Polio eradication in the Netherlands: a proposal for surveillance
Polio eradicatie in Nederland: een voorstel voor surveillance
van Loon AM, Rumke HC, Conyn-van Spaendonck MAE
RIVM Report 242500003
Polio-free certification in the framework of the global polio eradication programme, will require the implementation of a more active, comprehensive surveillance system. The Global and European Commissions for the Certification of the Eradication of Poliomyelitis have established the principles, criteria and process of polio-free certification, particularly with regard to surveillance. These include the use of performance indicators. Polio surveillance in the Netherlands should be based on the following elements. 1) Clinical surveillance consisting of mandatory notification of suspected patients and of reporting of patients with acute flaccid paralysis born in 1957 and thereafter. An expert committee has to be established for final classification of cases. 2) Virological surveillance comprising (a) diagnostic investigation of suspected polio patients and AFP patients, (b) analysis of a selection of enterovirus strains isolated in Dutch virus diagnostic laboratories, and (c) environmental surveillance. 3) Serological surveillance to determine the level of protection to poliomyelitis in the general population and specific risk groups. 4) Collection of information on vaccination coverage. The proposed surveillance system will meet the three objectives to detect possible (wild) poliovirus circulation, to determine the origin of circulating (wild) poliovirus, and to document the absence of wild poliovirus circulation in the Netherlands.