Stefanelli P, Bellino S, Fiore S, et al. - Researchers undertook this hospital-discharges based search to assess the completeness of the ascertainment of acute flaccid paralysis (AFP) cases in Italy, given AFP surveillance represents a principal strategy that has been adopted globally for monitoring the progress of the polio eradication initiative. They used the Italian Hospital Discharge Records (HDR) database to identify AFP cases in children under 15 years of age. A comparison was carried out between AFP cases identified between 2015 and 2016 vs those reported to the National Surveillance System (NSS). In Italy, documentation of 4,163 hospital discharges with a diagnosis of AFP happened during a 10-year period. For all diagnoses, a declining trend was reported and a reduction in annual incidence rate (IR) from 5.5 to 4.5 per 100,000 children was revealed during the study period. A remarkable underreporting was highlighted on comparing NSS with HDR data in 2015–2016; AFP cases from NSS were only 14% of those reported in HDR. In Liguria, Sicily, and Veneto Regions, the highest AFP IRs per 100,000 children estimated on HDR data were found. The national AFP rate was equivalent to 0.6, and thus failed to reach the target value. Experts concluded that a country’s progress towards polio eradication can be ultimately measured by AFP surveillance data. For evaluating the completeness of the notification data as well as to recognize the Regions with a low AFP ascertainment rate, the usefulness of the historical data collected by the HDR has been suggested, to ultimately improve the national surveillance system.