Genotyping of non-polio enteroviruses associated with acute flaccid paralysis in Thailand in 2013 and 2014

Abstract Background Acute flaccid paralysis (AFP) surveillance was conducted as part of the World Health Organization’s strategy for completely eradicating poliomyelitis and leaving non-polio enteroviruses NPEVs as one of the main potential causes of AFP. We aimed to detect NPEV in association with AFP. Methods We used 459 isolates reported to be Negative Polio and some NPEVs by the World Health Organization Polio Regional Reference Laboratory (Thailand), which had been obtained during polio surveillance programmes conducted in Thailand in 2013–2014. Of 459 isolates, 35 belonged to the genus Enterovirus by RT-PCR and genotyping by DNA sequencing. Results This study found 17 NPEV genotypes, with 3, 13 and 1 belonging to enterovirus (EV) species A (EV-A), EV-B, and EV-C, respectively. The EV-A types identified included coxsackievirus A2 (CA2), CA4, and EV71, typically associated with hand, foot and mouth diseases. EV-B is the most prevalent cause of AFP in Thailand, while CA21 was the only type of EV-C detected. The EV-B species (13/35; 76.5%) constituted the largest proportion of isolates, followed by EV-A (3/35; 17.6%) and EV-C (1/35; 5.9%). For the EV-B species, Echovirus (E) 30 and CVB were the most frequent isolates. E30, CVB, E14, and E6 were considered endemic strains. Conclusion NPEVs, e.g. CA4, are reported for the first time in Thailand. Despite some limitations to this study, this is the first report on the circulation patterns of NPEVs associated with AFP in Thailand. AFP surveillance has unearthed many unknown NPEVs and, the cases of death due to AFP occur annually. Therefore, it is important to study NPEVs in the wake of the eradication of poliovirus in the context of the continued incidence of paralysis.

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Gonotyping of non-polio enteroviruses associated with acute flaccid paralysis in Thailand in 2013 and 2014

10.21203/rs.3.rs-212310/v1 ◽

2021 ◽

Author(s):

Napa Onvimala ◽

Nathamon Kosoltanapiwat ◽

Pornpan Pumirat ◽

Muthita Vanaporn ◽

Suchitra Nimmanitya ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Flaccid Paralysis ◽

World Health ◽

Reference Laboratory ◽

Mouth Diseases ◽

Circulation Patterns ◽

The World ◽

Afp Surveillance ◽

Health Organization ◽

First Time

Abstract Background Acute flaccid paralysis (AFP) surveillance was conducted as part of the World Health Organization’s strategy for completely eradicating poliomyelitis and leaving non-polio enteroviruses NPEVs as one of the main potential causes of AFP. We aimed to detect NPEV in association with AFP.Methods We used 459 isolates reported to be Negative Polio and some NPEVs by the World Health Organization Polio Regional Reference Laboratory (Thailand), which had been obtained during polio surveillance programmes conducted in Thailand in 2013–2014. Of 459 isolates, 35 belonged to the genus Enterovirus by RT-PCR and genotyping by DNA sequencing.Results This study found 17 NPEV genotypes, with 3, 13 and 1 belonging to enterovirus (EV) species A (EV-A), EV-B, and EV-C, respectively. The EV-A types identified included coxsackievirus A2 (CA2), CA4, and EV71, typically associated with hand, foot and mouth diseases. EV-B is the most prevalent cause of AFP in Thailand, while CA21 was the only type of EV-C detected. The EV-B species (13/35; 76.5%) constituted the largest proportion of isolates, followed by EV-A (3/35; 17.6%) and EV-C (1/35; 5.9%). For the EV-B species, Echovirus (E) 30 and CVB were the most frequent isolates. E30, CVB, E14, and E6 were considered endemic strains.Conclusion NPEVs, e.g. CA4, are reported for the first time in Thailand. Despite some limitations to this study, this is the first report on the circulation patterns of NPEVs associated with AFP in Thailand. AFP surveillance has unearthed many unknown NPEVs and, the cases of death due to AFP occur annually. Therefore, it is important to study NPEVs in the wake of the eradication of poliovirus in the context of the continued incidence of paralysis.

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Evaluation of Acute Flaccid Paralysis Surveillance indicators in Sokoto State, Nigeria, 2012-2019: A secondary data analysis

10.21203/rs.3.rs-117324/v1 ◽

2020 ◽

Author(s):

Ismail Abdullateef Raji ◽

Auwal Abubakar Usman ◽

Abdulrahman Ahmad ◽

Saheed Gidado ◽

Abdulhakeem Abayomi Olorukooba ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Secondary Data ◽

High Sensitivity ◽

Flaccid Paralysis ◽

World Health ◽

Surveillance Network ◽

Polio Virus ◽

Acute Flaccid Paralysis Surveillance ◽

Afp Surveillance ◽

Health Organization

Abstract Background: Nigeria and indeed, entire Africa has been certified free of Wild Polio Virus (WPV) in 2020. However, the continent is still at risk of importation of WPV, especially in states like Sokoto in Nigeria, which has an international border. Furthermore, due to low immunity in some communities in Sokoto, outbreaks of the circulating Vaccine Derived Polio Virus (cVDPV) occur. Therefore, this paper evaluates the Acute Flaccid Paralysis (AFP) surveillance indicators in Sokoto state, Nigeria. Methods: This retrospective study was an analysis of routinely collected AFP surveillance data between 2012 and 2019 by the Sokoto state surveillance network. We assessed the Sokoto state AFP surveillance system using the AFP surveillance performance indicators. We performed all analyses using Microsoft Excel 2019.Results: Cumulatively, 3001 Acute Flaccid Paralysis (AFP) cases were reported over the evaluation period, out of which 1692 (56.4%) were males, and 2478 (82.4%) were below five years. More than half, 1773 (59.1%) had a fever at the beginning of the disease, and 1911 (63.7%) had asymmetric paralysis. The non-polio AFP rate (9.1 to 23.5%) and stool adequacy rate (92.5 to 100%) indicate high sensitivity. The proportion of cases that had stool samples collected early, timely transported to the laboratory and arrived at the laboratory in optimal condition were all above the World Health Organization (WHO) minimum standard of 80%. There was inadequate profile documentation of some suspected cases.Conclusions: Sokoto State has exceeded the WHO minimum standards in most of the AFP surveillance indicators. The performance of the system is sufficient enough to detect any reintroduction of WPV into the state. However, there is a need for improvement in data quality.

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

10.2196/preprints.14413 ◽

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

JMIR Public Health and Surveillance ◽

10.2196/14413 ◽

2019 ◽

Vol 5 (4) ◽

pp. e14413

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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Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019–2023

Applied and Environmental Microbiology ◽

10.1128/aem.00702-20 ◽

2020 ◽

Vol 86 (15) ◽

Cited By ~ 1

Author(s):

Peng Chen ◽

Yao Liu ◽

Haiyan Wang ◽

Guifang Liu ◽

Xiaojuan Lin ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Polio Eradication ◽

Flaccid Paralysis ◽

World Health ◽

Paralytic Poliomyelitis ◽

Environmental Surveillance ◽

Wild Poliovirus ◽

The World ◽

Afp Surveillance ◽

Case Based

ABSTRACT The Polio Endgame Strategy 2019–2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance. IMPORTANCE Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillance, provides continued high-quality surveillance performance in achieving the GPEI and detecting the circulation of enterovirus. Given the ongoing cVDPV outbreaks in the world, we present the surveillance capacity of environmental surveillance in capturing enterovirus circulation. The final poliovirus (especially VDPV) elimination has become increasingly complex, and the case-based AFP surveillance alone will lead to difficulties in early detecting dynamics of poliovirus transmission and monitoring the extent of environmental circulation. This study goes beyond previous work to provide a detailed comprehensive evaluation of the enterovirus surveillance and can be used to formulate a set of implementation plan and performance indicators for environmental surveillance.

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Investigation Report of cVDPV2 Outbreak in Bokh Woreda of Dollo Zone, Somali Regional State, Ethiopia

Case Reports in Infectious Diseases ◽

10.1155/2020/6917313 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Diriba Sufa ◽

Urge Gerema

Keyword(s):

Acute Flaccid Paralysis ◽

Addis Ababa ◽

Flaccid Paralysis ◽

World Health ◽

Reference Laboratory ◽

Health Extension Worker ◽

High Grade ◽

High Grade Fever ◽

Regional State ◽

Investigation Report

Background. Poliovirus isolates detected in persons or in the environment can fall into three major categories: wild, Sabin and Sabin-like, or vaccine-derived. Detection of wild or vaccine-derived poliovirus may constitute an emergency, which can be categorized as an event that can lead to an outbreak, depending on characteristics of the isolate and the context in which it appears. The aim of the study was investigation report of cVDPV2 outbreak in Bokh woreda of Dollo Zone, Somali regional state, Ethiopia. Methods. A team of experts drawn from different organizations was deployed to Bokh woreda to make detailed field investigation from May 25 to June 17, 2019. By using standard World Health Organization polio outbreak investigation checklist, document review of surveillance, immunization, and clinical data related to the case was made. Key informant’s interview was made to health professionals, managers, parents of case, woreda and kebele leaders, religious leaders, and HEWs related to acute flaccid paralysis outbreak. Result. The notified AFP case was a 39-month-old female from Angalo kebele of Bokh woreda, Dollo Zone. On 19th May 2019, the patient developed high grade fever and was taken to Angalo Health Post on 20th May 2019. As per the examination by a health extension worker, the child had high grade fever and neck stiffness with preliminary diagnosis of meningitis for which ceftriaxone injection was prescribed. Contact sample was taken from three children on 28th May 2019 and 29th May 2019 and was sent to Addis Ababa National Polio Laboratory. All contact stool samples were found to be positive for poliovirus type 2 and referred for sequencing in National Institute of Communicable Diseases (NICD), South Africa, the Regional Polio Reference Laboratory. Conclusion and Recommendation. The clinical presentation of the cases is compatible with poliovirus infection, improving the quality and coverage of supplementary polio immunization activities through proper planning; strict supervision and follow-up can reduce the occurrence of acute flaccid paralysis.

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The WHO Collaborating Centre for Biosafety in Microbiology

Microbiology Australia ◽

10.1071/ma08084 ◽

2008 ◽

Vol 29 (2) ◽

pp. 84

Author(s):

Tony Della-Porta ◽

Michael Catton

Keyword(s):

Infectious Diseases ◽

World Health Organization ◽

Significant Role ◽

World Health ◽

Reference Laboratory ◽

Raising Awareness ◽

The World ◽

Health Organization

The World Health Organization (WHO) Collaborating Centre for Biosafety in Microbiology has been established at the Victorian Infectious Diseases Reference Laboratory (VIDRL) for over 2 decades and played a significant role in the development of the WHO Laboratory Biosafety Manual and the WHO Biorisk Guidelines. It has also contributed to WHO?s international biosafety programmes and to the raising awareness of biosafety in Australia.

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Retrospective Analysis of Six Years of Acute Flaccid Paralysis Surveillance and Polio Vaccine Coverage Reported by Italy, Serbia, Bosnia and Herzegovina, Montenegro, Bulgaria, Kosovo, Albania, North Macedonia, Malta, and Greece

Vaccines ◽

10.3390/vaccines10010044 ◽

2021 ◽

Vol 10 (1) ◽

pp. 44

Author(s):

Stefano Fontana ◽

Gabriele Buttinelli ◽

Stefano Fiore ◽

Concetta Amato ◽

Marco Pataracchia ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Vaccine Coverage ◽

Laboratory Data ◽

Vaccine Uptake ◽

Flaccid Paralysis ◽

Data Management System ◽

Reference Laboratory ◽

Polio Vaccine ◽

Acute Flaccid Paralysis Surveillance ◽

Afp Surveillance

Here we analyzed six years of acute flaccid paralysis (AFP) surveillance, from 2015 to 2020, of 10 countries linked to the WHO Regional Reference Laboratory, at the Istituto Superiore di Sanità, Italy. The analysis also comprises the polio vaccine coverage available (2015–2019) and enterovirus (EV) identification and typing data. Centralized Information System for Infectious Diseases and Laboratory Data Management System databases were used to obtain data on AFP indicators and laboratory performance and countries’ vaccine coverage from 2015 to 2019. EV isolation, identification, and typing were performed by each country according to WHO protocols. Overall, a general AFP underreporting was observed. Non-Polio Enterovirus (NPEV) typing showed a high heterogeneity: over the years, several genotypes of coxsackievirus and echovirus have been identified. The polio vaccine coverage, for the data available, differs among countries. This evaluation allows for the collection, for the first time, of data from the countries of the Balkan area regarding AFP surveillance and polio vaccine coverage. The need, for some countries, to enhance the surveillance systems and to promote the polio vaccine uptake, in order to maintain the polio-free status, is evident.

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INTRODUCTION TO THE SYMPOSIUM ON EQUALITY VERSUS PRIORITY

Economics and Philosophy ◽

10.1017/s0266267115000073 ◽

2015 ◽

Vol 31 (2) ◽

pp. 201-202

Author(s):

Alex Voorhoeve

Keyword(s):

World Health Organization ◽

World Health ◽

Moral Value ◽

The World ◽

Health Organization ◽

First Time

This symposium publishes for the first time three key contributions to the debate on the nature and importance of the distinction between egalitarianism (the view that it is in itself bad, when and because it is unfair, for some to be worse off than others) and prioritarianism (the view that each person's welfare has diminishing marginal moral value and that the moral value of a person's welfare depends only on that person's level of welfare, and not on how anyone else fares). These papers were commissioned by the World Health Organization (WHO) in 2000. They were intended for publication in a WHO volume which has not yet materialized, and this has hindered access to these important papers. Permission was therefore secured from the WHO to publish them here.

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Synthetic Attempts Towards Eminent Anti-Viral Candidates of SARS-CoV

Mini-Reviews in Medicinal Chemistry ◽

10.2174/1389557521666210712205655 ◽

2021 ◽

Vol 21 ◽

Author(s):

Subhradip Kundu ◽

Debayan Sarkar

Keyword(s):

Clinical Trials ◽

Severe Acute Respiratory Syndrome ◽

Southern China ◽

World Health ◽

The World ◽

Entire World ◽

Chemical Companies ◽

Health Organization ◽

Synthetic Approaches ◽

First Time

: Severe Acute Respiratory Syndrome (SARS) aka SARS-CoV spread over southern China for the first time in 2002-2003 and history repeated again since last year and take away more than two million people so far. On March 11, 2020 COVID-19 outbreak was officially declared as pandemic by World Health Organization (WHO). Entire world united to fight back against this ultimate destruction. Around 90 vaccines are featured against SARS-CoV-2 and more than 300 active clinical trials are underway by several groups and individuals. So far, no drugs are currently approved that completely eliminates the deadly corona virus. The promising SARS-CoV-2 anti-viral drugs are favipiravir, remdesivir, lopinavir, ribavirin and avifavir. In this review, we have discussed the synthetic approaches elaborately made so far by different groups and chemical companies all around the world towards top three convincing anti-viral drugs against SARS-CoV-2 which are favipiravir, remdesivir and lopinavir.

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