Dados do Trabalho

Título

Characterization of Non-Polio Enteroviruses in children with acute flaccid paralysis in São Paulo State, 2022-2023

Introdução

Acute Flaccid Paralysis (AFP) is a clinical syndrome characterized by the sudden onset of limb weakness, typically linked to poliovirus types 1, 2, and 3 (poliomyelitis). In 1994, Brazil was certified by the World Health Organization (WHO) and the Pan American Health Organization (PAHO) as free from Wild Poliovirus. However, the virus still persists in Asian regions, such as Afghanistan and Pakistan, creating a risk of reintroduction into the country. In response, WHO implemented a strategic plan for the global eradication of poliomyelitis, focusing on childhood vaccination and active case investigation. Concurrently, the introduction and circulation of Non-Polio Enteroviruses (NPEV) in suspected AFP cases are monitored, reflecting the importance of these viruses in the post-polio era.

Objetivo (s)

The aim of this study was to determine the genotypes of NPEV detected in children with AFP during the Poliomyelitis Epidemiological Surveillance.

Material e Métodos

Between 2022 and 2023, one-stool sample collected from 276 children under 15 years of age from the AFP Surveillance Program in the state of São Paulo was sent to the Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute - State Reference Laboratory for Enteroviruses. Subsequently, original vial these specimens were sent to the National Reference Laboratory of AFP/Poliomyelitis, FIOCRUZ, Rio de Janeiro, to carry out the poliovirus research by cell culture isolation as per the WHO algorithm.  Among 246 cases, 5.4% (n=15) were positive for NPEV, and 1.4% for vaccine poliovirus type 3, Sabin-like (n=4). All NPEV strains were selected for this study and further were typed by Enteric Diseases Laboratory, Adolfo Lutz Institute, using sequencing of partial region of VP1 (viral protein 1).

Resultados e Conclusão

Of the NPEV strains analysed, 53% were genotyped by the State Reference Laboratory for Enteroviruses, Enteric Diseases Unit at the Adolfo Lutz Institute, identifying the presence of Echovirus 3 (E3) and E30, Coxsackievirus A19 (CVA19), Coxsackievirus B1 (CVB1), and CVB4. This research highlights the importance of epidemiological and laboratory surveillance in monitoring NPEV in cases of AFP, which is vital for effectively controlling these infections in the post-polio era. The analysis of epidemiological and clinical data enhances AFP surveillance in Brazil and demonstrates the genetic diversity of circulating NPEVs in São Paulo State. Grants: FAPESP 2018/21193-5; FESIMA SES-PRC-2023/10783, CAF n.º: 011/2023

Palavras Chave

non-polio enteroviruses; acute flaccid paralysis; molecular epidemiology