Search

In the context of the near-global eradication of wild poliovirus, the significance of non-polio enteroviruses (NPEVs) in causing acute flaccid paralysis (AFP) and their impact on public health has gained increased attention. This research, conducted from 2001 to 2021, examined stool samples from 1597 children under 15 years in São Paulo, Brazil, through the AFP/Poliomyelitis Surveillance Program, detecting NPEVs in 6.9% of cases. Among the 100 NPEV-positive strains analyzed, 90 were genotyped through genomic sequencing of the partial VP1 region, revealing a predominance of EV-B species (58.9%), followed by EV-A (27.8%) and EV-C (13.3%). This study identified 31 unique NPEV types, including EV-A71, CVB2, and E11, as the most prevalent, along with the first documented occurrence of CVA19 in Brazil. These findings emphasize the importance of NPEV genotyping in distinguishing AFP from poliomyelitis, enhancing understanding of these viruses' epidemiology. Moreover, it ensures that AFP cases are correctly classified, contributing to the effective surveillance and eradication efforts for poliomyelitis. [ABSTRACT FROM AUTHOR] more...

More than 100 types of non-polio enteroviruses (NPEVs) are ubiquitous in the human population and cause a variety of symptoms ranging from very mild to meningitis and acute flaccid paralysis (AFP). Much of the information regarding diverse pathogenic properties of NPEVs comes from the surveillance of poliovirus, which also yields NPEV. The analysis of 265 NPEV isolations from 10,433 AFP cases over 24 years of surveillance and more than 2500 NPEV findings in patients without severe neurological lesions suggests that types EV-A71, E13, and E25 were significantly associated with AFP. EV-A71 was also significantly more common among AFP patients who had fever at the onset and residual paralysis compared to all AFP cases. In addition, a significant disparity was noticed between types that were common in humans (CV-A2, CVA9, EV-A71, E9, and E30) or in sewage (CVA7, E3, E7, E11, E12, and E19). Therefore, there is significant evidence of non-polio viruses being implicated in severe neurological lesions, but further multicenter studies using uniform methodology are needed for a definitive conclusion. [ABSTRACT FROM AUTHOR] more...

Human non-polio enteroviruses (NPEVs) are the etiological agents involved in most cases of hand-foot-and-mouth disease (HFMD), herpangina and aseptic meningitis. Information on the epidemiology profiles of NPEV in the Ural Federal District and Western Siberia is very limited, with no published data available. The aim of this study is to describe NPEV incidence in the Ural Federal District and Western Siberia among patients with different forms of non-polio enterovirus infections (NPEVIs) during 2022, stratified by age and clinical manifestations. A total of 265 samples that tested positive for NPEV using a polymerase chain reaction (PCR) were genotyped by semi-nested PCR for the VP1 gene. The results showed that 21 genotypes were identified among patients in this study. CVA6 was the most common genotype for HFMD. CVA6, along with CVA10, accounted for the majority of herpangina cases, while CVA9 was implicated in most meningitis cases. Sequence and phylogenetic analysis showed that nearly all of the CVA6 strains identified in this study displayed a close genetic relationship to strains identified in other cities in Russia and strains from China. NPEV surveillance allows for monitoring the circulation of clinically relevant genotypes, resulting in continuous data about NPEV epidemiology. This is important for improving case prevention, diagnosis and guiding clinical management. [ABSTRACT FROM AUTHOR] more...

Enteroviruses (EVs) are associated with a wide spectrum of diseases involving various organs. Our aim was to give a historical overview of the genesis of clinical sample processing for EVs in the Slovak Republic (SR) during the 1958–2020 period, within the framework of the World Health Organization (WHO) polio program. Further, analyses were made of the data obtained from the archives of processed clinical sample surveillance using statistical methods. We used generalized additive models (GAM) with binomial distribution and logit link functions and an autoregressive moving average (ARMA) to analyze the data obtained during this 63-year period. Our results show trends in the composition of EV strains circulating in the population. Furthermore, statistically significant increasing trends of the non-polio enteroviruses (NPEVs) were observed over the studied time, represented by echoviruses (E) and coxsackieviruses A and B (CVA and CVB), with a cyclical pattern of occurrence. The most prevalent serotype over this period was CVB5, which became significantly more prevalent after 2000. While PVs, CVB1, and CVB3 were present in the second half of the studied period, CVA10, CVA16, E3, E25, and E30 appeared more frequently. [ABSTRACT FROM AUTHOR] more...

We describe the genesis of poliovirus (PV) and non-polio enterovirus (NPEV) surveillance program of sewage wastewaters from its inception to the present in the Slovak Republic (SR). Sampling procedures and evolution of the methodology used in the SR for the detection of PVs and NPEVs are presented chronologically. For statistical data processing, we divided our dataset into two periods, the first period from 1963 to 1998 (35 years), and the second period from 1999 to 2019 (21 years). Generalized additive models were used to assess temporal trends in the probability of occurrence of major EV serotypes during both periods. Canonical correspondence analysis on relative abundance data was used to test temporal changes in the composition of virus assemblages over the second period. The probability of occurrence of major viruses PV, coxsackieviruses (CVA, CVB), and Echoviruses (E)) significantly changed over time. We found that 1015 isolated PVs were of vaccine origin, called "Sabin-like" (isolates PV1, PV2, PV3). The composition of EV assemblages changed significantly during the second period. We conclude that during the whole period, CVB5, CVB4, and E3 were prominent NPEVS in the SR. [ABSTRACT FROM AUTHOR] more...

Background: Human non-polio enteroviruses (NPEVs) have been associated with certain life-threatening disorders in children. However, there is paucity of NPEV infection data in most developing countries. This study determined the 3-year prevalence of non-polio enteroviruses (NPEVs) among children in some Northern States of Nigeria. Materials and Methods: Duplicate stool samples were collected from 27778 children =15 years. These samples were processed and analyzed for characteristic NPEVs cytopathic effects (CPE) on L20B and RD cell lines. Tests were considered positive if the duplicate samples produced distinct CPE on both cell lines. Results: Of the 27778 samples processed, 3991 (14.4%) NPEVs were isolated. Participants of the male gender (14.5%) within the age range of 0-5 years (14.7%) from Yobe state (15.3%) whose samples were received in the month of June (22.2%) and in the year 2015 (18.8%) had the highest prevalence of NPEVs. June had significant risk factors of NPEVs (p=0.001, OR=1.95 [95%CI: 1.60-2.34]). However, there was no significant association between age, sex and location of sample collection with the prevalence of NPEV (p=0.05) Conclusions: This study revealed a relatively high prevalence of NPEVs among the study population. This calls for the need for government implementation of consistently improved water, food and environmental hygiene. [ABSTRACT FROM AUTHOR] more...

Background: The need to investigate the contribution of non-polio enteroviruses to acute flaccid paralysis (AFP) cannot be over emphasized as we move towards a poliovirus free world. Hence, we aim to identify non-polio enteroviruses recovered from the faeces of children diagnosed with AFP in Nigeria. Methods: Ninety-six isolates, (95 unidentified and one previously confirmed Sabin poliovirus 3) recovered on RD cell culture from the stool of children <15 years old diagnosed with AFP in 2014 were analyzed. All isolates were subjected to RNA extraction, cDNA synthesis and three different PCR reactions (one panenterovirus 5'-UTR and two different VP1 amplification assays). VP1 amplicons were then sequenced and isolates identified. Results: 92.71% (89/96) of the isolates were detected by at least one of the three assays as an enterovirus. Precisely, 79.17% (76/96), 6.25% (6/96), 7.30% (7/96) and 7.30% (7/96) of the isolates were positive for both, positive and negative, negative and positive, as well as negative for both the 5'-UTR and VP1 assays, respectively. In this study, sixty-nine (69) of the 83 VP1 amplicons sequenced were identified as 27 different enterovirus types. The most commonly detected were CV-B3 (10 isolates) and EV-B75 (5 isolates). Specifically, one, twenty-four and two of the enterovirus types identified in this study belong to EV-A, EV-B and EV-C respectively. Conclusions: This study reports the circulating strains of 27 non-polio enterovirus types in Nigerian children with AFP in 2014 and Nigerian strains of CV-B2, CV-B4, E17, EV-B80, EV-B73, EV-B97, EV-B93, EV-C99 and EV-A120 were reported for the first time. Furthermore, it shows that being positive for the 5'-UTR assay should not be the basis for subjecting isolates to the VP1 assays. [ABSTRACT FROM AUTHOR] more...

Introduction: Poliovirus infections have been established to be in circulation in the remaining three polio-endemic nations. These pathogens have been associated with several chronic diseases, particularly acute flaccid paralysis of children. This study sought to ascertain whether polioviruses are silently shed by apparently healthy schoolchildren in Bauchi, Katagum, and Misau local government areas of Bauchi state, Nigeria. Methodology: This was a cross-sectional prospective study that involved 200 stool samples collected from apparently healthy schoolchildren. All samples were processed and inoculated onto rhabdomyosarcoma (RD) and L20B cell-lines. Inoculated cell lines were monitored for cytopathic effects (CPEs) for 10 days with one subculture after first 5 days. Results: None of the samples came down with CPEs on L20B, and thus all samples were negative for poliovirus; however, three were positive for non-polio enteroviruses (NPEVs) on RD and not on the L20B cell line: one coxsackie B virus from a seven-year-old male, and two others were untypeable isolates, one each from a male and a female child. The coxsackie B virus was identified by microneutralization test using polyclonal sera as described by the World Health Organization. Conclusions: Findings from this investigation indicate the absence of polioviruses in the children studied. This is an indication of good polio immunization coverage in these communities. However, more intensive and periodic surveillance is required to confirm the presence or exclude the absence of polioviruses in these communities and other parts of Nigeria. [ABSTRACT FROM AUTHOR] more...

Surveillance for acute flaccid paralysis syndrome (AFP) in children under 15 is the backbone of the Global Polio Eradication Initiative. Laboratory examination of stool samples from AFP cases allows the detection of, along with polioviruses, a variety of non-polio enteroviruses (NPEV). The etiological significance of these viruses in the occurrence of AFP cases has been definitively established only for enteroviruses A71 and D68. Enterovirus Coxsackie A2 (CVA2) is most often associated with vesicular pharyngitis and hand, foot and mouth disease. Among 7280 AFP cases registered in Russia over 20 years (2001–2020), CVA2 was isolated only from five cases. However, these included three children aged 3 to 4 years, without overt immune deficiency, immunized with 4–5 doses of poliovirus vaccine in accordance with the National Vaccination Schedule. The disease resulted in persistent residual paralysis. Clinical and laboratory data corresponded to poliomyelitis developing during poliovirus infection. These findings are compatible with CVA2 being the cause of AFP. Molecular analysis of CVA2 from these patients and a number of AFP cases in other countries did not reveal association with a specific phylogenetic group, suggesting that virus genetics is unlikely to explain the pathogenic profile. The overall results highlight the value of AFP surveillance not just for polio control but for studies of uncommon AFP agents. [ABSTRACT FROM AUTHOR] more...

Abstract: Background: The 66 serotypes of human enteroviruses (EVs) are classified into four species A–D, based on phylogenetic relationships in multiple genome regions. Partial VP1 amplification and sequence analysis are reliable methods for identifying non-polio enterovirus serotypes, especially in negative cell culture specimens from patients with residual paralysis. Objectives: In Iran during the years 2000–2002, there were 29 residual paralysis cases with negative cell (RD, HEp2 and L20B) culture results. Study design: The genomic RNA was extracted from stool specimens from cases of residual paralysis and detected by amplification of the 5′-nontranslated region using RT-PCR with Pan-EV primers. Partial VP1 amplification by semi-nested RT-PCR (snRT-PCR) and sequence analysis were done. Results: Specimens from the 29 culture-negative cases contained echoviruses of six different serotypes. Conclusions: The global eradication of wild polioviruses is near and study of non-polio enteroviruses, which can cause poliomyelitis, is increasingly important to understand their pathogenesis. The VP1 sequences, derived from the snRT-PCR products, allowed rapid molecular analysis of these non-polio strains. [Copyright &y& Elsevier] more...