Epidemiologia delle paralisi flaccide acute in Italia: 1996-1998

The World Health Organization (WHO) programme for "Global eradication of Poliomyelitis" established since 1988 has achieved substantial goals, and paralytic poliomyelitis, already eradicated from the Americas, has also become a rare disease in many other parts of the world. The goal is realistic and could be reached during the first decade of the third millennlum. To achieve the certification of the eradication of poliomyelitis in a country, it must be verified that no paralync poliomyelitis due to wild poliovirus occurs over an extended period of time in the context of an active surveillance of Acute Flaccid Paralysis (AFP). In Italy the active AFP surveillance started in 1996 as a pilot study, and was gradually extended at national level in 1997. The rate of non-polio AFP found was 0.61 cases per 100,000 in 1997 and 0.67 in 1998. The values were lower than the rate of l case per 100,000, in the population aged less than 15 years, considered acceptable by the WHO. However, during the three year survey seven cases of vaccine associated paralytic poliomyelitis (VAPP) were identified and no wild poliovirus was detected. The underestimation of AFP cases in 1997 was particularly due to the delay in organizing the regional hospital network In 1998 an improvement of the biological samples collection has been evidenced. This study is the first systematic attempi to determine the rate of AFP in Italy.