Clinical and enterovirus findings associated with acute flaccid paralysis in the republic of Korea during the recent decade

Abstract

Acute flaccid paralysis (AFP) is described as sudden onset of flaccid paralysis in one or more limbs in children caused by polioviruses (PVs). PV eradication is achieved through intensive immunization and AFP attentive surveillance, according to the World Health Organization. Since 1998, the Korea Centers for Disease Control and Prevention has conducted surveillance system. This is an overview of surveillance in the Republic of Korea during the 10-year period from 2002 to 2011. The surveillance system for wild PV eradication was conducted through reporting and laboratory testing. Cell culture isolates were identified by neutralization tests using standard polyclonal antisera typing. The molecular methods were used for further characterization to improve specificity. For genotyping, semi-nested RT-PCR was used to amplify part of the viral protein 1 gene. Patients below 5 years of age accounted for the largest proportion of cases, and a positive association between age and incidence was found. In the total 285 cases, Guillain-Barré syndrome was the major leading causes of AFP. Non-polio enterovirus was detected in some AFP patients. EV71 was detected in 21 cases and Coxsackievirus (C) A2, CA6, CA9, CB2, CB3, CB4, CB5, and Echovirus (E) 25, E30, Sabin strain polio 2, polio 1 and 3 were also detected in some patients. The present study represents a comprehensive 10-year country-based survey of AFP in the Republic of Korea. This surveillance could provide better understanding of the epidemiologic pattern, and clinical manifestations associated with specific genotypes of AFP in the Republic of Korea.

Neurotropic Enterovirus Infections in the Central Nervous System

“…Most patients with flaccid paralysis only partially recover, and some of them show persistent weakness. Furthermore, other enteroviruses, such as coxsackievirus and echovirus, were also detected in flaccid paralysis patients, although their incidence is low [ 21 ]. Guillain-Barre syndrome (GBS) is an inflammatory pathologic condition; the typical sign for this disease is acute inflammatory demyelinating polyradiculoneuropathy, which is usually present days after respiration of the gastrointestinal illness.…”

A national cross-sectional study for poliovirus seroprevalence in the Republic of Korea in 2012: implication for deficiency in immunity to polio among middle-aged people

“…Although WPV has not been detected since Korea was declared WPV-free in 2001 [ 12 ], the Korean population could be at risk of infection through the importation of WPV or vaccine-derived PV, similar to what has been reported in England and Wales [ 17 ]. Therefore, in this study, we evaluated the seroprevalence of neutralizing antibodies to PV1, PV2, and PV3 in broad age groups in the Republic of Korea.…”

“…The immunization of PV is given three times to all infants at 2, 4, and 6–18 months of age, followed by a booster shot before school entry at between 4 and 6 years of age [ 10 ]. The immunization level for PV has been sustained at an estimated 90–95% since 1980 [ 12 ]; however, the seroprevalence of anti-PV antibodies has not been investigated in the Republic of Korea since the introduction of the IPV. Therefore, this study was designed to estimate the level of immunity against PV1, PV2, and PV3 in broad age groups, ranging from 6 to 84 years of age, in the Republic of Korea.…”

Evolutionary phylogeography and transmission pattern of echovirus 14: an exploration of spatiotemporal dynamics based on the 26-year acute flaccid paralysis surveillance in Shandong, China

“…For the detection of circulating EVs, AFP surveillance has also provided a major source of information in China, as specialized EV surveillance based on other approaches or populations was still very limited. In addition, studies conducted in other countries [18, 22–27] also described the NPEV serotypes identified from the AFP surveillance, and the information had attracted more attention of the scholars worldwide.…”