio infection were observed. In about 50% of the reported AFP cases Guillain-Barre Syndrome was diagnosed. To date, the AFP surveillance in the Netherlands does not meet the WHO criteria for adequate surveillance for certification as polio-free according to the polio eradication initiative. An observed AFP-rate of at least 1 per 100,000 is accepted as proof of sufficient sensitivity of the surveillance system. Along with timeliness of the reports, we are concerned of the low proportion of cases of whom faecal samples are adequately virologically investigated (58% one faecal sample, of which 51% within 14 days after onset of disease; 11% two samples). Recommendations for optimalisation: introducing initial reporting by telephone (immediate reporting and advice on adequate specimen collection); improved information of the paediatricians through NSCK newsletters, presentations and publications extending of the surveillance to neurologists.<br>
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    Sponsors
    IGZ
    URI
    http://hdl.handle.net/10029/258039
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