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Following the World Health Organization (WHO) recommendation, Australia conducts surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age as the main method to monitor its polio-free status. Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2014, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.4 non-polio AFP cases per 100,000 children, meeting the WHO performance criterion for a sensitive surveillance system. Non-polio enteroviruses can also be associated with AFP and enterovirus A71 and echovirus types 6 and 7 were identified from clinical specimens from cases of AFP. Globally, 359 cases of polio were reported in 2014, with the 3 endemic countries, Afghanistan, Nigeria and Pakistan, accounting for 95% of the cases. In May 2014, the WHO declared the international spread of wild poliovirus to be a public health emergency of international concern and has since maintained recommendations for polio vaccination of travellers from countries reporting cases of wild polio.

In July 2007, wild poliovirus type 1 was isolated from a patient suffering poliomyelitis in Melbourne, Australia with onset in Pakistan. The imported case of polio demonstrates the ongoing risk faced by polio-free countries until the global certification of polio eradication. The poliovirus was detected by the National Poliovirus Reference Laboratory (NPRL) for Australia; accredited by the World Health Organization (WHO). The NPRL acts as the national laboratory for the Pacific Islands, Brunei Darussalam and Papua New Guinea. Additionally, the NPRL functions as a regional reference laboratory for the WHO Western Pacific Region. The NPRL, in collaboration with the Australian Paediatric Surveillance Unit, co-ordinates surveillance for acute flaccid paralysis (AFP), a major clinical presentation of poliovirus infection. After classification of AFP cases by the Polio Expert Committee, the non-polio AFP rate for Australia in 2007 was 0.65 per 100,000 children aged less than 15 years, below the performance indicator of 1.0 per 100,000 set by the WHO. Adequate faecal sample collection totalled 48% (13/27) of eligible AFP notifications, below the 80% performance indicator recommended by the WHO. During 2007, 119 specimens were referred to the NPRL, 70 from AFP cases and 49 from other sources, including contacts of the wild poliovirus importation, all negative for poliovirus infection. Coxsackievirus A4 was isolated from 1 case and adenovirus from 2 cases. During 2007, 1313 cases of poliomyelitis due to wild poliovirus infection were reported world-wide: 1207 occurring in the 4 remaining polio endemic countries and 106 cases reported in 5 non-endemic countries.

Acute flaccid paralysis is the main clinical manifestation of poliomyelitis. Faecal specimens from cases of acute flaccid paralysis in Australia are referred to the National Poliovirus Reference Laboratory for virus culture to determine if poliovirus is the causative agent. Isolations of poliovirus are tested to determine whether they have characteristics of the Sabin oral polio vaccine virus strains or wild type polioviruses. In 2002, a poliovirus type 3, which tested as Sabin vaccine-like, was isolated from an Australian patient with acute flaccid paralysis. A non-polio enterovirus, Echovirus type 18, was isolated from the faecal specimens of another case of acute flaccid paralysis. In the same period, the laboratory identified 35 Sabin-like polioviruses from 52 referred specimens and isolates from cases without acute flaccid paralysis. Australia is a member nation of the World Health Organization's Western Pacific region that was declared free of endemic wild poliovirus in October 2000. Poliomyelitis remains endemic in three of the WHO regions of the world and wild poliovirus may be re-introduced to Australia. While the number of polio-endemic countries has been reduced to seven, the total number of wild polioviruses identified increased in 2002 compared to 2001 due to a sharp rise in isolations of wild virus from Northern India. Until global eradication of poliomyelitis is achieved, it is essential that a high level of poliovirus vaccination coverage, and surveillance for cases of acute flaccid paralysis, be maintained in Australia.