Paediatric surveillance of Acute Flaccid Paralysis in the Netherlands in 1997

Abstract

The main goal of AFP surveillance in the Netherlands is to qualify for WHO certification as a polio-free country. Surveillance for AFP has been established in the Netherlands as part of the NSCK surveillance system since October 1992. The NSCK surveillance system is an activity of the Dutch Paediatric Association using an 'active' surveillance approach to monitor rare disorders in the child population. The survey on AFP carried out by the RIVM comprises a collection of additional information on clinical and laboratory findings, vaccination status and remaining complaints from the reported AFP cases through questionnaires. Compliance with the scheme in general is high (91% in 1997) but AFP reporting is still lagging behind. We can conclude that although the required non-polio AFP rate of 1 per 100,000 children has not been reached yet, a slow but steady increase has been reported over the years, from 0.39 in 1995, to 0.56 in 1996 and 0.63 in 1997. Thanks to the implementation of recommendations made in previous reports, progress has also been made for adopting all performance criteria used by WHO in the certification process. Therefore we suggest that the implementation of recommendations be continued, including the extension of the system to neurologists and a further improvement in its efficiency. The need for adequate and timely faecal sampling should continue to be stressed as well as the timely provision of case-specific information.