Original Research

Description of non-polio enteroviruses identified in two national surveillance programmes in South Africa

Wayne Howard, Dana Savulescu, Leigh Berrie, Adrian J. Puren
Southern African Journal of Infectious Diseases | Vol 35, No 1 | a196 | DOI: https://doi.org/10.4102/sajid.v35i1.196 | © 2020 Wayne Howard, Dana Savulescu, Leigh Berrie, Adrian J. Puren | This work is licensed under CC Attribution 4.0
Submitted: 13 March 2020 | Published: 15 December 2020

About the author(s)

Wayne Howard, National Institute for Communicable Diseases, Johannesburg, South Africa; and Faculty of Health, University of Witwatersrand, Johannesburg, South Africa
Dana Savulescu, National Institute for Communicable Diseases, Johannesburg, South Africa
Leigh Berrie, Faculty of Health, University of Witwatersrand, Johannesburg, South Africa; and National Priority Programmes, National Health Laboratory Services, Johannesburg, South Africa
Adrian J. Puren, National Institute for Communicable Diseases, Johannesburg, South Africa; and Faculty of Health, University of Witwatersrand, Johannesburg, South Africa


Share this article

Bookmark and Share

Abstract

Background: Human enteroviruses (EV) consist of 106 serotypes and four species: EV-A, EV-B, EV-C and EV-D. Enteroviruses cause clinical symptoms varying from severe to mild. Knowledge of EV burden in South Africa is limited, and as non-polio EV are important causes of acute flaccid paralysis (AFP) and meningitis, information on the circulating serotypes is vital.

Methods: Between 2010 and 2012, a total of 832 stool and viral isolate specimens were obtained from two national surveillance programmes at the National Institute for Communicable Diseases: the Rotavirus Sentinel Surveillance Programme (RSSP) and the AFP surveillance programme. Real-time polymerase chain reaction and Sanger sequencing were performed to detect and serotype EV.

Results: Non-polio EV were detected in 446 specimens, of which 308 were sequenced. Stool specimens yielded a greater variety of serotypes than viral cultures. EV-B viruses were predominant (58.44%), whilst EV-C viruses were detected in 31% of the specimens tested. South African prevalence for these viruses was higher than other countries, such as France with less than 2%, and Spain and the United States with less than 10%. The most common serotype detected was Enterovirus 99 (EV-C, 8.63%), which has not been reported in other regions.

Conclusion: Direct sequencing from stool specimens yields a broader, more comprehensive description of EV infections compared to sequencing from viral cultures. Disease-associated serotypes were detected, but only in small numbers. This study provides a baseline for EV strain circulation; however, surveillance needs to be expanded to improve EV knowledge in South Africa.


Keywords

human enteroviruses; meningitis; NICD; stool specimens; disease-associated serotypes; South Africa.

Metrics

Total abstract views: 745
Total article views: 580


Crossref Citations

No related citations found.