Key result
Nonpolio enteroviruses were detected in 29.5% of children with nonpolio acute flaccid paralysis compared to 2.6% of healthy controls, with 66 distinct serotypes identified, most frequently EV71.
Observational (n=3,566)
Yes
A highly diverse spectrum of 66 nonpolio enterovirus serotypes, predominantly enterovirus 71, is associated with nonpolio acute flaccid paralysis in India, highlighting the need for continued surveillance post-polio eradication.
Because of the broadened acute flacid paralysis (AFP) definition and enhanced surveillance, many nonpolio AFP (NP-AFP) cases have been reported in India since 2005. To determine the spectrum of nonpolio enterovirus (NPEV) serotypes associated with NP-AFP from polio-endemic and -free regions, we studied antigenic diversity of AFP-associated NPEVs. Of fecal specimens from 2,786 children with NP-AFP in 1 polio-endemic and 2 polio-free states, 823 (29.5%) were positive for NPEVs in RD cells, of which 532 (64.6%) were positive by viral protein 1 reverse transcription PCR. We identified 66 serotypes among 581 isolates, with enterovirus 71 most frequently (8.43%) detected, followed by enterovirus 13 (7.1%) and coxsackievirus B5 (5.0%). Most strains within a serotype represented new genogropups or subgenogroups. Agents for ≈35.0% and 70.0% of culture-positive and -negative cases, respectively, need to be identified. Association of human enterovirus with NP-AFP requires better assessment and understanding of health risks of NPEV infections after polio elimination.
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Rao et al. (2012) conducted an observational in Nonpolio acute flaccid paralysis (NP-AFP) (n=3,566). Nonpolio enterovirus (NPEV) infection vs. Healthy children without acute flaccid paralysis was evaluated on NPEV positivity in cell culture. Nonpolio enteroviruses were detected in 29.5% of children with nonpolio acute flaccid paralysis compared to 2.6% of healthy controls, with 66 distinct serotypes identified, most frequently EV71.
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