Can Non-Polio Enteroviruses Be Tamed with a Vaccine to Minimize Paralysis Caused by Them?

Background: While we are inching towards global eradication of polio, the paralysis due to non-polio viruses (NPEV) poses greater challenge. Factors responsible for causing Acute Flaccid Paralysis (AFP) were studied in 3596 AFP patients in 64 districts of Uttar-Pradesh, India, to observe indirect relationship of AFP with wild polio as well as NPEV. A recent study suggests the need to investigate polio virus negative but NPEV positive AFP cases. Methods: The lab results of the stool samples of these children were line listed and analysed to observe the association of various factors with respect to presence of paralysis on 60 follow-up days. Taking zero OPV dose AFP cases as a biological base, we studied the relationship of presence of paralysis at 60 follow-up days to that of presence of NPEV in stool samples while polio virus was present or absent. Results: 70 of the 86 AFP cases (81%) with zero OPV dose and having only NPEV isolated in stool samples were having paralysis at 60 follow-up days. There were 4.54% (162) AFP cases, which did not carry any polio virus but were having NPEV isolated in the stool samples and paralysis at 60 follow-up days. 79% (75/95) of zero OPV dose children, who were having residual weakness at 60 follow-up days, were carrying both polio virus as well as NPEV in their stool samples. Total AFP cases, having residual weakness at 60 follow-up days and having NPEV in stool samples, decreased with increase in OPV doses;a behavior similar to what wild polio viruses (WPV) have to OPV. Conclusions: Maybe polio like NPEV is active for causing severe paralysis in children and is responding to the OPV. As is evident in the studies by M. Margalith, B. Fattal et al. [1] that there is an antibody response to the enteroviruses, we can think of coming out with a vaccine against the enteroviruses. Therefore, enterovirus vaccine can be produced on similar lines to that of OPV, as now we have enough isolates of NPEV. Effective NPEV surveillance system also needs to be in place.

山东省急性弛缓性麻痹病例非脊髓灰质炎肠道病毒感染监测分析

[目的 ]了解山东省急性弛缓性麻痹 (AFP)病例非脊灰肠道病毒 (NPEV)的感染情况。 [方法 ]按照WHO规定的方法 ,对山东省 1 998～2 0 0 1年所有AFP病例的大便标本均采用RD、Hep 2和L2 0B细胞进行病毒分离鉴定。 [结果 ]共分离出 1 4 6株NPEV ,其中艾柯 (Echo)病毒占 56 1 6 % ,病毒型别分布广泛 ,夏秋季为NPEV流行高峰 ;5岁以下儿童分离率最高 ;多数NPEV感染者麻痹前均伴有发热、腹泻、颈项强直和肌肉疼痛 ,麻痹部位以单下肢、双下肢、四肢麻痹为主 ,发病60d后随访 2 7 40 %的病例仍残留麻痹 ;1 4 6例NPEV阳性的AFP病例中 ,疫苗相关病例 (VAPP) 1例 ,格林巴利综合征(GBS) 60例 ,脑脊髓炎 1 0例 ,其他非脊灰病例 75例 ;RD细胞对NPEV的分离率高于Hep 2细胞的分离率。 [结论 ]NPEV在山东省AFP病例中具有较高的感染率 。

贵州省急性弛缓性麻痹病例非脊髓灰质炎肠道病毒感染监测分析

目的了解贵州省急性弛缓性麻痹(AFP)病例非脊灰肠道病毒(NPEV)的感染情况。方法按照WHO规定的方法,对贵州省2004-2005年所有AFP病例的大便标本均采用RD、Hep-2和L20B细胞进行病毒分离鉴定。结果共分离出55株NPEV,其中艾柯(Echo)病毒占45.5%,病毒型别分布广泛,夏秋季为NPEV流行高峰;≤5岁儿童分离率最高。发病60d后随访23.6%的病例仍残留麻痹;55例NPEV阳性的AFP病例中,临床诊断以格林巴利综合征(GBS)13例,创伤性神经炎13例,不明原因瘫痪11例,单神经炎7例所占比例较高;RD细胞对Echo病毒敏感,Hep-2细胞对CoxB病毒敏感。结论 NPEV在贵州省AFP病例中具有较高的感染率,在无脊灰证实以后应加强NPEV感染与AFP病因学的研究。

Global study of viral myocarditis: A systematic review and meta-analysis

Objective:To investigate the prevalence of viral myocarditis worldwide.Methods:We conducted a systematic search for the prevalence of the most common viruses in myocarditis and 75 studies were included for statistical analysis of the prevalence of adenovirus,hepatitis C virus,cytomegalovirus,Ebola virus,human herpesvirus 6,influenza virus,parvovirus,and non-polio enteroviruses.Results:The highest prevalence was related to B19(25.0%)and non-polio enteroviruses(18%).The prevalence of human herpesvirus 6,cytomegalovirus,and Ebola virus was12.8%,5.5%,and 3.1%,respectively.Hepatitis C virus accounted for 6.1%of the disease,the adenoviruses contributed to 5.2%of viral myocarditis.The lowest incidence was related to the influenza virus with 2.0%.Conclusions:Treatment of myocarditis is still problematic and may depend on the etiologic diagnosis.So it is important to know the commonly occurring viral factors in myocarditis and timely diagnosis and treatment are also imperative.

青海省2008-2010年AFP病例和健康儿童NPEV监测分析

目的对青海省2008-2010年急性迟缓型麻痹(AFP)病例和健康儿童非脊髓灰质炎肠道病毒(NPEV)监测结果进行分析。方法按WHO规定的方法对青海省2008-2010年AFP病例监测系统报告的所有病例和393份健康儿童的粪便标本均采用RD、Hep-2和L20B细胞进行病毒分离,对分离到的NPEV进行型别鉴定。结果 3年共分离到86株NPEV,分别为柯萨奇B组病毒(COXB)12株、埃可病毒(ECHO)42株、不能定型32株。结论青海省2008-2010年分离到的NPEV主要为埃可病毒,未分离到柯萨奇A组病毒。

福建省2000—2012年AFP阳性病例流行病学特征

目的了解福建省在无脊髓灰质炎后,病毒分离阳性的AFP病例流行特征。方法对2000—2012年病毒分离阳性的AFP病例进行流行病学分析。结果 13年共报告AFP病例1 822例,年均发病率1.70/10万。共采集1 807例标本进行病毒分离,PV阳性4.6%,NPEV阳性11.1%,PV+NPEV混合阳性0.4%,阴性83.9%。PV组中,<1岁占44.6%,流动人口占10.8%,未全程免疫占24.1%,残留麻痹率27.7%,均高于其他组;NPEV组中,<1岁仅占9.5%,流动人口仅占2.5%,未全程免疫仅占9.0%,残留麻痹率仅12.4%。结论在维持无脊灰阶段,需继续提高口服脊灰疫苗(OPV)覆盖率,重点是流动儿童和边远山区儿童。加强NPEV防控亦可减少AFP病例及致残率。

辽宁省1990～2005年非脊髓灰质炎肠道病毒逆转录-聚合酶链反应鉴定及其病例的流行病学分析

目的了解辽宁省急性弛缓性麻痹(AFP)病例中非脊髓灰质炎肠道病毒(NPEV)感染的情况。方法用逆转录-聚合酶链反应(RT-PCR)对NPEV进行鉴定,并对NPEV感染病例进行流行病学分析。结果辽宁省1990～2005年AFP病例中共有98例NPEV感染病例,NPEV分离率为7.8%。其中67.3%的病例为4岁以下儿童;59.2%的病例出现在6～8月;主要临床表现有发热(56.2%)、肌肉疼痛(29.6%)、腹泻(12.2%);58.2%的NPEV感染病例被诊断为格林-巴利综合征(GBS)。结论用RT-PCR方法鉴定NPEV快速、简单、经济、特异性强;NPEV可能是GBS的重要病因之一。