Acute flaccid paralysis surveillance systems for expansion to other diseases, 2003-2004.

Since the 1988 World Health Assembly resolution to eradicate poliomyelitis, the number of countries where polio is endemic has decreased from 125 in 1988 to six at the end of 2003. As part of the eradication strategy, a global surveillance system was established to 1) identify acute flaccid paralysis (AFP) cases in children aged < or =15 years and 2) deploy a network of accredited laboratories to perform virologic testing of stool specimens to determine whether the paralysis resulted from poliovirus infection. As AFP surveillance systems matured, countries increasingly applied AFP surveillance strategies and infrastructure to detect other diseases. This report describes the status of global AFP surveillance, including its expansion or use as a model in 131 (66%) of 198 countries for the reporting of measles and other vaccine-preventable diseases. As poliomyelitis is eradicated, AFP surveillance systems in these and other countries might be further expanded and adapted to improve the detection of and response to other diseases.