Key result
Enterovirus excretion persists up to 946 days across multiple serotypes in patient stool samples.
Why the study?
Enteroviruses can cause severe clinical outcomes in patients with primary immunodeficiency due to an impaired ability to clear infections, warranting characterization of excretion, circulating serotypes, and genetic diversity.
Observational (n=138)
Tunisian patients with primary immunodeficiency exhibit prolonged enterovirus excretion with diverse serotypes, highlighting the need for ongoing molecular surveillance.
Answers are grounded in this paper and cite their sources.
Prolonged excretion in primary immunodeficiency supports surveillance; leaves open transmission risks and serotype evolution.
Enteroviruses (EVs) are small, non-enveloped RNA viruses that can cause diverse clinical outcomes, particularly severe in patients with primary immunodeficiency (PID) due to their impaired ability to clear infections. This study aimed to characterize EV excretion among 138 Tunisian PID patients over a five-year period, to identify circulating EV serotypes and assess their genetic diversity. A total of 558 stool samples were collected and analyzed by virus isolation and intratypic differentiation using RT-qPCR. Molecular typing was performed through Sanger sequencing of the VP1 region and whole genome sequencing using Next-Generation Sequencing (NGS) technologies. Phylogenetic analysis was conducted using the Maximum Likelihood (ML) method. EVs were detected in 55 stool samples from 23 patients. The excretion kinetics of EVs ranged between 30 and 946 days. Thirteen serotypes were identified, including one Poliovirus (PV) and twelve Non-Polio Enteroviruses (NPEVs), predominantly belonging to species B. Two previously unreported serotypes in Tunisia were detected: Coxsackievirus A5 (CVA5) and Echovirus type 19 (E19). In addition, five patients presented enhanced susceptibility to the excretion of successive EV serotypes, and one patient exhibited a co-infection. A possible recombination event was identified in one patient involving Coxsackievirus B5 (CVB5), Coxsackievirus A9 (CVA9) and Coxsackievirus B1 (CVB1) sequences. Phylogenetic analysis showed close genetic relationships with European, American and Asian strains. These findings underscore the dynamic nature of EV circulation and the importance of ongoing molecular surveillance to detect emerging serotypes and guide public health strategies.
No takes yet. Share an insight, caveat, or question.
Salem et al. (2026) conducted an observational in Primary immunodeficiency (n=138). Enterovirus infection was evaluated on Enterovirus detection and excretion kinetics. Enterovirus excretion was detected in 23 of 138 Tunisian patients with primary immunodeficiency, with excretion kinetics ranging from 30 to 946 days and 13 distinct serotypes identified.
Synapse has enriched 10 related papers. Consider them for comparative context: