Non-Polio Enteroviruses, the Neglected and Emerging Human Pathogens:Are we Waiting for the Sizzling Enterovirus Volcano to Erupt?

Abstract

Enteroviruses consist of a lar ge group of pathogenic viruses, poliovirus being the notorious member . For the last several decades, all the attention and resources were directed towards control and eradication of poliomyelitis in India. There is very little research on non-polio enteroviruses (NPEVs), the cousins of poliovirus, which are associated with a wide range of diseases, especially in infants and young children. We have established an active research group on NPEVs during the last six years and showed that about 35% of non-polio acute flaccid paralysis (NP-AFP) children were positive for NPEV infections, and detected 66 serotypes in NP-AFP children, EV71 being more frequently detected followed by Echovirus 13 and CVB5. Long-term comparative epidemiological studies on NPEVs and rotavirus in acute diarrhoea revealed for the first time, that, NPEV association is as significant as that of rotavirus. A surprising observation was the contrasting seasonal prevalence between enterovus- and rotavirus-associated diarrhoea, the former predominating in non-winter months and the latter occurring primarily in the winter season. NPEVs were associated with epidemics-like outbreaks during which they were detected in up to 50% children with acute diarrhoea. In recent years, enterovirus has been identified to be associated with acute encephalitis cases in Uttar Pradesh. HFMD outbreaks have been reported in recent years, including a major outbreak in Bangalore in 2013. Since, no studies exist in India on the biology of EVs, including HFMD, we have recently initiated work on this emer ging disease. Our studies uncover an ur gent need for detailed studies on these “so far” neglected and emerging viruses for effective child health management in the country.