Molecular Characterization of Enteroviruses Isolated from Acute Flaccid Paralysis Cases in Poland, 1999–2014

Enteroviruses (EVs) are among viral pathogens that can cause acute flaccid paralysis (AFP). This study represents an overview of EVs isolated through AFP surveillance in Poland between 1999 and 2014. The presence of enteroviruses was studied in stool samples that were collected from 747 AFP cases and their asymptomatic contacts. Fifty five (6.12%) cases of AFP were associated with enterovirus isolation. Out of the 55 positive cases, 40 were associated with detection of enterovirus in patient, and 15 with detection of EV in healthy contact, without positive detection in paralytic patient. Polioviruses were isolated from 35 AFP cases. The results of this study showed that about 43.6% of positive AFP cases were found in association with the isolation of non-polio enteroviruses (NPEV). A total of 12 different types of the species B were detected (CVA9, CVB1, CVB3, CVB4, CVB5, E3, E4, E9, E11, E13, E30), and one additional isolate represented the species enterovirus A (EV71). Among the 12 serotypes of species B, CVB3 and CVB5 were more frequently detected than others, representing 40% of the characterized isolates, followed by CVB4 (16%), E4 (8%), and E11(8%). Phylogenetic analysis revealed that strains from Poland had the closest genetic relationship with isolates previously identified in Europe (France, Finland, Denmark, Moldova) but also in other parts of the world (Tunisia, China, USA), suggesting wide distribution of these lineages. The paper provides information about NPEV circulation in Poland in the past 16 years, about its association with the AFP and it indicates the need for monitoring NPEV circulation even after the eradication of poliomyelitis.

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

10.1101/116004 ◽

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.

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Cases of Acute Flaccid Paralysis Associated with Coxsackievirus A2: Findings of a 20-Year Surveillance in the Russian Federation

Microorganisms ◽

10.3390/microorganisms10010112 ◽

2022 ◽

Vol 10 (1) ◽

pp. 112

Author(s):

Olga E. Ivanova ◽

Armen K. Shakaryan ◽

Nadezhda S. Morozova ◽

Yulia A. Vakulenko ◽

Tatyana P. Eremeeva ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Laboratory Data ◽

Foot And Mouth Disease ◽

Polio Eradication ◽

Vaccination Schedule ◽

Flaccid Paralysis ◽

Global Polio Eradication Initiative ◽

Afp Surveillance ◽

Stool Samples ◽

The Russian Federation

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.

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Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012–2019

Viruses ◽

10.3390/v13030411 ◽

2021 ◽

Vol 13 (3) ◽

pp. 411

Author(s):

Youngsil Yoon ◽

Yong-Pyo Lee ◽

Deog-Yong Lee ◽

Hye-Jin Kim ◽

June-Woo Lee ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Neurological Diseases ◽

Acute Disseminated Encephalomyelitis ◽

Polio Eradication ◽

Flaccid Paralysis ◽

Acute Flaccid Paralysis Surveillance ◽

Afp Surveillance ◽

Polymerase Chain

The risk of polio importation and re-emergence persists since epidemic polio still occurs in some countries, and the resurgence of polio occurring almost 20 years after polio eradication was declared in Asia has been reported. We analyzed the results of acute flaccid paralysis (AFP) surveillance in Korea to assess the quality of AFP surveillance and understand the etiology of non-polio enterovirus (NPEV)-associated central nervous system diseases in a polio-free area. We investigated 637 AFP patients under 15 years of age whose cases were confirmed during 2012–2019 by virus isolation, real-time reverse transcription polymerase chain reaction, and VP1 gene sequencing. Among the 637 AFP cases, NPEV was detected in 213 (33.4%) patients, with the majority observed in EV-A71, with 54.9% of NPEV positives. EV-A71 has been shown to play a role as a major causative agent in most neurological diseases except for Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), and meningitis. This study provides information on the AFP surveillance situation in Korea and highlights the polio eradication stage in the monitoring and characterization of NPEV against the outbreak of neurological infectious diseases such as polio.

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Identification and characterization of unrecognized viruses in stool samples of non-polio acute flaccid paralysis children by simplified VIDISCA

Virology Journal ◽

10.1186/1743-422x-11-146 ◽

2014 ◽

Vol 11 (1) ◽

pp. 146 ◽

Cited By ~ 12

Author(s):

Shahzad Shaukat ◽

Mehar Angez ◽

Muhammad Alam ◽

Maarten F Jebbink ◽

Martin Deijs ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Flaccid Paralysis ◽

Stool Samples ◽

Identification And Characterization

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Performance of Acute Flaccid Paralysis surveillance in Bauchi State, Nigeria, 2016

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7780 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Luka M. Ibrahim ◽

Adamu Ningi ◽

Jalal-Eddeen Saleh

Keyword(s):

Stool Specimen ◽

Acute Flaccid Paralysis ◽

Case Definition ◽

Flaccid Paralysis ◽

World Health ◽

Polio Virus ◽

Specimen Collection ◽

Afp Surveillance ◽

Stool Samples ◽

Definition Of

ObjectiveTo identify and address gaps in acute flaccid surveillance for polioeradication in Buchi stateIntroductionPoliomyelitis a disease targeted for eradication since 19881still pose public health challenge. The Eastern Mediterranean andAfrican Regions out of the six World Health Organization (WHO)Regions are yet to be certified polio free2. The certification of theWHO Africa region is largely dependent on Nigeria, while the WHOEastern Mediterranean is dependent on Pakistan and Afghanistan.Surveillance for acute flaccid paralysis (AFP) is one of the criticalelements of the polio eradication initiative. It provides the neededinformation to alert health managers and clinician to timely initiateactions to interrupt transmission of the polio disease and evidence forthe absence of the wild polio virus.3,4One of the core assignments ofthe certification committee in all regions is to review documentationto verify the absence of wild poliovirus.5Good and completedocumentation is the proxy indication of the quality of the systemwhile poor documentation translates to possibilities of missing wildpoliovirus in the past. We evaluated the performance of the AFPsurveillance system in Bauchi, which is among the 11 high risks statesfor wild polio virus in Nigeria to identify and address gaps in thesurveillance system.MethodsWe conducted a cross-sectional study in Bauchi State. We assessedthe material and documentations on AFP surveillance in eighteen of thetwenty Local Government Areas (LGAs). We assessed the knowledgeof the clinician at focal and non-focal sites on case definition of AFP,the number and method of stool specimen collection to investigate acase and types of training received for AFP surveillance. We verifiedAFP case investigations for the last three years: The caregivers(mothers) were interviewed to authenticate the reported informationof AFP cases, the method used for stool specimen collection andfeedbacks. Community leaders’ knowledge on AFP surveillance wasalso assessed. Data was entered and analyzed in excel spread sheet.ResultsReview of the expected deliverables of 18 out of the 20 LGAdisease surveillance and notification officers (DSNO) revealed thatonly 2(11%), 5(28%), 6(33%) and 7(39%) had evidence of poliooutbreak investigation, supervisory reports, minutes of meeting andsurveillance work plan respectively. Of the 31 AFP cases investigated,correct and complete information was 39% for birth day, 26% forbirth month of the child, 23% for date of onset of paralysis and 23%for date of investigation. Contacts of informants, AFP 001-3 weredeficient in the focal and non-focal sites. The non-focal also lackedguidelines for integrated disease surveillance and response (IDSR)and terms of reference for surveillance focal person.Knowledge of case definition of AFP was 71% and 30% amongclinician at the focal and non-focal sites, respectively and 88% and55% for method of stool collection among clinician at focal and non-focal sites. Among the 38 care givers (mothers) interviewed 16 (42%)did not remember the day or month the investigation for the AFPwas conducted, 36(95%) gave the correct number of stool samples,15(40%) mentioned that the stool samples were collected 24 hoursapart and only 12 (32%) received feedbacks. Majority (79%) of thecommunity leaders interviewed were aware of AFP and knew thatstool was the specimen for investigation of the AFP but 21% did notknow whom to report a case of AFP in their communityConclusionsOur study revealed knowledge and documentations gaps in AFPsurveillance for certification of polio-free in Nigeria. The stateministry of health and the WHO consultants in the polio eradicationunit should update the knowledge of the health care workers at theoperational levels on AFP surveillance. The state ministry of healthand the WHO consultants should also provide all essential documentsrequired for quality AFP surveillance and ensure their judicious use.

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2D Self-assembly and Electronic Characterization of Oxygen-Boron-Oxygen-Doped Chiral Graphene Nanoribbons

Chemical Communications ◽

10.1039/d1cc01901e ◽

2021 ◽

Author(s):

Lei Jin ◽

Nerea Bilbao ◽

Yang Lv ◽

Xiao-Ye Wang ◽

Soltani Paniz ◽

...

Keyword(s):

Edge Effects ◽

Self Assembly ◽

Quantum Confinement ◽

Graphene Nanoribbons ◽

One Dimensional ◽

The Past ◽

Different Types

Graphene nanoribbons (GNRs), quasi-one-dimensional strips of graphene, exhibit a nonzero bandgap due to quantum confinement and edge effects. In the past decade, different types of GNRs with atomically precise structures...

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Detection of non-polio and polio enteroviruses in Acute Flaccid Paralysis surveillance in Turkey

Acta Microbiologica et Immunologica Hungarica ◽

10.1556/030.2021.01353 ◽

2021 ◽

Author(s):

Gulay Korukluoglu ◽

Umit Ozdemirer ◽

Fatma Bayrakdar ◽

Zehra Unal ◽

Yasemin Cosgun ◽

...

Keyword(s):

Acute Flaccid Paralysis ◽

Flaccid Paralysis ◽

Sequencing Analysis ◽

National Data ◽

Polio Virus ◽

Vaccination Rates ◽

Acute Flaccid Paralysis Surveillance ◽

Polio Vaccination ◽

Afp Surveillance ◽

Comprehensive Study

AbstractPoliomyelitis was a disease feared worldwide, striking suddenly and paralysing mainly children for life. Monitoring of suspected cases of poliomyelitis is carried out with Acute Flaccid Paralysis (AFP) surveillance in Turkey. This study examines national data of AFP surveillance and the epidemiology of enteroviruses (EV) in Turkey from 2000 to 2019 and gives an overview of the detected serotypes of EVs. A total of 13,640 samples collected from patients with 5216 AFP pre-diagnosed cases (2 samples from each patient) and 3,208 contacts, during a 20-year period (2000–2019) were investigated. All isolated polioviruses were tested for their wild or vaccine origin according to the WHO recommended protocol by PCR and sequencing analysis were performed. Enterovirus positivity was detected in a total of 915 cases, which were identified as 204 Sabin-like polio virus (SLPV) and 711 non-polio enterovirus (NPEV). Of the 204 SLPV, 141 (69.1%) AFP were detected in patients and 63 (30.9%) were detected in samples taken from their contacts. Of the 711 NPEVs, 516 (72.5%) were from AFP cases and 195 (27.5%) were detected in samples taken from their contacts. It is concluded that the reason for the higher detection rate of NPEV in samples from AFP pre-diagnosed cases is attributed to the polio vaccination rates reaching 97% between 2008 and 2019 in Turkey. The most frequently detected NPEV serotypes were Coxackie A24, B3, and Echo 30. This retrospective study is the first comprehensive study in Turkey to evaluate the results of the AFP surveillance in the last 20 years.

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Genomic characterization of coxsackievirus type B3 strains associated with acute flaccid paralysis in south-western India

Journal of General Virology ◽

10.1099/jgv.0.000391 ◽

2016 ◽

Vol 97 (3) ◽

pp. 694-705 ◽

Cited By ~ 6

Author(s):

Rongala Laxmivandana ◽

Sarah S. Cherian ◽

Prasanna Yergolkar ◽

Shobha D. Chitambar

Keyword(s):

Acute Flaccid Paralysis ◽

Flaccid Paralysis ◽

Western India ◽

Genomic Characterization

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Isolation and molecular characterization of Adenovirus in suspected acute flaccid paralysis patients: A preliminary report from Pakistan

Archives of Virology ◽

10.1007/s00705-021-05346-x ◽

2022 ◽

Author(s):

Zainab Khattak ◽

Aamer Ali Shah ◽

Syed Sohail Zahoor Zaidi ◽

Nayab Mahmood ◽

Muhammad Masroor Alam ◽

...

Keyword(s):

Molecular Characterization ◽

Preliminary Report ◽

Acute Flaccid Paralysis ◽

Flaccid Paralysis

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Enterovirus D68 Subclade B3 Circulation in Senegal, 2016: Detection from Influenza-like Illness and Acute Flaccid Paralysis Surveillance

Scientific Reports ◽

10.1038/s41598-019-50470-z ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Amary Fall ◽

Ndack Ndiaye ◽

Mamadou Malado Jallow ◽

Mamadou Aliou Barry ◽

Cheikh Saad Bou Touré ◽

...

Keyword(s):

Active Surveillance ◽

Acute Flaccid Paralysis ◽

Flaccid Paralysis ◽

Influenza Like Illness ◽

Acute Flaccid Paralysis Surveillance ◽

Afp Surveillance ◽

Enterovirus D68 ◽

Low Levels ◽

Respiratory Specimens ◽

Children Under 5

Abstract Following the 2014 outbreak, active surveillance of the EV-D68 has been implemented in many countries worldwide. Despite subsequent EV-D68 outbreaks (2014 and 2016) reported in many areas, EV-D68 circulation remains largely unexplored in Africa except in Senegal, where low levels of EV-D68 circulation were first noted during the 2014 outbreak. Here we investigate subsequent epidemiology of EV-D68 in Senegal from June to September 2016 by screening respiratory specimens from ILI and stool from AFP surveillance. EV-D68 was detected in 7.4% (44/596) of patients; 40 with ILI and 4 with AFP. EV-D68 detection was significantly more common in children under 5 years (56.8%, p = 0.016). All EV-D68 strains detected belonged to the newly defined subclade B3. This study provides the first evidence of EV-D68 B3 subclade circulation in Africa from patients with ILI and AFP during a 2016 outbreak in Senegal. Enhanced surveillance of EV-D68 is needed to better understand the epidemiology of EV-D68 in Africa.

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