Outbreak of Poliomyelitis in Albania and Neighboring Countries in 1996

During the 1996 outbreak of poliomyelitis in Albania and neighboring countries, comprehensive laboratory investigations of 145 Albanians afflicted by acute flaccid paralysis (AFP) were carried out. A total of 125 stool specimens or rectal swabs and 120 samples of venous blood were screened for poliovirus types 1, 2, and 3 and the homotypic neutralizing antibody (3). Only 74 cases were labelled as wild type 1 poliovirus-induced AFP, though the number would be 85 or more if samples exclusively positive for antipoliovirus immunoglobulin M (IgM) were also included. There is no information about the possible role of enteroviruses other than poliovirus in the etiology of AFP among the remaining Albanians afflicted by AFP during the 1996 outbreaks. The roles of coxsackievirus types A4, -6, -7, -9, -11, -14, and -21 and B1 to -6; echovirus types 1, 2, 3, 4, 6, 7, 9, 11, 14, and 16; and enterovirus types 70, 71, and 72, documented to cause AFP (5), could not be minimized in the Albanian population. Furthermore, enterovirus 71 was implicated during the 1990s for causing acute neurological disease with AFP in 24 patients in Brazil (1).