D'Errico Marcello M, Barbadoro Pamela, Bacelli Sonia, Esposto Elisabetta, Moroni Vania, Scaccia Federica, Tantucci Luana, Prospero Emilia
Institute of Infectious Diseases and Public Health, Università Politecnica delle Marche, Italy.
BMC Infect Dis. 2008 Oct 9;8:135. doi: 10.1186/1471-2334-8-135.
The last case of poliomyelitis due to transmission of indigenous wild poliovirus occurred in Italy in 1982, however, it is important to guarantee a high quality surveillance as there is a risk of importation of cases from areas where polio is endemic. Stopping poliovirus transmission is pursued through a combination of high infant immunization coverage and surveillance for wild poliovirus through reporting and laboratory testing of all cases of acute flaccid paralysis (AFP) among children under fifteen years of age. The aim of this study was to describe and to evaluate 11 years of active surveillance in the Marches (Italy) in terms of: incidence, aetiology and clinical manifestation of AFP cases.
The active Acute Flaccid Paralysis surveillance has been carried out in the Marches region since February 1997 by the Chair of Hygiene which established a regional hospital network. Active surveillance involves 15 hospital centres.
In the considered period, 0-15 years population varied between 187,051 in 1997 to 201,625 in 2007, so the number of AFP expected cases is 2 per year. From February 1997 to October 2007, 27 cases were found with rates of 1.0/100,000 in 1997; 2.0/100,000 in 1998; 1.0/100,000 in 1999; 0.5/100,000 in 2000; 2.5/100,000 in 2001; 1.0/100,000 in 2002; 0 in 2003; 0.5/100,000 in 2004; 1.5/100,000 in 2005; 2.0/100,000 in 2006; 1.5/100,000 in 2007. In 29.6% of cases two stool samples were collected in 14 days from the symptoms onset. The 60-days follow-up is available for 23 out of 27 cases reported. In 44.5% of cases the definite diagnosis was Guillain Barrè syndrome.
In general, the surveillance activity is satisfactory even if in presence of some criticalities in biological samples collection. The continuation of surveillance, in addition to the maintenance of current levels of performance, will tend to a further and more detailed sensitization of all workers involved, in order to obtain spontaneous and prompt reporting, and to achieve the optimal standards recommended by the WHO both in the collection of biological samples and the availability of 60 days follow-up, with the goal of eradicating polio from all countries.
意大利本土野生脊髓灰质炎病毒传播导致的最后一例脊髓灰质炎病例发生在1982年，然而，由于存在从脊髓灰质炎流行地区输入病例的风险，保证高质量监测很重要。通过高婴儿免疫覆盖率以及对15岁以下儿童所有急性弛缓性麻痹（AFP）病例进行报告和实验室检测来监测野生脊髓灰质炎病毒，从而阻断脊髓灰质炎病毒传播。本研究的目的是从AFP病例的发病率、病因和临床表现方面描述和评估意大利马尔凯大区11年的主动监测情况。
自1997年2月起，马尔凯大区卫生学主席建立了一个区域医院网络，开展急性弛缓性麻痹主动监测。主动监测涉及15个医院中心。
在研究期间，0至15岁人口数量从1997年的187,051人变化到2007年的201,625人，因此每年预期的AFP病例数为2例。1997年2月至2007年10月，共发现27例病例，1997年发病率为1.0/10万；1998年为2.0/10万；1999年为1.0/10万；2000年为0.5/10万；2001年为2.5/10万；2002年为1.0/10万；2003年为0；2004年为0.5/10万；2005年为1.5/10万；2006年为2.0/10万；2007年为1.5/10万。29.6%的病例在症状出现后14天内采集了两份粪便样本。报告的27例病例中有
