Report of the Australian National Polio Reference Laboratory, 1 July to 31 December 2000.

The Australian National Polio Reference Laboratory at the Victorian Infectious Diseases Reference Laboratory (VIDRL) is responsible for processing and testing samples for poliovirus from all Australian patients with acute flaccid paralysis and for identifying and characterising polioviruses recovered from untyped enteroviruses submitted from Australian laboratories. From 1 July to 31 December 2000, a total of 12 specimens from 7 patients with AFP were referred to the NPRL. Poliovirus type 3 Sabin-like was isolated from samples from 2 patients with suspected vaccine- associated paralytic poliomyelitis. No viruses were isolated from samples from the remaining 5 patients. Since 1995 a total of 1,325 isolates have been referred for testing from laboratories throughout Australia. Seven hundred (53%) were confirmed as Sabin vaccine-like polioviruses, 542 (41%) were non-polio enteroviruses and 82 (6%) yielded no virus or viruses other than enteroviruses. At Kyoto, Japan in October 2000, the Western Pacific Region of the World Health Organization was declared wild polio-free. This represents a significant step towards the global eradication of poliovirus with one quarter of the world's population free of endemic infections from wild poliovirus. Surveillance of AFP and containment of wild polioviruses has been coordinated at the VIDRL. Since February 2000, Australia has been developing and implementing a plan for the containment of wild poliovirus stocks and potentially infectious materials.

Report of the Australian National Polio Reference Laboratory. 1 January to 31 December 1998.

The Australian National Polio Reference Laboratory was established at the Victorian Infectious Diseases Reference Laboratory (VIDRL) in late 1994 to carry out virological confirmation of the eradication of poliomyelitis in Australia. The laboratory is responsible for transporting samples from all Australian patients with acute flaccid paralysis (AFP) to VIDRL for poliovirus culture, identification and intratypic differentiation. The laboratory also performs polio serology on selected serum samples from AFP patients when faecal samples are not available. In 1998, faecal specimens were received from 11 patients with AFP. Adenovirus type 2 was isolated from 1 patient and an untypable non-polio enterovirus from another. No viruses were isolated from the other 9 patients. Since 1995, over 820 isolates have been transported to VIDRL from laboratories in five Australian states for testing. Three hundred and seventy three (45%) were confirmed as Sabin vaccine-like polioviruses, 416 (51%) were non-polio enteroviruses and 24 (3%) yielded no virus or viruses other than enteroviruses. Eight polioviruses are still uncharacterised.

Australia's last reported case of wild poliovirus infection.

In 1986 tests on faeces collected from a 22 year old Australian born man who had symptoms consistent with poliomyelitis yielded poliovirus type 3. In a neutralisation test using a panel of monoclonal antibodies the isolate was identified as wild poliovirus type 3 at that time. After further classification using microneutralisation, nucleic acid probe hybridisation, immunoassay and sequencing carried out in three laboratories between 1994 and 1997, the isolate has been reclassified as 'Sabin-like' with 'wild type' characteristics. This case has been quoted in the literature as Australia's last case of locally acquired wild poliovirus. Efforts are now being made to identify the true last case in Australia. This article describes the isolation, identification and further characterisation of this virus.

Immunity to hepatitis B, poliomyelitis and measles in fully vaccinated aboriginal and Torres Strait Island children.

OBJECTIVE: To determine the immunity to hepatitis B, poliomyelitis and measles in fully vaccinated Aboriginal and Torres Strait Island children in north Queensland. METHODOLOGY: A cross-sectional survey of immunity in a sample of children; 101 fully vaccinated Aboriginal and Torres Strait Island children, with a median age of 24.5 months, from 10 communities in North Queensland participated in this study. The main outcome measures were the prevalence of adequate antibody levels against hepatitis B, poliomyelitis and measles. RESULTS: Only 54% (95% CI 44-63%) of the children had adequate immunity (> or = 10 m iu/mL) to hepatitis B, and one child had been infected despite vaccination. Although all the children (95% CI 96-100%) had adequate immunity (i.e. neutralizing antibodies at a dilution of > or = 1:8) to poliovirus 2, only 93% (95% CI 86-96%) and 60% (95% CI 50-69%) had adequate immunity to polioviruses 1 and 3, respectively. Nearly all (96%; 95% CI 90-98%) of the children had adequate immunity (i.e. detectable IgG antibody) to measles. CONCLUSIONS: Although a relatively low proportion of the children had adequate antibody levels against hepatitis B the clinical significance of this observation is uncertain. Further studies are needed to determine whether fully vaccinated Torres Strait Island children have been adequately protected and whether they require a booster dose of hepatitis B vaccine. A substantial proportion of fully vaccinated Aboriginal and Torres Strait Island children are inadequately protected against poliomyelitis, and therefore any such child with acute flaccid paralysis should be investigated fully for poliomyelitis. Vaccinated Aboriginal and Torres Strait Island children are well protected against measles, as are other Australian children.