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Duration of enterovirus shedding in stool
Insights
Enterovirus (EV) shedding can persist in stool for up to 11 weeks post-infection, though throat excretion is typically shorter. This study tracked EV shedding duration in children, finding prolonged fecal shedding is common.
Area of Science:
- Virology
- Pediatric Infectious Diseases
Background:
- Enterovirus (EV) infections are common in children, but the duration of viral shedding is not well-defined.
- Understanding EV shedding is crucial for infection control and transmission dynamics.
Purpose of the Study:
- To determine the duration of enterovirus shedding in the throat and stool of infected children.
- To investigate the potential for subclinical coinfections and interference with vaccine poliovirus.
Main Methods:
- Prospective study of 12 children infected with enterovirus.
- Regular throat swab and stool sample collection for virus isolation over several weeks.
- Analysis of EV serotypes, coinfections, and vaccine poliovirus presence.
Main Results:
- Enterovirus was detected in throats for 1-2 weeks post-infection in most cases.
- Stool excretion of EV persisted for up to 11 weeks in some children.
- Subclinical enterovirus coinfections and coexistence with vaccine poliovirus were observed.
Conclusions:
- Enterovirus shedding from the throat is generally short-lived (≤2 weeks).
- Prolonged fecal enterovirus excretion (up to 11 weeks) is possible in children.
- Coinfection with non-polio enteroviruses and vaccine poliovirus can occur without apparent interference.
Abstract:
Excretion of enterovirus (EV) may persist for months after an EV infection; the exact duration of excretion, however, is not yet known. Twelve children who were infected with EV between September 1998 and June 1999 were enrolled into this study. The patients included 4 boys and 8 girls, aged from 1 month to 5 years. Six patients were asked to join this virus isolation program, and the other 6 were followed-up regularly. Only 2 of the patients were infected with EV 71. To delineate the duration of EV shedding in each case, throat swabs for virus isolation were performed every 1 or 2 weeks for at least 1 month, and stools were analyzed for at least 2 months following the same schedule. After the infection, EV was identifiable in the throat in 4 patients for 1 to 2 weeks. Excretion of EV through stool was evidenced for up to 7 weeks in 6 patients, 8 weeks in 3, and 11 weeks in 1. In the 2 patients who failed to show up for follow-up visits from the 7th week, excretion of EV through stool was recorded for at least 7 weeks. Different serotypes of EV could be isolated from the same patient who was not experiencing febrile illness in 2 instances in a series of virus cultures. Coexistence of vaccine poliovirus and non-polio EV, both isolated from stool, was evidenced in 2 patients. Results from this study suggest that EV may not be identified from the throat 2 weeks after the infection, but its excretion through stool can persist for up to 11 weeks. This study also demonstrated that subclinical EV coinfection could occur, and that live vaccine poliovirus did not interfere with the invasion of other non-polio EV.