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Etiological agents of acute poliomyelitis in south India
N Deivanayagam1, K Nedunchelian, S Vasudevan
1Advanced Center for Clinical Epidemiological Research & Training (ACCERT), Madras Medical College.
Abstract:
This study was done to identify the specific etiological agents that cause acute poliomyelitis (APM). All the children newly diagnosed clinically as APM at the Institute of Child Health, Madras, during the period May 1988 to May 1989 were recruited. Stool specimen collection, transportation and identification of viruses by culture were done by standard procedures. The total number of children recruited was 312. Specimens were contaminated/insufficient in 10. Analysis was done for 302 cases. Polio virus type II was identified in 25.5% children, type I in 18.5%, type III in 15.9%, multiple polioviruses in 6.3% and non-polio enteroviruses (NPEV) in 20.2% cases. No virus was identified in 13.6%. Among the APM cases clinically diagnosed, the proportion of NPEV has increased considerably from 5% in 1984 to 20.2% in 1988-89. The age distribution was not significantly different between polio viruses and NPEV. The distribution of polio viruses and NPEV did not differ significantly in relation to immunization status, source of water supply, method of excreta disposal and the clinical types. For surveillance and control/eradication program of poliomyelitis, laboratory confirmation is essential.
Insights
This study identified the causes of acute poliomyelitis (APM) in children. Non-polio enteroviruses (NPEV) are increasingly detected, highlighting the need for laboratory confirmation in APM surveillance.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Acute poliomyelitis (APM) is a serious neurological disease.
- Identifying the etiological agents of APM is crucial for disease control.
- Previous studies indicated a lower prevalence of non-polio enteroviruses (NPEV) in APM cases.
Purpose of the Study:
- To determine the specific etiological agents causing acute poliomyelitis (APM) in children.
- To assess the changing prevalence of NPEV in APM cases.
- To evaluate the necessity of laboratory confirmation for APM surveillance and eradication programs.
Main Methods:
- Clinical diagnosis of APM in children aged 0-12 years.
- Stool specimen collection, transportation, and viral identification via standard culture procedures.
- Analysis of 302 confirmed APM cases from May 1988 to May 1989.
Main Results:
- Poliovirus types I, II, and III were identified in 18.5%, 25.5%, and 15.9% of cases, respectively.
- Non-polio enteroviruses (NPEV) were identified in 20.2% of cases, a significant increase from 5% in 1984.
- No virus was identified in 13.6% of cases; multiple polioviruses were found in 6.3%.
Conclusions:
- A significant rise in NPEV as a cause of APM has been observed.
- Laboratory confirmation is essential for accurate APM surveillance, control, and eradication efforts.
- NPEV and poliovirus distributions showed no significant difference based on age, immunization, water supply, sanitation, or clinical type.