XXXX in Oman: acute flaccid paralysis surveillance leading to early detection and rapid response to a type 3 outbreak.

@entity1 @entity5011 @entity3328 @entity9925
Countries are increasingly requesting guidance on carrying out acute flaccid paralysis (AFP) surveillance, aimed at detecting and confirming all cases of @entity3328 . The experience of Oman provides many lessons in this respect. AFP surveillance in Oman was established systematically. First, an epidemiologist was assigned to coordinate surveillance, and a laboratory for performing polio-virus isolation was identified. Next, operational guidelines for AFP surveillance were developed and widely promoted among health staff. The quality of the system has been monitored for more than 3 years with selected performance indicators. From January 1990 to April 1993, 49 AFP cases were reported, corresponding to an average annual rate of 2.1 AFP cases per 100,000 @entity1 aged less than 15 years. A total of 98% of the AFP cases were investigated within 48 hours of being reported; two stool samples were obtained from 94% of the cases. Following complete investigation, nearly a third of the reported AFP cases were classified as being clinically compatible with @entity5011 . Four AFP cases, all reported in 1991, were confirmed to be due to wild type 3 @entity9925 . Because AFP surveillance detected these cases rapidly, Oman was able to carry out outbreak control measures promptly and more than 350,000 extra doses of oral @entity9925 vaccine were delivered to @entity1 under 6 years of age.
