scholarly journals Enterovirus Surveillance (EVSurv) in Germany

2021 ◽  
Vol 9 (10) ◽  
pp. 2005
Author(s):  
Kathrin Keeren ◽  
Sindy Böttcher ◽  
Sabine Diedrich
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Positive Sample ◽  
Flaccid Paralysis ◽  
Continuous Data ◽  
Older Children ◽  
Federal States ◽  
German Federal States

The major aim of the enterovirus surveillance (EVSurv) in Germany is to prove the absence of poliovirus circulation in the framework of the Global Polio Eradication Program (GPEI). Therefore, a free-of-charge enterovirus diagnostic is offered to all hospitals for patients with symptoms compatible with a polio infection. Within the quality proven laboratory network for enterovirus diagnostic (LaNED), stool and cerebrospinal fluid (CSF) samples from patients with suspected aseptic meningitis/encephalitis or acute flaccid paralysis (AFP) are screened for enterovirus (EV), typing is performed in all EV positive sample to exclude poliovirus infections. Since 2006, ≈200 hospitals from all 16 German federal states have participated annually. On average, 2500 samples (70% stool, 28% CSF) were tested every year. Overall, the majority of the patients studied are children <15 years. During the 15-year period, 53 different EV serotypes were detected. While EV-A71 was most frequently detected in infants, E30 dominated in older children and adults. Polioviruses were not detected. The German enterovirus surveillance allows monitoring of the circulation of clinically relevant serotypes resulting in continuous data about non-polio enterovirus epidemiology.

AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6

PEDIATRICS ◽  
1962 ◽  
Vol 29 (3) ◽  
pp. 418-431
Author(s):  
David T. Karzon ◽  
Norman S. Hayner ◽  
Warren Winkelstein ◽  
Almen L. Barron
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Virus Type ◽  
Alimentary Tract ◽  
Febrile Illness ◽  
Acute Onset ◽  
Etiologic Agent ◽  
Abdominal Muscles ◽  
Older Children ◽  
Echo Virus

The clinical features of 130 cases of aseptic meningitis syndrome associated with ECHO virus type 6 infection were studied. Characteristically, the onset was acute with the development of fever, headache, muscle pains, and vomiting. A biphasic course was present in 8% of the cases. The physical findings included mild to moderate stiffness or spasm of the neck, back, and posterior thigh muscles. Disturbance in sensorium, cranial nerve involvement, and bulbar signs were conspicuously absent. Absence of deep tendon and superficial reflexes occurred in 16% of the cases. Evidence of mild muscle weakness occurred in 39% of cases, more commonly in the axial rather than peripheral muscles. Most of these patients had bilateral weakness of the anterior neck muscles, but included in the group were five with bilateral weakness of the back or abdominal muscles and six with some involvement of the extremities. Neuromuscular changes were mild and frequently questionable. Where follow-up was available, the changes were usually found to be transient. The effect of age upon the clinical picture was analyzed. Only 3 of 130 patients were less than 4 years of age. Young children had a more acute onset and were admitted to the hospital more promptly than older children and adults. The incidence of pleurodynia was 38% in adults and only 5% in patients less than 20 years of age. The cerebrospinal fluid revealed pleocytosis, with lymphocyte counts ranging from a few cells to 930/mm3. The protein values exceeded 40 mg/100 ml in 48% of the cases, the highest value being 102 mg/100 ml. An undifferentiated febrile illness in household associates of patients with aseptic meningitis, characterized by headache, vomiting and muscle pain, was associated with a high recovery rate of ECHO 6 virus. This is presumably the forme fruste of the fully developed aseptic meningitis syndrome. ECHO 6 virus was recovered from four patients in whom there was evidence of neurologic involvement beyond that seen in the aseptic meningitis syndrome. ECHO 6 virus was the probable etiologic agent in two of these cases. A 15-year-old girl with mild encephalitis marked by disorientation, hallucinations, and weakness of the legs yielded ECHO 6 from her alimentary tract. ECHO 6 was recovered from the cerebrospinal fluid and alimentary tract of a 15-year-old boy with features of the Guillain-Barré syndrome.

scholarly journals Acute Flaccid Paralysis surveillance in Polio Eradication and Beyond: Learning from Bangladesh

2021 ◽  
Author(s):  
Humayra Binte Anwar ◽  
Yameen Mazumder ◽  
Sanjana Nujhat ◽  
Bushra Zarin Islam ◽  
Anna Kalbarczyk ◽  
...  
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Technical Assistance ◽  
Acute Flaccid Paralysis ◽  
Grey Literature ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Depth Information ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance

Abstract IntroductionGlobal Polio Eradication Initiative, GPEI led by the World Health Organization (WHO), helped to develop standard acute flaccid paralysis surveillance (AFP) system worldwide, including Bangladesh, which comprises infrastructure, knowledge, expertise, funding, technical assistance, and trained personnel. AFP surveillance can complement any disease surveillance systems, and many countries are now utilizing these polio surveillance assets for monitoring other vaccine-preventable diseases. This paper outlines how AFP surveillance has evolved in Bangladesh over time, its success and challenging factors, and its potential to accomplish other health goals.MethodologyThis mixed-method study includes a grey literature review, a survey for quantitative and qualitative information on barriers and facilitators, and Key Informant Interviews (KIIs) to gather relevant in-depth information on AFP surveillance in Bangladesh. Grey literature was collected online and paper documentation from different stakeholders. Online and in-person surveys were conducted in six divisions of Bangladesh, including Dhaka, Rajshahi, Rangpur, Chittagong, Sylhet, and Khulna, to map tacit knowledge ideas, approaches, and experiences. KIIs were conducted at global, national, and sub-national levels. Data were then combined on focused emerging themes, including history, challenges, and successes of the AFP surveillance system in Bangladesh.ResultsAFP surveillance in Bangladesh was first introduced in 1990 at the district and Upazila level major hospitals. High population growth, low performance, hard-to-reach areas, and groups of people residing in risky zones were major challenges to implementing this surveillance system. Surveillance was gradually enriched by establishing certification standards and community-based AFP surveillance and improved Surveillance Immunization Medical Officer (SIMO) network activities, laboratory activities, and proper monitoring and evaluation. In Bangladesh, a national disease surveillance system and a laboratory are now being used for multiple diseases, including polio, measles, Japanese Encephalitis, Neonatal Tetanus etc.ConclusionIn Bangladesh, it is evident that the AFP surveillance system is supporting the health system more broadly by building knowledge, experience, and assets and forming a strong platform for other health programs. In addition, its strengths can be leveraged for combating new and emerging diseases like COVID-19. However, the sustainability of the AFP surveillance in Bangladesh still needs collaborative support from partners, mainly technical assistance.

scholarly journals Acute flaccid paralysis (AFP) surveillance: challenges and opportunities from 18 years’ experience, Spain, 1998 to 2015

2018 ◽  
Vol 23 (47) ◽  
Author(s):  
Josefa Masa-Calles ◽  
Nuria Torner ◽  
Noemí López-Perea ◽  
María de Viarce Torres de Mier ◽  
Beatriz Fernández-Martínez ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Notification Rate ◽  
Surveillance Network ◽  
Challenges And Opportunities ◽  
Afp Surveillance ◽  
The Mean ◽  
Annual Proportion

Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It allows detecting poliovirus (PV) reintroductions from endemic countries. This study describes AFP surveillance in Spain from 1998 to 2015. During this time, 678 AFP cases were reported to the Spanish National Surveillance Network. The mean notification rate was 0.58 AFP cases/100,000 population under 15 years old (range: 0.45/100,000–0.78/100,000). Two periods (P) are described: P1 (1998–2006) with the AFP notification rate ranging from 0.66/100,000 to 0.78/100,000, peaking in 2001 (0.84/100,000); and P2 (2007–2015) when the AFP rate ranged from 0.43/100,000 to 0.57/100,000, with the lowest rate in 2009 (0.31/100,000). No poliomyelitis cases were caused by wild PV infections, although two Sabin-like PVs and one imported vaccine-derived PV-2 were detected. Overall, 23 (3.4%) cases met the hot case definition. Most cases were clinically diagnosed with Guillain–Barré syndrome (76.9%; 504/655). The adequate stool collection rate ranged from 33.3% (7/21) to 72.5% (29/40). The annual proportion of AFP cases with non-polio enterovirus findings varied widely across the study period. AFP surveillance with laboratory testing for non-polio enteroviruses must be maintained and enhanced both to monitor polio eradication and to establish sensitive surveillance for prompt detection of other enteroviruses causing serious symptoms.

Non-polio enteroviruses in acute flaccid paralysis children of India: Vital assessment before polio eradication

2009 ◽  
Vol 45 (7-8) ◽  
pp. 409-413 ◽  
Author(s):  
Tapan N Dhole ◽  
Archana Ayyagari ◽  
Rashmi Chowdhary ◽  
Akhalesh K Shakya ◽  
Nikky Shrivastav ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis

scholarly journals Characterization of group B coxsackieviruses isolated from non-polio acute flaccid paralysis patients in Pakistan: vital assessment before polio eradication

2017 ◽  
Vol 145 (12) ◽  
pp. 2473-2481 ◽  
Author(s):  
M. ANGEZ ◽  
S. SHAUKAT ◽  
R. ZAHRA ◽  
M. M. ALAM ◽  
S. SHARIF ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Phylogenetic Analyses ◽  
Fatal Outcome ◽  
Polio Eradication ◽  
Amino Acid Sequences ◽  
Flaccid Paralysis ◽  
Coxsackievirus B ◽  
Molecular Phylogenetic ◽  
Group B ◽  
Viral Protein 1

SummaryPakistan is at the verge of polio eradication but isolation of non-polio enteroviruses (NPEVs) from acute flaccid paralysis (AFP) cases may result in serious or even fatal outcome. Many enteroviruses share similar symptoms and epidemiology as is the case with poliovirus and coxsackievirus (CV). The present study was designed to genetically characterize coxsackievirus B (CV-B) serotypes isolated from non-polio acute flaccid paralytic children, as well as to understand their probable role in paralysis. A total of 63 (20·1%) out of 313 stool samples during 2013 were found positive for NPEVs in rhabdomyosarcoma cells. Only 24 (38·0%) NPEVs were typed as CV-B by microneutralization assay and were further characterized by sequencing of the viral protein 1 (VP1) gene. Molecular phylogenetic analyses classified the study strains into six coxsackievirus B serotypes (coxsackievirus B1 to B6) with their respective prototype strains with evidence of epidemiological linkage and distinct clusters. Moreover, four major differences were found within the amino acid sequences of BC-loop in VP1 of CV-B strains. In conclusion, this study presented the molecular evolutionary genetic overview and distinct phylogenetic pattern of CV-B isolates from AFP cases in Pakistan, and explored the possible link between CV-B infections and AFP cases. Furthermore, our data reveal that these viruses might contribute to the incidence of paralysis in population and there is need of time to establish an enterovirus surveillance system for better understanding of epidemiological and virological characteristics of NPEV infections associated with AFP cases in the country.

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 Prevalence and Risk Factors for ESBL/AmpC-E. coli in Pre-Weaned Dairy Calves on Dairy Farms in Germany

2021 ◽  
Vol 9 (10) ◽  
pp. 2135
Author(s):  
Laura Patricia Weber ◽  
Sylvia Dreyer ◽  
Maike Heppelmann ◽  
Katharina Schaufler ◽  
Timo Homeier-Bachmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Animal Health ◽  
Significant Risk ◽  
Dairy Farms ◽  
Positive Sample ◽  
Dairy Calves ◽  
Federal States ◽  
E Coli ◽  
German Federal States ◽  
Waste Milk

The objectives of this study were to ascertain the fecal ESBL/AmpC-E. coli prevalence and to detect risk factors for their occurrence in young pre-weaned calves and their dams on large dairy farms in Germany. From 2018–2019 we investigated 2816 individual fecal samples from pre-weaned dairy calves and their dams, representing seventy-two farms (mean = 667 milking cows) from eight German federal states. To assess possible risk factors associated with ESBL/AmpC-E. coli prevalence in calves and dams, a questionnaire was performed, collecting management data. We observed an ESBL/AmpC-E. coli prevalence of 63.5% (95% CI: 57.4–69.5) among the sampled calves and 18.0% (95% CI: 12.5–23.5) among the dams. On all farms, at least one positive sample was obtained. To date, this is the highest ESBL/AmpC-E. coli prevalence observed in dairy herds in Europe. Feeding with waste milk was identified as a significant risk factor for a high prevalence of ESBL/AmpC-E. coli in calves. Many calves at large dairies in Germany are fed with waste milk due to the large amounts generated as a result of antibiotic dry-off routines and mastitis treatment with antibiotics. Other notable risk factors for high ESBL/AmpC-E. coli in calves were the general fitness/health of dams and calves, and the quality of farm hygiene. Taken together, these findings suggest that new or improved approaches to animal health management, for example, antibiotic dry cow management (selective dry cow therapy) and mastitis treatment (high self-recovery), as well as farm hygiene, should be researched and implemented.

scholarly journals Detection of Imported Wild Polioviruses and of Vaccine-Derived Polioviruses by Environmental Surveillance in Egypt

2012 ◽  
Vol 78 (15) ◽  
pp. 5406-5409 ◽  
Author(s):  
Soile Blomqvist ◽  
Laila El Bassioni ◽  
Eman M. El Maamoon Nasr ◽  
Anja Paananen ◽  
Svetlana Kaijalainen ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Environmental Surveillance ◽  
Wild Type ◽  
Wild Poliovirus ◽  
Afp Surveillance

ABSTRACTSystematic environmental surveillance for poliovirus circulation has been conducted in Egypt since 2000. The surveillance has revealed three independent importations of wild-type poliovirus. In addition, several vaccine-derived polioviruses have been detected in various locations in Egypt. In addition to acute flaccid paralysis (AFP) surveillance, environmental surveillance can be used to monitor the wild poliovirus and vaccine-derived poliovirus circulation in populations in support of polio eradication initiatives.

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