Dados do Trabalho

Título

Genotyping of non-polio enteroviruses associated with acute flaccid paralysis in São Paulo State, Brazil, from 2001 to 2021. Detection of Species Enterovirus A, B and C.

Introdução

Acute Flaccid Paralysis (AFP) is the most common clinical presentation of infection caused by poliovirus 1, 2 and 3 (poliomyelitis). In Brazil, the last case of wild poliovirus was reported in 1989, and the country has been certified by the World Health Organization (WHO) as free of wild poliovirus since 1994. The global eradication of wild poliovirus is very close, for this reason non-polio enteroviruses (NPEV) assume an increasingly relevant role in cases of AFP and others diseases of public health relevance Enteroviruses comprise a diverse group of viruses with multiple genotypes. By studying the genotypes of enteroviruses we can gain valuable insights into the epidemiology of these viruses.

Objetivo (s)

The present study aims to describe the types of isolated NPEVs, their diversity, and the epidemiological aspects associated with AFP infections in paediatric patients from São Paulo State, Brazil, over a 21-year period of surveillance.

Material e Métodos

Between 2001 and 2021, one-stool sample collected from 1,597 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. Among 1,597 cases AFP, NPEV was detected in 6.9% of the samples analysed over the 21-year surveillance period. A total of one hundred (90.1%, n=100/111) NPEV strains were selected for this study and further was typed by Enteric Diseases Laboratory Adolfo Lutz Institute using molecular methods and sequencing of partial region of VP1 (viral protein 1).

Resultados e Conclusão

Out of 100 NPEV-positive samples, 90 (90.0 %) could be genotyped. Of those, 53 (58.9%) were assigned to EV-B species, 25 (27.8%) were assigned to EV-A, and 12 (13.3%) were assigned to EV-C, which comprised 17, 9, and 5 genotypes, respectively. This study reports the circulating strains distinct of 31 types of NPEV during the period analysed. EV-A71, CVB2 and E11 were the main circulating NPEVs in the Sao Paulo State, and first evidence of CVA19 in Brazil. The analysis of epidemiological and clinical data contributes to the AFP surveillance in South America and showed high genetic diversity of circulating NPEV.

Palavras-chave

Non-polio enteroviruses, acute flaccid paralysis, molecular epidemiology.

Agradecimentos

Support: FAPESP 2017/05350-0.