Poliomyelitis surveillance in Shandong

In Shandong Province, China, programmes were initiated in 1991 for mass immunization against poliomyelitis and for the immediate reporting of acute flaccid paralysis (AFP). The incidence of non-poliomyelitis AFP was found to be 0.46-0.61 cases per 100 000 children per annum. It appeared that illness resembling the Guillain-Barre syndrome was underreported. The incidence of such illness peaked among children aged 2-3 years. Although laboratory investigations have improved, in 1992 they were still inadequate in nearly a third of confirmed poliomyelitis cases. As the prevalence of wild poliovirus declines in China, reliable laboratory support needs to be established and adequately sensitive and specific AFP surveillance be developed if poliomyelitis is to be eradicated.