Potential for the Australian and New Zealand paediatric intensive care registry to enhance acute flaccid paralysis surveillance in Australia: a data-linkage study

Abstract

BackgroundAustralia uses acute flaccid paralysis (AFP) surveillance to monitor its polio-free status. The World Health Organization criterion for a sensitive AFP surveillance system is the annual detection of at least one non-polio AFP case per 100,000 children aged less than 15 years, a target Australia has not consistently achieved. Children exhibiting AFP are likely to be hospitalised and may be admitted to an intensive care unit. This provides a potential opportunity for active AFP surveillance.MethodsA data-linkage study for the period from 1 January 2005 to 31 December 2008 compared 165 non-polio AFP cases classified by the Polio Expert Panel with 880 acute neurological presentations potentially compatible with AFP documented in the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry.ResultsForty-two (25%) AFP cases classified by the Polio Expert Panel were matched to case records in the ANZPIC Registry. Of these, nineteen (45%) cases were classified as Guillain-Barré syndrome on both registries. Ten additional Guillain-Barré syndrome cases recorded in the ANZPIC Registry were not notified to the national AFP surveillance system.ConclusionsThe identification of a further ten AFP cases supports inclusion of intensive care units in national AFP surveillance, particularly specialist paediatric intensive care units, to identify AFP cases that may not otherwise be reported to the national surveillance system.

Towards public health surveillance of intensive care services in NSW, Australia

“…, as they can cause outbreaks of severe illness. There was interest in enhancing surveillance efforts for poliomyelitis 18 , and in monitoring influenza patterns and burden by reporting on positive influenza results and antiviral pharmacological information linked to ICU patients. Although it was recognised that there were processes for notification of diseases reportable under the Public Health Act 2010 (NSW) 19 , positive notifiable laboratory results linked to ICU patients would be valuable in monitoring for the emergence of more virulent strains and rarer syndromes, for which recognition and normal passive notification may be delayed.…”