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. 2021 Aug;93(8):4720-4728.
doi: 10.1002/jmv.26804. Epub 2021 Feb 9.

Molecular characterization of non-polio enteroviruses isolated from acute flaccid paralysis patients in Uganda

Phionah Tushabe  1 , Wayne Howard  2 , Josephine Bwogi  1 , Molly Birungi  1 , James P Eliku  1 , Proscovia Kakooza  3 , Henry Bukenya  1 , Prossy Namuwulya  1 , Joseph Gaizi  1 , Mayi Tibanagwa  1 , Theopista Kabaliisa  1 , Julius Mulindwa  4 , Dennis Muhanguzi  5 , Melinda Suchard  2   6 , Nicksy Gumede  7 , Barnabas Bakamutumaho  1
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Molecular characterization of non-polio enteroviruses isolated from acute flaccid paralysis patients in Uganda

Phionah Tushabe et al. J Med Virol. 2021 Aug.

Abstract

Enteroviruses (EVs) are RNA viruses that can cause many clinical syndromes including acute flaccid paralysis (AFP). Within the global polio laboratory network, EVs are categorized either as polioviruses or non-polio enteroviruses (NPEVs). Specific NPEVs have been described in polio-like residual paralytic events in AFP patients. Retrospective analysis of 112 NPEV isolates from AFP patients was performed and thirty one NPEV types were identified of which 91% were Enterovirus B and 9% were Enterovirus A species. The NPEVs were distributed across the country with most patients in the eastern region (41/89; 46.1%). The highest proportion of patients were children less than 5 years (77/89; 86.5%) and male patients were more common (54/89; 60.7%). Echovirus 11 (11/89; 12.4%) was frequently observed and phylogenetic analysis of these sequences revealed high diversity. Coxsackievirus B5 (CV-B5), CV-B6, E21, and EV-B69 were only seen in patients with residual paralysis. Analyses of the EV-A71 sequence indicated a unique genogroup.

Keywords: Non polio enteroviruses; acute flaccid paralysis; residual paralysis; semi-nested PCR.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of NPEV types in Uganda for the period 2006–2016. NPEV, non‐polio enterovirus
Figure 2
Figure 2
Phylogenetic tree showing NPEV types obtained (2006–2016) following amplification of part of the VP1 region. Study sequences are shown with a blue, red, purple or black dot; reference sequences are shown without a dot; E11 study sequences are shown with selected sequences from elsewhere; Enterovirus B types with 3 or more study sequences (except E11) are shown as a compressed subtree. Tree was inferred with the Maximum Likelihood method based on the General Time Reversible model as identified by the best DNA/protein models program in MEGA7. NPEV, non‐polio enterovirus
Figure 3
Figure 3
Phylogenetic tree of the sequence UGA‐14‐3679 with representative EV‐A71 sequences belonging to genogroups A–H and subgenogroups C1‐C5 and B0‐B5 as proposed by Bessaud et al. The sequence UGA‐14‐3679 is indicated with a red diamond. Tree was inferred with the Maximum Likelihood method based on the Kimura 2‐parameter model as identified by the best DNA/protein models program in MEGA7
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