EPIDEMIOLOGICAL AND LABORATORY SURVEILLANCE OF ACUTE FLACCID PARALYSIS CASES TO MAINTAIN MOLDOVA'S STATUS AS A POLIO-FREE COUNTRY, 2002–2025

Abstract

Objectives. To evaluate the epidemiological and laboratory surveillance of acute flaccid paralysis (AFP) cases in the Republic of Moldova during 2002–2025 in the context of maintaining the country’s polio-free status.

Methods. AFP cases reported and investigated epidemiologically and virologically between 2002 and 2025 were analyzed according to World Health Organization recommendations. Two stool samples were planned for each case, collected 24–48 hours apart. Virus isolation and identification were performed in RD and L-20B cell cultures, and the origin of isolated poliovirus strains was confirmed by the WHO Regional Reference Laboratory at the Robert Koch Institute, Berlin.

Results. During the study period, 148 AFP cases were recorded among children across all regions of the country, and 296 stool samples were collected and investigated. No case of poliomyelitis caused by wild poliovirus and no vaccine-associated poliomyelitis case was identified. All isolated polioviruses were vaccine strains. The most frequent final diagnoses included postinfectious peripheral neuropathies, other nonspecific neurological disorders, polyradiculopathy/Guillain-Barré/Landry syndrome, and traumatic neuropathy. A weekly AFP reporting system, including zero reporting, has operated in the Republic of Moldova since 1995.

Conclusions. Continuous AFP surveillance, adequate virological investigation, and final classification of every case remain essential for the early detection of a possible imported case and for maintaining the Republic of Moldova’s polio-free status.