First description and phylogenetic analysis of coxsackie virus A non‐polio enteroviruses and parechoviruses A in South Sudanese children

Abstract

Enteroviruses (EV) and parechoviruses A (PeV‐A) are commonly circulating viruses able to cause severe disease. Surveillance studies from sub‐Saharan Africa are limited and show high but variable infection rates and a high variation in genotypes. This is the first study to describe EV and PeV‐A circulation in children in South Sudan. Of the fecal samples collected, 35% and 10% were positive for EV and PeV‐A, respectively. A wide range of genotypes were found, including several rarely described EV and PeV‐A types. Coxsackie virus A (CVA) EV‐C types, particularly CVA13, were the most dominant EV types. The CVA13 types had a high diversity with the majority belonging to four different previously described clusters. PeV‐A1 and ‐A14 were the most common PeV‐A genotypes. A lack of representative data from our and other studies from sub‐Saharan Africa demonstrates the need for more systematic surveillance of non‐polio EV and PeV‐A types in this region.

Global landscape of coxsackieviruses in human health

“…On the other hand, among healthy infants and AFP patients in African countries, a wide circulation of several CV types and lineages from EV-C species was found, especially CVA13, demonstrating a significant intratypic diversity ( Sadeuh-Mba et al, 2013 ). Apart from CVA13, studies have also reported high detection rates of CVA11, CVA17, CVA20, CVA21, and CVA24 in these countries, in contrast to prevalent types in Europe, America, and Asia ( Couderé et al, 2023 ; Rakoto-Andrianarivelo et al, 2005 ; Silva et al, 2008 ). Interestingly, enterovirus C circulating strains may favor the emergence of recombinant cVDPVs in areas where OPVs are massively used.…”

“…A 28-year follow-up investigation carried out in a Finnish cohort of CNS infection revealed an increased risk of adult-onset schizophrenia and other psychoses in CVB5-infection patients during the newborn period ( Rantakallio et al, 1997 ). Recently, CVA13 was the most prevalent EV-type detected in patients with Nodding syndrome, a rare epileptic disorder of unknown cause occurring in sub-Saharan Africa ( Couderé et al, 2023 ).…”