scholarly journals Etiologic Involvement of Enterovirus and Human Bocavirus in Acute Flaccid Paralysis Cases in India

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S313-S313
Author(s):  
Manjari Baluni ◽  
Dharamveer Singh ◽  
Sneha Ghildiyal ◽  
Tanzeem Fatima ◽  
Amreen Zia ◽  
...  
Keyword(s):  
Real Time ◽  
Viral Infections ◽  
Acute Flaccid Paralysis ◽  
Clinical Specimen ◽  
Clinical Manifestations ◽  
Etiologic Agent ◽  
Flaccid Paralysis ◽  
Human Bocavirus ◽  
Stool Specimens ◽  
Pcr Targeting

Abstract Background Acute flaccid paralysis (AFP), characterized by the rapid onset of asymmetric paralysis, can be caused by a variety of viral infections or coinfections. Besides wild-type and revertant vaccine strains of polioviruses, several nonpolio enteroviruses, have also been associated with AFP. Enteroviruses (EVs) are RNA viruses in the family Picornaviridae comprising more than 100 serotypes that are divided into four species, human enteroviruses A to D. The clinical manifestations of EVs range from conjunctivitis, respiratory tract infection, myocarditis, meningitis, encephalitis, and neonatal sepsis, like illness. Human Bocavirus (HBoV), a newly classified member of the Parvoviridae family, has been detected frequently in feces of diarrhoeic children suggesting its possible etiological involvement in the disease. Methods Total 586 stool specimens were collected in 2016 from children suspected for AFP. Molecular method for targeting 5’ untranslated region (UTR) and VP1 capsid region was used for detection of human enteroviruses (HEV), human boca viruses (HBoV) and saffold viruses in direct clinical specimen. Results EV RNA was detected in 103 (17.6%) of 586 stool specimens by real-time RT-PCR targeting the highly conserved 5’ UTR region. Out of them, 71 (12.11%) were NPEV, partially sequenced by VP1 which revealed the prevalence of echovirus (ECV) 19 (n = 6), ECV 11 (n = 7), ECV 18 (n = 4), ECV 33 (n = 5), ECV 29 (n = 1), ECV 25 (n = 2), ECV 24 (n = 3), ECV 3 (n = 3), ECV 14 (n = 2), ECV 13 (n = 1), ECV 2 (n = 1), ECV 20 (n = 2), ECV 27 (n = 4), ECV 6 (n = 2), CV A10 (n = 2), CV A9 (n = 1), CV A6 (n = 2), CV B4 (n = 1), CV B5 (n = 3), CV B6 (n = 3), EV 80 (n = 1), EV 83 (n = 1), EV 97 (n = 2). Total 63 (10.75%) HBoVs were detected by real-time PCR which were further sequenced by VP1, consists of HBoV-1 (n = 8), HBoV-2 (n = 15), HBoV-3 (n = 9) and HBoV-4 (n = 5). Out of them 9 (1.5%) were detected as co infection with NPEVs. Phylogenetic analysis showed 0.9 - 5.6% divergence at nucleotide level among HBoVs. Total 9 (1.5%) saffold viruses was detected and characterized by VP1 sequencing. Conclusion ECV and HBoV were found the main etiologic agent in children suspected with AFP. Molecular typing of these viruses is useful for characterizing emerging serotypes and their epidemiological investigation. Disclosures All authors: No reported disclosures.

scholarly journals Epidemiology and Clinical Characteristics of Rotavirus and Norovirus Infections in Hospitalized Children Less Than 5 Years of Age With Acute Gastroenteritis in Tehran, Iran

2020 ◽  
Author(s):  
Arash Arashkia ◽  
Behrooz Nejat ◽  
Mahsa Farsi ◽  
Somayeh Jalilvand ◽  
Alireza Nateghian ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Clinical Manifestations ◽  
Children's Hospital ◽  
Severe Gastroenteritis ◽  
Children’S Hospital ◽  
Stool Specimens ◽  
Commercial Enzyme Immunoassay

Acute gastroenteritis is one of the most important causes of death in children in developing countries which cause by different enteropathogens, including bacteria, viruses, and parasites. Among these, most of the acute gastroenteritis in children are caused by viral infections mainly by rotavirus and norovirus. This study aimed to study the epidemiological and clinical status of acute gastroenteritis resulting from rotavirus and norovirus in children between June 2015 and June 2016 in Iran. A total of 211 stool specimens were collected from Ali Asghar Children's Hospital and Bahrami Children's Hospital in Tehran, from June 2015 to June 2016. The samples were screened by commercial enzyme immunoassay (EIA) Ridascreen kit and real time RT-PCR to detect rotavirus and norovirus genogroups I and II, respectively. The information on demographic and clinical manifestations was collected, and data analyzed using IBM SPSS statistics version 22. Overall, the detection rate of rotavirus was 25.6 %, and for norovirus infection, it was 17.5%. All norovirus positive specimens belonged to genogroup II. Higher rates of rotavirus infections were observed in children from 7 to 24 months, and higher rates of norovirus infections were detected in children from 1 to 12 months. Clinical symptoms were not different between rotavirus and norovirus case-patients. The present study not only highlights the importance of rotavirus and norovirus infections in Iran but also verifies the relevance of norovirus as the cause of severe gastroenteritis in children.

scholarly journals Detection of Campylobacter species in stool specimens from patients with symptoms of acute flaccid paralysis in South Africa

2018 ◽  
Vol 12 (07) ◽  
pp. 542-549
Author(s):  
Mandile Samantha Thobela ◽  
Anthony Marius Smith ◽  
Shelina Moonsamy ◽  
Heleen Du Plessis ◽  
Nevashan Govender ◽  
...  
Keyword(s):  
South Africa ◽  
Acute Flaccid Paralysis ◽  
Bacterial Culture ◽  
Flaccid Paralysis ◽  
Campylobacter Coli ◽  
Motor Weakness ◽  
Causative Agents ◽  
Stool Specimens ◽  
Campylobacter Spp ◽  
True Association

Introduction: Guillain-Barré Syndrome (GBS) is an autoimmune disease characterized by acute or subacute symmetrical ascending motor weakness, areflexia, and mild-to-moderate sensory abnormalities. Campylobacter jejuni is reported to be the most common bacterium associated with GBS cases. Despite the eradication of polio, the number of reported GBS cases remains considerably high in South Africa with the causative agents not being well described. Methodology: The aim of the study was to investigate the proportion of Campylobacter spp. detected in stool specimens from patients with symptoms of acute flaccid paralysis (AFP). Stool specimens from patients presenting with AFP, that were negative for polio and non-polio enteroviruses (NPENT), were processed and screened for the presence of Campylobacter spp. using quantitative PCR (qPCR). Results: Of the 512 stool specimens screened between October 2014 to December 2015, 12% (62/512) were positive for Campylobacter spp. Of these 62 Campylobacter infections: 77.4% (48/62) was C. jejuni; 19.4% (12/62) was Campylobacter coli; 3.2% (2/62) was mixed infections of C. jejuni and C. coli. Conclusions: True association of the disease with Campylobacter spp. will enable the proportion of Campylobacter-induced GBS to be better described in South Africa; this can only be done through systematic studies that include bacterial culture and serology together with molecular methodologies.

Acute Flaccid Myelitis: A Clinical Review

2020 ◽  
Vol 40 (02) ◽  
pp. 211-218
Author(s):  
Olwen C. Murphy ◽  
Carlos A. Pardo
Keyword(s):  
Spinal Cord ◽  
Acute Flaccid Paralysis ◽  
Clinical Manifestations ◽  
Transverse Myelitis ◽  
The United States ◽  
Acute Onset ◽  
Flaccid Paralysis ◽  
Limb Weakness ◽  
Acute Flaccid Myelitis ◽  
Enterovirus D68

AbstractAcute flaccid myelitis (AFM) is an emerging disorder primarily affecting children that is characterized by acute flaccid paralysis accompanied by abnormalities of the spinal cord gray matter on magnetic resonance imaging. In most cases, prodromal fever or respiratory symptoms occur, followed by acute-onset flaccid limb weakness. Respiratory, axial, bulbar, facial, and extraocular muscles may also be affected. The clinical manifestations have been described as “polio-like,” due to striking similarities to cases of poliomyelitis. The primary site of injury in AFM is the anterior horn cells of the spinal cord, resulting in a motor neuronopathy. Seasonal peaks of cases have occurred in the United States every 2 years since 2012. However, AFM remains a rare disease, which can make it challenging for physicians to recognize and differentiate from other causes of acute flaccid paralysis such as Guillain–Barre syndrome, spinal cord stroke, and transverse myelitis. Epidemiological evidence suggests that AFM is linked to a viral etiology, with nonpolio enteroviruses (in particular enterovirus D68) demonstrating a plausible association. The epidemiology, possible etiological factors, clinical features, differential diagnosis, treatment, and outcomes of AFM are discussed in this review.

scholarly journals Surveillance during an era of rapidly changing poliovirus epidemiology in India: the role of one vs. two stool specimens in poliovirus detection, 2000–2010

2013 ◽  
Vol 142 (1) ◽  
pp. 163-171 ◽  
Author(s):  
C. V. CARDEMIL ◽  
M. RATHEE ◽  
H. GARY ◽  
K. WANNEMUEHLER ◽  
A. ANAND ◽  
...  
Keyword(s):  
Maximum Likelihood ◽  
Maximum Likelihood Estimation ◽  
Stool Specimen ◽  
Acute Flaccid Paralysis ◽  
Likelihood Estimation ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Stool Specimens

SUMMARYSince 2004, efforts to improve poliovirus detection have significantly increased the volume of specimen testing from acute flaccid paralysis (AFP) patients in India. One option to decrease collection and testing burden would be collecting only a single stool specimen instead of two. We investigated stool specimen sensitivity for poliovirus detection in India to estimate the contribution of the second specimen. We reviewed poliovirus isolation data for 303984 children aged <15 years with AFP during 2000–2010. Using maximum-likelihood estimation, we determined specimen sensitivity of each stool specimen, combined sensitivity of both specimens, and sensitivity added by the second specimen. Of 5184 AFP patients with poliovirus isolates, 382 (7·4%) were identified only by the second specimen. Sensitivity was 91·4% for the first specimen and 84·5% for the second specimen; the second specimen added 7·3% sensitivity, giving a combined sensitivity of 98·7%. Combined sensitivity declined, and added sensitivity increased, as the time from paralysis onset to stool collection increased (P = 0·032). The sensitivity added by the second specimen is important to detect the last chains of poliovirus transmission and to achieve certification of polio eradication. For sensitive surveillance, two stool specimens should continue to be collected from each AFP patient in India.

scholarly journals Human Bocavirus Prevalence In Children With Acute Gastroenteritis From Rural Communities In The Northen Region Of South Africa

2019 ◽  
Author(s):  
Mpumelelo Casper Rikhotso ◽  
Ronewa Khumela ◽  
Jean Pierre Kabue ◽  
Afsatou Ndama Traoré ◽  
Natasha Potgieter
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Real Time ◽  
Real Time Pcr ◽  
Acute Gastroenteritis ◽  
Enteric Viruses ◽  
Health Care Facilities ◽  
Human Bocavirus ◽  
Stool Samples ◽  
Pcr Targeting

AbstractBACKGROUNDAcute gastroenteritis (AGE) is a leading cause of morbidity and mortality in young children worldwide. Human Bocavirus (HBoV) is an emerging virus globally associated with diarrhea. The aim of this study was to demonstrate the prevalence of HBoV genotypes in children (≤5 years) from rural communities in South Africa (SA) suffering from AGE.MATERIAL AND METHODA total of 141 fecal samples of children ≤5 years with acute gastroenteritis (AGE) were collected from rural Primary Health Care facilities in the Vhembe district of SA between June 2017 and July 2018. Clinical symptoms and demographic data were also recorded. A total of 102 (72%) were outpatients and 39 (28%) were hospitalized patients. Human Bocavirus (HBoV) genotypes were determined using Real-Time Multiplex PCR. DNA extracts of positive samples were confirmed by conventional PCR targeting the NS1 gene. Co-infection with other enteric viruses were determined in HBoV positive samples using Real-Time PCR.RESULTSHBoV was detected in 8 (5.7%) children with AGE. Children were in the age group between 1-24 months. HBoV1 and HBoV3 genotypes were each detected in 3 (37.5%) stool samples and HBoV2 in 2 (25%) stool samples. Co-infection with other enteric viruses included Rotavirus (37.5%); Adenovirus (37.5%); Norovirus (25%) and Astrovirus (12.5%).CONCLUSIONHBoV infections could be seen as a potential emerging diarrheal pathogen in South Africa. Further studies are required to understand the role of HBoV infections in children and adults with acute gastroenteritis.Author summaryAcute gastroenteritis (AGE) is recognized as a major cause for mortality in children ≤5 years of age in Africa and other developing countries. Viruses known to be involved in AGE includes Rotavirus, Norovirus, Astrovirus and Adenovirus and have been reported globally. Recently the Human Bocavirus (HBoV) have been reported in numerous studies globally as a potential cause of diarrhea. In this study, the prevalence and genetic diversity of human Bocavirus in children with AGE from rural communities in Limpopo, South Africa were investigated. In total, 141 stool samples from children ≤ 5 years with AGE were assessed for the presence of HBoV using Real-Time PCR. HBoV were detected in 8 (5.7%) patients and included 3 positive samples for HBoV1 and HBoV3 respectively and 2 positive for HBoV2. No HBoV4 were detected. Among the 8 positive HBoV samples, co-infection with other enteric viruses were found in 7 (87.5%) samples, while mono infection with HBoV alone was detected in 1 (12.5%) patient. HBoV mixed infection with Rotavirus (3/8; 37.5%); Adenovirus (3/8; 37.5%); Norovirus (2/8; 25%) and Astrovirus (1/8; 12.5%) were observed in this study. This study reported for the first time on the prevalence of human Bocavirus in children with AGE from rural communities in South Africa.

scholarly journals Preponderance of Enterovirus Species C in RD-L20B cell culture negative stool samples from children diagnosed with Acute Flaccid Paralysis in Nigeria

2017 ◽  
Author(s):  
J.A. Adeniji ◽  
A.O. Oragwa ◽  
U.E. George ◽  
U.I. Ibok ◽  
T.O.C. Faleye ◽  
...  
Keyword(s):  
Cell Culture ◽  
Acute Flaccid Paralysis ◽  
Direct Detection ◽  
Rna Extraction ◽  
Clinical Specimen ◽  
Flaccid Paralysis ◽  
Surveillance Program ◽  
Two Samples ◽  
Afp Surveillance ◽  
Stool Samples

AbstractsRecently, a reverse transcriptase seminested polymerase chain reaction (RT-snPCR) assay was recommended by the WHO for direct detection of enteroviruses from clinical specimen. In this study, we use the assay and its modification to screen acute flaccid paralysis (AFP) samples previously confirmed negative for enteroviruses by the RD-L20B algorithm.Thirty paired stool suspensions collected in 2015 as part of the national AFP surveillance program in different states of Nigeria were analyzed in this study. The samples were previously confirmed negative for enteroviruses by the polio laboratory in accordance with the WHO recommended RD-L20B cell culture based algorithm. Two samples previously confirmed to contain enteroviruses were included as positive controls. All samples were subjected to RNA extraction, and the RT-snPCR assay and its modifications. All amplicons were sequenced and enteroviruses identified using the enterovirus genotyping tool.Overall, amplicons were recovered from the two controls and 50% (15/30) of samples screened. Fourteen were successfully typed of which, 7.1% (1/14), 21.4% (3/14), 64.3% (9/14) and 7.1% (1/14) were EV-A, EV-B, EV-C and a mixture of EV-B and C (EV-C99 and E25), respectively. The two controls were identified as EV-C99 and CV-A1, both EV-Cs. The PV-2 detected had VP1 ILE143. Hence, a vaccine strain.The results of this study showed that about 50% of enterovirus infections (including some Sabin PV2s) are being missed by the RD-L20B cell culture based algorithm. This highlights the value of the RT-snPCR assay and its modifications. The circulation and preponderance of EV-Cs in Nigeria was also confirmed.

scholarly journals Whole-Genome Sequences of Enteroviruses D94 and D111 Isolated from Stool Specimens in Angola

2021 ◽  
Vol 10 (40) ◽  
Author(s):  
Shur-Wern W. Chern ◽  
Nicksy Gumede ◽  
Christina J. Castro ◽  
W. Allan Nix ◽  
Terry Fei Fan Ng
Keyword(s):  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
Whole Genome ◽  
Genome Sequences ◽  
Stool Specimens

We report the whole-genome sequences of new enterovirus D94 and D111 strains, isolated from a culture from stool specimens collected from acute flaccid paralysis (AFP) cases for poliovirus surveillance in Angola during 2010.

scholarly journals Polio-like deformity: a diagnostic dilemma

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Khaled A Ben Salem ◽  
Pieter H Maré ◽  
Matthew Goodier ◽  
Leonard C Marais ◽  
David M Thompson
Keyword(s):  
Acute Flaccid Paralysis ◽  
Clinical Manifestations ◽  
Flaccid Paralysis ◽  
Paralytic Poliomyelitis ◽  
Foot Deformities ◽  
Level Of Evidence ◽  
Gait Patterns ◽  
Short Limb ◽  
Eradicate Polio ◽  
Made In

ABSTRACT BACKGROUND: Significant advances have been made in the global effort to eradicate polio. Vaccine-associated poliovirus, or other enteroviruses, may still affect the anterior horn cell and cause acute flaccid paralysis. Following the acute disease, residual paralysis results in lower motor neuron weakness, altered growth and deformity. Our study aims to describe the clinical manifestations of a group of children that mimic that of classic paralytic poliomyelitis METHODS: We identified six children from our paediatric orthopaedic database that presented with polio-like deformities. Their clinical and imaging records were reviewed and described, together with the clinical manifestations of paralytic poliomyelitis RESULTS: Limb hypoplasia, pathological gait patterns and foot deformities were consistent features. The median leg length discrepancy was 2.5 cm (range 2-4 cm). The gait patterns observed included a Trendelenburg gait in 33% (n=2), a short limb gait in 50% (n=3), and one case with a combination of Trendelenburg, short limb and steppage gait. Tensor fascia lata contracture was present in 50% (n=3) of our patients. Foot deformities ranged from calcaneo-cavo-valgus to equino-cavo-varus deformities CONCLUSION: Despite significant advances made in the global fight to eradicate polio, we still see children with clinical manifestations reminiscent of the disease. Orthopaedic surgeons should remain familiar with the assessment and diagnosis of the sequelae of paralytic poliomyelitis Level of evidence: Level 5 Keywords: poliomyelitis, vaccine-associated paralytic poliomyelitis, polio-like deformity, acute flaccid paralysis

scholarly journals The Acute Flaccid Paralysis (AFP) Surveillance System in Yemen, 2010-2015: Descriptive Study Based on Secondary Data Analysis (Preprint)

2019 ◽  
Author(s):  
Khaled Abdullah Almoayed ◽  
Ali Bin Break ◽  
Mutahar Al-Qassimi ◽  
Ali Assabri ◽  
Yousef Khader
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Descriptive Study ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Sample Collection ◽  
Afp Surveillance ◽  
Stool Specimens ◽  
Central Level

BACKGROUND Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. OBJECTIVE This study aimed to evaluate the performance of the AFP surveillance system in Yemen from 2010 to 2015, identify components that require strengthening, and compare the indicators by year and governorates. METHODS This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The World Health Organization (WHO) minimum performance standards were used to evaluate the performance of the AFP surveillance system. RESULTS A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for the nonpolio AFP rate of cases per 100,000 members of the population younger than 15 years of age, proportion of AFP cases reported within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which nonpolio enterovirus was isolated. However, the proportion of specimens that arrived at the central level within 3 days of the first sample collection and the proportion of stool specimens with results sent from the reference laboratory within 28 days of receipt did not reach targets in 2011 and 2015, respectively. CONCLUSIONS The AFP surveillance system in Yemen has met most of the WHO indicator levels. Nevertheless, the evaluation showed areas of weakness regarding the arrival of specimens at the central level within 3 days of the first sample collection and delays in processing of the results and submitting feedback by the laboratory. Therefore, there is a need to strengthen the follow-up of specimens submitted to the laboratory.

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