Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Department of Medical Sciences, National Institute of Health, MOPH, Nonthaburi, Thailand.
Virol J. 2021 Jul 23;18(1):153. doi: 10.1186/s12985-021-01621-0.
Acute flaccid paralysis (AFP) surveillance was conducted as part of the World Health Organization's strategy for completely eradicating poliomyelitis and leaving non-polio enteroviruses NPEVs as one of the main potential causes of AFP. We aimed to detect NPEV in association with AFP.
We used 459 isolates reported to be Negative Polio and some NPEVs by the World Health Organization Polio Regional Reference Laboratory (Thailand), which had been obtained during polio surveillance programmes conducted in Thailand in 2013-2014. Of 459 isolates, 35 belonged to the genus Enterovirus by RT-PCR and genotyping by DNA sequencing.
This study found 17 NPEV genotypes, with 3, 13 and 1 belonging to enterovirus (EV) species A (EV-A), EV-B, and EV-C, respectively. The EV-A types identified included coxsackievirus A2 (CA2), CA4, and EV71, typically associated with hand, foot and mouth diseases. EV-B is the most prevalent cause of AFP in Thailand, while CA21 was the only type of EV-C detected. The EV-B species (13/35; 76.5%) constituted the largest proportion of isolates, followed by EV-A (3/35; 17.6%) and EV-C (1/35; 5.9%). For the EV-B species, Echovirus (E) 30 and CVB were the most frequent isolates. E30, CVB, E14, and E6 were considered endemic strains.
NPEVs, e.g. CA4, are reported for the first time in Thailand. Despite some limitations to this study, this is the first report on the circulation patterns of NPEVs associated with AFP in Thailand. AFP surveillance has unearthed many unknown NPEVs and, the cases of death due to AFP occur annually. Therefore, it is important to study NPEVs in the wake of the eradication of poliovirus in the context of the continued incidence of paralysis.
急性弛缓性麻痹（AFP）监测是世界卫生组织根除脊髓灰质炎战略的一部分，该战略将非脊髓灰质炎肠道病毒（NPEV）视为 AFP 的主要潜在病因之一。我们旨在检测与 AFP 相关的 NPEV。
我们使用了世界卫生组织脊髓灰质炎区域参考实验室（泰国）报告的 459 株被认为是无脊灰和一些 NPEV 的分离株，这些分离株是在 2013-2014 年期间在泰国进行的脊髓灰质炎监测计划中获得的。在 459 株分离株中，35 株通过 RT-PCR 和 DNA 测序进行基因分型被归为肠道病毒属。
本研究发现了 17 种 NPEV 基因型，其中 3、13 和 1 种分别属于肠道病毒（EV）A 种（EV-A）、EV-B 和 EV-C。鉴定的 EV-A 型包括柯萨奇病毒 A2（CA2）、CA4 和 EV71，通常与手足口病有关。EV-B 是泰国 AFP 最常见的病因，而 CA21 是唯一检测到的 EV-C 型。EV-B 种（13/35；76.5%）构成了分离株的最大比例，其次是 EV-A（3/35；17.6%）和 EV-C（1/35；5.9%）。对于 EV-B 种，Echovirus（E）30 和 CVB 是最常见的分离株。E30、CVB、E14 和 E6 被认为是地方性菌株。
例如 CA4 的 NPEV 首次在泰国报道。尽管本研究存在一些局限性，但这是泰国首次报告与 AFP 相关的 NPEV 循环模式。AFP 监测发现了许多未知的 NPEV，并且 AFP 每年都会导致死亡。因此，在根除脊髓灰质炎的背景下，研究 NPEV 对于持续发生的麻痹病例非常重要。
