Emerging Non-Polio Enteroviruses recognized in the framework of the Acute Flaccid Paralyses (AFP) surveillance system in Northern Italy, 2016-2018.


Journal

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933

Informations de publication

Date de publication:
May 2021
Historique:
received: 15 12 2020
revised: 16 03 2021
accepted: 18 03 2021
pubmed: 28 3 2021
medline: 5 6 2021
entrez: 27 3 2021
Statut: ppublish

Résumé

Acute Flaccid Paralyses Surveillance (AFPS) monitors the emergence of polioviruses and can track Non-Polio Enteroviruses (NPEVs). We report AFPS activity in the Lombardy region (Northern Italy) from 2016 to 2018. Fecal and respiratory samples were collected from children <15 years who met the WHO definition of an AFP case, analyzed by virus isolation in cell cultures (RD/L20B) and by a one-step real-time RT-PCR assay specific for the 5'-noncoding-region of NPEV. NPEV-positive specimens were further analyzed by sequencing a fragment of the VP1 gene. 36 AFP cases (89 stool and 32 respiratory samples) were reported with an incidence of 1.1/100'000, 0.9/100'000, 0.6/100'000 children <15 years in 2016, 2017, 2018, respectively. Poliovirus was not identified, whereas NPEVs were detected in 19.4% (7/36) of AFP cases. The presence of one Echovirus-25 (2016), two EV- and D68 (2016 and 2018), one EV-A71 (2016), and one Echovirus-30 (2016) sharing high nucleotide identity with NPEVs detected in Europe was identified. The absence of polio was confirmed. The unpredicted detection of emerging EV-D68, EV-A71, and E-30 sharing high sequence nucleotide similarity with viruses involved in the latest outbreaks, provided valuable and up-to-date information, emphasizing the importance of monitoring NPEVs through AFPS.

Sections du résumé

BACKGROUND BACKGROUND
Acute Flaccid Paralyses Surveillance (AFPS) monitors the emergence of polioviruses and can track Non-Polio Enteroviruses (NPEVs). We report AFPS activity in the Lombardy region (Northern Italy) from 2016 to 2018.
METHODS METHODS
Fecal and respiratory samples were collected from children <15 years who met the WHO definition of an AFP case, analyzed by virus isolation in cell cultures (RD/L20B) and by a one-step real-time RT-PCR assay specific for the 5'-noncoding-region of NPEV. NPEV-positive specimens were further analyzed by sequencing a fragment of the VP1 gene.
RESULTS RESULTS
36 AFP cases (89 stool and 32 respiratory samples) were reported with an incidence of 1.1/100'000, 0.9/100'000, 0.6/100'000 children <15 years in 2016, 2017, 2018, respectively. Poliovirus was not identified, whereas NPEVs were detected in 19.4% (7/36) of AFP cases. The presence of one Echovirus-25 (2016), two EV- and D68 (2016 and 2018), one EV-A71 (2016), and one Echovirus-30 (2016) sharing high nucleotide identity with NPEVs detected in Europe was identified.
CONCLUSION CONCLUSIONS
The absence of polio was confirmed. The unpredicted detection of emerging EV-D68, EV-A71, and E-30 sharing high sequence nucleotide similarity with viruses involved in the latest outbreaks, provided valuable and up-to-date information, emphasizing the importance of monitoring NPEVs through AFPS.

Identifiants

pubmed: 33771675
pii: S1201-9712(21)00275-7
doi: 10.1016/j.ijid.2021.03.057
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

36-40

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

Laura Pellegrinelli (L)

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. Electronic address: laura.pellegrinelli@unimi.it.

Cristina Galli (C)

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.

Valeria Primache (V)

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.

Laura Bubba (L)

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.

Gabriele Buttinelli (G)

Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.

Paola Stefanelli (P)

Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.

Elena Pariani (E)

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.

Sandro Binda (S)

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.

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Classifications MeSH