Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012–2019

• Main Authors: Youngsil Yoon, Yong-Pyo Lee, Deog-Yong Lee, Hye-Jin Kim, June-Woo Lee, Sangwon Lee, Chun Kang, Wooyoung Choi, Joong Hyun Bin, Young Hoon Kim, Myung-Guk Han, Hae Ji Kang
• Format: Article
• Language: English
• Published: MDPI AG 2021-03-01
• Series: Viruses
• Subjects: acute flaccid paralysis (AFP); surveillance; poliovirus; enterovirus
• Online Access: https://www.mdpi.com/1999-4915/13/3/411

The risk of polio importation and re-emergence persists since epidemic polio still occurs in some countries, and the resurgence of polio occurring almost 20 years after polio eradication was declared in Asia has been reported. We analyzed the results of acute flaccid paralysis (AFP) surveillance in Korea to assess the quality of AFP surveillance and understand the etiology of non-polio enterovirus (NPEV)-associated central nervous system diseases in a polio-free area. We investigated 637 AFP patients under 15 years of age whose cases were confirmed during 2012–2019 by virus isolation, real-time reverse transcription polymerase chain reaction, and VP1 gene sequencing. Among the 637 AFP cases, NPEV was detected in 213 (33.4%) patients, with the majority observed in EV-A71, with 54.9% of NPEV positives. EV-A71 has been shown to play a role as a major causative agent in most neurological diseases except for Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), and meningitis. This study provides information on the AFP surveillance situation in Korea and highlights the polio eradication stage in the monitoring and characterization of NPEV against the outbreak of neurological infectious diseases such as polio.