title: Characterization of the non-polio enterovirus infections associated with acute flaccid paralysis in South-Western India.
abstract: Non-polio enteroviruses (NPEVs) have been reported frequently in association with acute flaccid paralysis (AFP) cases during Polio Surveillance Programs (PSPs) worldwide. However, there is limited understanding on the attributes of their infections. This study reports characteristics of NPEVs isolated from AFP cases, investigated during PSPs held in 2009-2010, in Karnataka and Kerala states of south-western India having varied climatic conditions. NPEV cell culture isolates derived from stool specimens that were collected from 422 of 2186 AFP cases (<1-14 years age) and 17 of 41 asymptomatic contacts; and details of all AFP cases/contacts were obtained from National Polio Laboratory, Bangalore. The distribution of NPEV infections among AFP cases and circulation pattern of NPEV strains were determined by statistical analysis of the data. Genotyping of all NPEV isolates was carried out by partial VP1 gene sequencing and phylogenetic analysis. NPEV positive AFP cases were significantly higher in children aged <2 years; with residual paralysis; in summer months; and in regions with relatively hot climate. Genotyping of NPEVs identified predominance of human enteroviruses (HEV)-B species [81.9%-Echoviruses (E): 57.3%; coxsackieviruses (CV) B: 15%; numbered EVs: 8.9%; CVA9: 0.7%] and low levels of HEV-A [14.5%-CVA: 6%; numbered EVs: 8.5%] and HEV-C [3.6%-CVA: 2.6%; numbered EVs: 1%] species, encompassing 63 genotypes. EV76 (6.3%) and each of E3, CVB3 and E9 (4.97%) were found frequently during 2009 while E11 (6.7%), CVB1 (6.1%), E7 (5.1%) and E20 (5.1%) were detected commonly in 2010. A marked proportion of AFP cases from children aged <2 years; presenting with fever; and from north and south interior parts of Karnataka state was detected with E/numbered EVs than that found with CVA/CVB. This study highlights the extensive genetic diversity and diverse circulation patterns of NPEV strains in AFP cases from different populations and climatic conditions.
authors: Enteric Viruses Group, National Institute of Virology, Pune, India.
authors: Rongala
authors: R
authors: Laxmivandana
authors: Prasanna
authors: P
authors: Yergolkar
authors: Varanasi
authors: V
authors: Gopalkrishna
authors: Shobha D
authors: SD
authors: Chitambar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000818:Animals; D002460:Cell Line; D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000235:genetics* / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000821:virology; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D051379:Mice; D010243:Paralysis / Q000453:epidemiology* / Q000821:virology; D010802:Phylogeny; D015995:Prevalence; D012621:Seasons; D017422:Sequence Analysis, DNA; D014764:Viral Proteins / Q000235:genetics
chemical_list: D014764:Viral Proteins
references: J Med Virol. 2009 Feb;81(2):317-24
references: 19107980
references: Epidemiol Rev. 2000;22(2):298-316
references: 11218380
references: Emerg Infect Dis. 2003 Sep;9(9):1082-8
references: 14519244
references: J Med Virol. 2003 May;70(1):81-5
references: 12629647
references: J Med Virol. 2012 Nov;84(11):1803-8
references: 22997084
references: Virus Res. 2009 Jan;139(1):32-8
references: 19013201
references: J Med Virol. 2006 Jan;78(1):98-104
references: 16299728
references: Curr Opin Infect Dis. 2003 Oct;16(5):375-81
references: 14501988
references: J Med Virol. 2012 Apr;84(4):624-31
references: 22337302
references: Intervirology. 1974;4(2):119-27
references: 4217326
references: Indian J Med Res. 2004 Apr;119(4):149-56
references: 15147120
references: Afr J Med Med Sci. 2010 Dec;39 Suppl:201-8
references: 22416664
references: J Clin Microbiol. 2006 Aug;44(8):2698-704
references: 16891480
references: J Clin Microbiol. 1999 May;37(5):1288-93
references: 10203472
references: Public Health Rep. 2009 May-Jun;124(3):471-4
references: 19445426
references: Indian J Med Ethics. 2012 Apr-Jun;9(2):114-7
references: 22591873
references: Expert Rev Mol Diagn. 2007 Jul;7(4):419-34
references: 17620049
references: Mol Biol Evol. 2011 Oct;28(10):2731-9
references: 21546353
references: Virol J. 2010 Oct 20;7:277
references: 20959020
references: J Paediatr Child Health. 2009 Jul-Aug;45(7-8):409-13
references: 19712176
references: Diagn Microbiol Infect Dis. 2006 Jan;54(1):31-6
references: 16290030
references: J Microbiol Immunol Infect. 2005 Dec;38(6):417-24
references: 16341342
references: N Engl J Med. 1999 Sep 23;341(13):936-42
references: 10498488
references: J Med Microbiol. 2005 Jan;54(Pt 1):1-2
references: 15591247
references: J Virol Methods. 2010 May;165(2):330-2
references: 20214926
references: BMC Infect Dis. 2007 Feb 15;7:6
references: 17300736
references: Indian J Pediatr. 2001 Oct;68(10):927-9
references: 11758127
references: Emerg Infect Dis. 2012 Nov;18(11):1833-40
references: 23092622
references: Indian J Pediatr. 2005 Mar;72(3):267; author reply 267-8
references: 15812129
references: J Neurovirol. 2005 Oct;11(5):424-33
references: 16287683
references: Roum Arch Microbiol Immunol. 2009 Jan-Mar;68(1):20-6
references: 19507623
references: Bull World Health Organ. 1995;73(5):597-603
references: 8846485
references: Clin Rev Allergy Immunol. 2012 Apr;42(2):121-30
references: 20890797