Molecular characterization of non-polio enteroviruses isolated from acute flaccid paralysis patients in Uganda

J Med Virol. 2021 Aug;93(8):4720-4728. doi: 10.1002/jmv.26804. Epub 2021 Feb 9.

Abstract

Enteroviruses (EVs) are RNA viruses that can cause many clinical syndromes including acute flaccid paralysis (AFP). Within the global polio laboratory network, EVs are categorized either as polioviruses or non-polio enteroviruses (NPEVs). Specific NPEVs have been described in polio-like residual paralytic events in AFP patients. Retrospective analysis of 112 NPEV isolates from AFP patients was performed and thirty one NPEV types were identified of which 91% were Enterovirus B and 9% were Enterovirus A species. The NPEVs were distributed across the country with most patients in the eastern region (41/89; 46.1%). The highest proportion of patients were children less than 5 years (77/89; 86.5%) and male patients were more common (54/89; 60.7%). Echovirus 11 (11/89; 12.4%) was frequently observed and phylogenetic analysis of these sequences revealed high diversity. Coxsackievirus B5 (CV-B5), CV-B6, E21, and EV-B69 were only seen in patients with residual paralysis. Analyses of the EV-A71 sequence indicated a unique genogroup.

Keywords: Non polio enteroviruses; acute flaccid paralysis; residual paralysis; semi-nested PCR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Central Nervous System Viral Diseases / epidemiology
  • Central Nervous System Viral Diseases / virology*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Enterovirus / classification
  • Enterovirus / genetics*
  • Enterovirus / isolation & purification*
  • Enterovirus Infections / epidemiology
  • Enterovirus Infections / virology*
  • Epidemiological Monitoring
  • Feces / virology
  • Female
  • Genetic Variation
  • Genotype*
  • Humans
  • Male
  • Myelitis / epidemiology
  • Myelitis / virology*
  • Neuromuscular Diseases / epidemiology
  • Neuromuscular Diseases / virology*
  • Phylogeny*
  • Poliomyelitis / virology
  • Retrospective Studies
  • Sequence Analysis, DNA
  • Sex Factors
  • Uganda / epidemiology

Supplementary concepts

  • acute flaccid myelitis