Adenovirus isolation rates in acute flaccid paralysis patients

Abstract

Adenoviruses usually cause asymptomatic or mild infection, but occasionally they produce various severe syndromes including neurological disorders. Association of adenovirus infection with acute flaccid paralysis has been investigated. Shedding of adenovirus with feces was detected in 1.05% of young children (mostly infants) with acute flaccid paralysis syndrome versus 0.42% in healthy contact children (P < 0.01). However, 85% of adenoviruses in the pediatric AFP patients belonged to HAdV-C species, which does not have a known neuropathogenic potential. Also, 40% of adenoviruses were isolated from patients with consequently established diagnosis of traumatic neuritis at the discharge, which was not compatible with virus ethology of neurological lesions. Higher adenovirus prevalence in young neurological patients could be affected by an underlying immune deficiency or by congestion in children's hospitals. Indeed, among 70 patients (40 infants, 30 adults) with primary immune deficiencies, asymptomatic shedding of adenoviruses was found in 10-17%; in one adult patient a mixture of HAdV-C2 and HAdV-D15 persisted for several months. Adenoviruses also could be detected in feces of 12% and 57% of healthy young children from two orphanages, respectively. A significant fraction of samples in these groups contained adenovirus mixtures. Therefore, immune deficiencies and congested groups in children's facilities (orphanages and hospitals) could affect significantly the prevalence of adenovirus shedding. The role of adenoviruses in AFP requires further study.

Acute Flaccid Myelitis in the United States, August–December 2014: Results of Nationwide Surveillance

“…There are other recognized etiologies of AFP, and specifically AFM, including nonpolio enteroviruses [20–22], flaviviruses such as West Nile, St Louis, and Japanese encephalitis viruses [4, 23, 24], herpesviruses [25, 26], adenoviruses [27, 28], and others [3]. Although these pathogens may also be associated with other forms of AFP, including Guillain-Barré syndrome and acute transverse myelitis, AFM caused by these pathogens usually occurs sporadically, with the exception of EV-A71 outbreaks in East Asia [29, 30].…”

Investigation of Adenovirus Isolation Frequency from the Stool Samples of Patients Suspected with Acute Flaccid Paralysis

“…Temaslı olgularda saptanan bu oran, kişinin immün sisteminin yeterliliğine bağlı olarak, virusun sindirim sisteminde asemptomatik olarak bulunabileceğini göstermektedir. Ivanova ve arkadaşlarının 13 çalışmasında da, sağlıklı küçük çocuklarda dışkı ile virus salınım oranı %12-57 arasında bildirilmiştir.…”

“…Son yıllarda yapılan çalışmalarda ise, AFP'li olguların dışkı ve diğer klinik örneklerinde bazı adenovirus tiplerinin saptanması, bu virusların AFP etiyolojisindeki olası rollerini düşündürmeye başlamıştır [8][9][10][11][12][13] . Bu noktadan hareketle, bu çalışmada, AFP şüpheli olguların dışkı örneklerinden adenovirus izolasyon sıklığının araştırılması amaçlanmıştır.…”

Identification of a novel intertypic recombinant species D human adenovirus in a pediatric stem cell transplant recipient

“…Shedding in stool for prolonged periods of time has been well documented for adenoviruses not recognized as causative agents of gastroenteritis [21-24]. Interestingly, recent studies conducted using PCR-based detection and typing procedures in sub-Saharan and other African communities, reported a high prevalence of HAdV-D DNA in diahrreal and non-diahrreal stools of patients of various age groups [25-27].…”