In autumn 2015, the detection number of enterovirus D68 increased in Japan, and many cases of severe bronchial asthma and acute flaccid paralysis were observed. At that time, among WPR countries Japan was a country not implementing AFP surveillance, which was implemented in 174 countries in 194 WHO member countries. Since May 2018, ''acute flaccid paralysis (excluding poliomyelitis)'' was introduced into the notification diseases based on the Infectious Disease Law. Acute flaccid paralysis cases under 15 years old were reported to the National Epidemiological Surveillance of Infectious Diseases (NESID) system within 7 days after the diagnosis. From around October 2018, the number of AFP reports has increased. Many cases were preschool children, and the median age was 4 years old.