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00925njm 22002777a 4500 dc Masa-Calles, Josefa author Torner, Núria author Lopez-Perea, Noemi author Torres-de Mier, Maria de Viarce author Fernandez Martinez, Beatriz author Cabrerizo, Maria author Gallardo-García, Virtudes author Malo, Carmen author Margolles, Mario author Portell, Margarita author Abadía, Natividad author Blasco, Aniceto author García-Hernández, Sara author Marcos, Henar author Rabella, Nuria author Marín, Celia author Fuentes, Amelia author Losada, Isabel author Gutiérrez, Juan García author Nieto, Alba author García Ortúzar, Visitación author Garcia-Cenoz, Manuel author Arteagoitia, José María author Blanco Martínez, Ángela author Rivas, Ana author Castrillejo, Daniel author 2018 Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It allows detecting poliovirus (PV) reintroductions from endemic countries. This study describes AFP surveillance in Spain from 1998 to 2015. During this time, 678 AFP cases were reported to the Spanish National Surveillance Network. The mean notification rate was 0.58 AFP cases/100,000 population under 15 years old (range: 0.45/100,000-0.78/100,000). Two periods (P) are described: P1 (1998-2006) with the AFP notification rate ranging from 0.66/100,000 to 0.78/100,000, peaking in 2001 (0.84/100,000); and P2 (2007-2015) when the AFP rate ranged from 0.43/100,000 to 0.57/100,000, with the lowest rate in 2009 (0.31/100,000). No poliomyelitis cases were caused by wild PV infections, although two Sabin-like PVs and one imported vaccine-derived PV-2 were detected. Overall, 23 (3.4%) cases met the hot case definition. Most cases were clinically diagnosed with Guillain-Barré syndrome (76.9%; 504/655). The adequate stool collection rate ranged from 33.3% (7/21) to 72.5% (29/40). The annual proportion of AFP cases with non-polio enterovirus findings varied widely across the study period. AFP surveillance with laboratory testing for non-polio enteroviruses must be maintained and enhanced both to monitor polio eradication and to establish sensitive surveillance for prompt detection of other enteroviruses causing serious symptoms. Euro Surveill. 2018 Nov;23(47). 10.2807/1560-7917.ES.2018.23.47.1700423 1560-7917 1560-7917 Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 30482263 http://hdl.handle.net/20.500.12105/8982 Spain Acute flaccid paralysis surveillance Enterovirus Poliomyelitis eradication Surveillance Vaccine preventable disease Acute flaccid paralysis (AFP) surveillance: challenges and opportunities from 18 years' experience, Spain, 1998 to 2015