Research Journal of Medicine and Medical Sciences, 2(1): 25-28, 2007
© 2007, INSInet Publication
Corresponding Author: Oderinde Bamidele Soji, WHO. National Polio Laboratory, Medical Microbiology Department,
University of Maiduguri Teaching Hospital (UMTH), P.M.B. 1414 Maiduguri. Borno State. Nigeria.
Tel / Fax: 234 76 235668, E-mail: sojihunter@yahoo.com
25
Non-polio Enteroviruses Implicated in Acute Flaccid Paralysis in Northern Nigeria.
Oderinde Bamidele Soji, Olabode Atanda Olayinka, Harry Tekena Obu, Baba Marycelin Mandu,
1 2 3 4
Bukbuk David Nadeba and Ogunmola Olamide Olayinka
5 6
WHO National Polio Laboratory, Medical Microbiology Department,
1,6
University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Borno State, Nigeria.
WHO National Polio Laboratory, College of Medical Sciences, University of Maiduguri,
3,4
Borno State, Nigeria.
WHO National Polio Laboratory, Department of Microbiology,
5
University of Maiduguri, Borno State, Nigeria.
Virology Department, Federal College of Veterinary and Medical Laboratory Sciences (FCVMLS),
2
National Veterinary Research Institute (NVRI), Vom. Plateau State. Nigeria.
Abstract: Out of 4171 stool samples collected from 2097 children with acute flaccid paralysis (AFP) in
10 northern states of Nigeria in 2002 and 2003,307 (14.6%) cases had non-polio enteroviruses (NPEVs)
isolated from their faeces using RD and L20B cell lines. During the sixty days follow-up after onset of
AFP, 24 (7.8%) of 307 cases had residual paralysis. Identification of the NPEVs associated with cases
that had residual paralysis revealed coxsackie B, echovirus, 3, 4, 7, 12, 13, 27, 29 and 33 respectively
with 1 (4.2%) mixtures of coxsackie B and echovirus, 13 (54.2%)echovirus, 6 (25%) indeterminates and
4 (16.7%) negatives resulting due to loss of virus in storage.It is advocated that, as preventive initiative
is intensified on poliovirus with provision of portable water and creating awareness on the importance of
hygiene in endemic communities, the NPEVs infection rate will reduce drastically.
Keywords: Non polio enteroviruses, acute flaccid paralysis, cell culture, virus isolation,
microneutralization tests, virus identification.
INTRODUCTION
Non-polio enteroviruses (NPEVs) belongs to the
family picornaviridae and genus, enterovirus. They
comprise_coxsackieviruses A1- A24 (no A23), B1- B6,
Echovirus 1-34 (no 10 or 28); and Enteroviruses 68-
[1,2]
71 . They cause a wide spectrum of diseases that can
[3]
involve any organ with severity from life – threatening
with a significant morbidity to mild subclinical
infections . NPEVs are primarily spread by the
[4]
faecal- oral route and are common in children but
adults can also be infected. For instance, Echovirus has
been implicated in multiple human disease syndrome,
including paralysis . The World Health Organisation
[5]
reports revealed that from 1967 to 1970, paralysis was
present in less than 1% of all patients with echovirus
and coxsackievirus infections . Moreover, 12 patients
[6]
with residual paralysis of 77 AFP cases due to
coxsackieviruses have been reported in Scotland from
1956 to 1973 . Although the majority of the AFP
[7]
cases are mild and transient, persistent muscle
weakness or total paralysis or even death has been
reported . However not all Poliovirus or NPEVs
[8]
induced AFP end
in residual paralysis, but outbreaks of infections with
NPEVs is worldwide, affecting many countries . There
[9]
is scarcity of information on the role of NPEVs among
AFP cases with residual paralysis in Nigeria. Therefore
this study was designed to assess children with NPEVs
induced AFP that ended up with residual paralysis.
MATERIALS AND METHODS
The study area was restricted to 10 northern states
of Nigeria (Figure1.) with a total of 234 Local
Government Areas. These states were designated by
WHO for the National Polio Laboratory, Maiduguri,
Nigeria in the Polio Eradication Programme. The
methods adopted for AFP surveillance and Laboratory
testing of faecal specimens isolation and isolation and
typing of isolates were as described in the WHO Polio
Laboratory Manual, 2004. In brief, Surveillance
Officers and Pediatricians collected two faecal
specimens per AFP case, 24 hours apart and within 14
days of the onset of paralysis, and were sent in jablow
box with ice packs to preserve the cold chain to