The key surveillance system recommended to detect transmission of poliovirus has been and will remain surveillance for cases of AFP. In other words, the gold standard for spotting circulation is AFP surveillance, which continues to be a cornerstone of polio eradication. Active surveillance system not only rapidly detects polio in almost real-time, but in fact helps detect many other vaccine-preventable and communicable diseases.
Certification of polio-free status requires the absence of wild polio virus transmission from any source for at least three successive years together with timely and sensitive AFP surveillance that meets Global Certification Commission standards. Furthermore, AFP surveillance is part of global post-certification strategy.
The four steps of AFP surveillance include finding and reporting cases with AFP among children less than fifteen years of age, rapidly collecting and transporting/shipping stool samples for analysis at who accredited laboratory, isolating and identifying poliovirus in the laboratory and mapping the virus to determine the origin of the virus strain. If poliovirus presence is detected, it allows outbreak response activities to be initiated rapidly.