Retrospective Analysis of Six Years of Acute Flaccid Paralysis Surveillance and Polio Vaccine Coverage Reported by Italy, Serbia, Bosnia and Herzegovina, Montenegro, Bulgaria, Kosovo, Albania, North Macedonia, Malta, and Greece.

Here we analyzed six years of acute flaccid paralysis (AFP) surveillance, from 2015 to 2020, of 10 countries linked to the WHO Regional Reference Laboratory, at the Istituto Superiore di Sanità, Italy. The analysis also comprises the polio vaccine coverage available (2015-2019) and enterovirus (EV) identification and typing data. Centralized Information System for Infectious Diseases and Laboratory Data Management System databases were used to obtain data on AFP indicators and laboratory performance and countries' vaccine coverage from 2015 to 2019. EV isolation, identification, and typing were performed by each country according to WHO protocols. Overall, a general AFP underreporting was observed. Non-Polio Enterovirus (NPEV) typing showed a high heterogeneity: over the years, several genotypes of coxsackievirus and echovirus have been identified. The polio vaccine coverage, for the data available, differs among countries. This evaluation allows for the collection, for the first time, of data from the countries of the Balkan area regarding AFP surveillance and polio vaccine coverage. The need, for some countries, to enhance the surveillance systems and to promote the polio vaccine uptake, in order to maintain the polio-free status, is evident.

Acute flaccid paralysis surveillance in bosnia and herzegovina: Recent isolation of two sabin like type 2 poliovirus.

The WHO Regional Commission for the Certification of Poliomyelitis Eradication has recently indicated Bosnia and Herzegovina (B&H) as a high risk country for transmission, following importation, of wild poliovirus (WPV) or circulating vaccine-derived poliovirus (cVDPV). We analyzed data on Acute Flaccid Paralysis (AFP) surveillance between 2007 to 2016, and the trend of polio immunization coverage in B&H. The majority of AFP cases was recorded in 2016 suggesting an enhancement of the AFP surveillance activities. However, the decline in the immunization coverage, around 74%, and the isolation of two Sabin-like poliovirus type 2 strains, one of them close to a VDPV, require a particular attention in the area. Although B&H has successfully maintained its polio-free status since 2002 several challenges need to be addressed.

[Strategy for administering hepatitis B vaccine to newborns in Bosnia-Herzegovina]. / Strategija uvodenja neonatalne hepatitis B vakcine u Bosni i Hercegovini.

BACKGROUND: Neonatal hepatitis B vaccination is the best effective measure for prevention hepatitis B infection in the countries with intermediate to high levels of HB endemicity. METHODS: Epidemiological methods of research had the aim to follow the incidence rates of viral hepatitis B and HBsAg carriers and to determine influence on the risks of transmission hepatitis B infection in new-borns in Bosnia and Herzegovina. Serologic immunogenic quality of hepatitis B vaccine is researched. RESULTS: Bosnia and Herzegovina has high incidence of hepatitis B virus in the Europe. The incidence of HBsAg carriers is changing with increasing from 2000. to 2003. Data from this surveillance show in Bosnia and Herzegovina that in one notified case of hepatitis B there is 3.59 cases of HBsAg carriers. Hepatitis B vaccine induces anti-HBs antibodies titres > 10 IJ/ml, considered as seroprotective in 99, 10% vaccinated. CONCLUSION: Neonatal hepatitis B vaccination is new vaccine in national immunization program in Bosnia and Herzegovina. Hepatitis B vaccines are safe and effective in inducing neutralizing HBs antibodies play and have important role in protecting new-borns.

[Expected incidence of post-vaccination complications in vaccination programs]. / Ocekivana incidencija postvakcinalnih komplikacija u programima vakcinacije.

Incidence rate of the harder adverse immunization reactions in the Program of the vaccination children in Federation Bosnia and Herzegovina is similar in the terms of kind and frequency as in the countries with high quality programme of the vaccination. In the period from 2002-2003 year cases of the adverse reactions were not registered, as vaccinal form of polyomyelitis, toxic syndrome or sudden acute deaths. The adverse events following immunization were classified in relation to 100,000 applicated vaccines, the incidence rate of supurative lymphadenitis at BCG vaccination reported are 32@100000, anaphylaxia at MMR vaccination 0.8@100000, DTP vaccination encephalopathy 1@100000 and at TT vaccination anaphylaxia 2@100000 administered vaccines.