The importance of enterovirus surveillance in a Post-polio world

Holm-Hansen, Charlotte; Midgley, Sofie; Schjørring, Susanne; Fischer, Thea Kølsen

doi:10.1016/j.cmi.2017.02.010

Cited by 14 publications

(7 citation statements)

References 12 publications

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“…Increasing awareness and better diagnostic and virus characterisation techniques have improved ascertainment of EV-D68 over the past decade. However, despite there being many published outbreak reports on EV-D68, there remains a paucity of population-based surveillance that could be used to describe the disease burden, range of syndromes caused, risks of acquisition and of severe outcomes [ 4 ]. Arrangements for routine enterovirus diagnostic typing are also highly variable [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Prospective enterovirus D68 (EV-D68) surveillance from September 2015 to November 2018 indicates a current wave of activity in Wales

et al. 2018

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Since 7 June 2018, an enterovirus D-68 (EV-D68) season (the third since 2015) is ongoing in Wales, with 114 confirmed cases thus far. Median age of the 220 cases since 2015 is 2.5 years (2.5 years in intensive care cases), 94% were hospitalised, 17% (n = 38) in intensive care. All had respiratory symptoms; bronchiolitis symptoms were reported in 60 cases, severe respiratory symptoms in 23 and acute flaccid myelitis in two cases.

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Section: Discussionmentioning

confidence: 99%

Prospective enterovirus D68 (EV-D68) surveillance from September 2015 to November 2018 indicates a current wave of activity in Wales

et al. 2018

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“…P oliomyelitis is an acute infectious intestinal disease caused by poliovirus, which is mainly transmitted from person to person through the fecal-oral route, humans are the only known host of poliovirus. 1,2 Poliomyelitis is disappearing as a result of planned immunization, but sporadic cases still occur in some developing countries, with the current prevalence rate being less than 1/1,000,000 worldwide. [3][4][5] In some patients, poliovirus invades the anterior horn of the spinal cord and selectively destroys motor neurons, resulting in their death or motor weakness, which in turn leads to paralysis of the muscle fibers innervated by the motor neurons.…”

Section: Introductionmentioning

confidence: 99%

Total Hip Arthroplasty in the Nonparalytic Limb of Residual Poliomyelitis Patients: A Propensity Score Matched Study

Chen

et al. 2023

Orthopaedic Surgery

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Objective Poliomyelitis is a rare neuromuscular disease that can cause hip osteoarthritis on the contralateral side due to an abnormal mechanical weight‐bearing state, making some residual poliomyelitis patients candidates for total hip arthroplasty (THA). The aim of this study was to investigate the clinical outcome of THA in the nonparalytic limbs of these patients compared with those of non‐poliomyelitis patients. Methods Patients treated between January 2007 and May 2021 were retrospectively identified in a single center arthroplasty database. Eight residual poliomyelitis cases that met the inclusion criteria were matched to non‐poliomyelitis cases in a ratio of 1:2 based on age, sex, body mass index (BMI), age‐adjusted Charlson comorbidity index (aCCI), surgeon, and operation date. The hip function, health‐related quality of life, radiographic outcomes, and complications were analyzed with unpaired Student's t test, Mann–Whitney test, Fisher's exact test or analysis of covariance (ANCOVA). Survivorship analysis was determined using the Kaplan–Meier estimator analysis and Gehan‐Breslow‐Wilcoxon test. Results After a mean follow‐up of about 5 years, patients with residual poliomyelitis had worse postoperative mobility outcomes(P < 0.05), but there was no difference in total modified Harris hip score (mHHS) or European quality of life‐visual analogue scale (EQ‐VAS) between the two groups (P > 0.05). There was no difference in radiographic outcomes or complications between the two groups, and patients had similar postoperative satisfaction (P > 0.05). No readmission or reoperation occurred in the poliomyelitis group (P > 0.05), but the postoperative limb length discrepancy (LLD) in the residual poliomyelitis group was greater than that in the control group (P < 0.05). Conclusion Functional outcomes, health‐related quality of life improvement were similarly significantly improved in the nonparalytic limb of residual poliomyelitis patients after THA compared with conventional osteoarthritis patients. However, the residual LLD and weak muscle strength of the affected side will still influence mobility, so residual poliomyelitis patients should be fully informed of this outcome before surgery.

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“…Since the noti cation of EV is non-mandatory in most countries in the EU, including Germany, their surveillance relies on voluntary reporting of clinicians, hospitals or laboratories [5,21]. Efforts to harmonize and collate surveillance data on the European level have recently been established through the European Non-Poliovirus Enterovirus Network (ENPEN) [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of 17 years of MERIN (Meningitis and Encephalitis register in Lower Saxony, Germany) surveillance system: participants acceptability survey, completeness and timeliness of data

Luczynska

Beyrer

Holle

et al. 2023

Preprint

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Background A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system’s objectives and performance, and identifying areas for improvement. Methods To assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory’s performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed. Results We received 30 questionnaires, 25 from pediatric and 5 from neurological departments, of 21 hospitals (66% response rate). High levels of satisfaction with the communication (≥ 96%), timeliness (≥ 81%), and distribution of the results (≥ 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany’s polio-free status was rated the lowest (61%). Providing medical reports digitally as well regular as updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1–3], EV diagnostics via PCR took one day [IQR 0–6] and EV isolation on cell culture 11 days [IQR 10–13]. Conclusion MERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. Our results emphasise the importance of recognizing and considering participants’ motivations and expectations, and addressing their priorities, even if this is not the surveillance system’s main focus. This approach can be applied to surveillance systems of other non-mandatory notifiable diseases.

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The importance of enterovirus surveillance in a Post-polio world

Cited by 14 publications

References 12 publications

Prospective enterovirus D68 (EV-D68) surveillance from September 2015 to November 2018 indicates a current wave of activity in Wales

Prospective enterovirus D68 (EV-D68) surveillance from September 2015 to November 2018 indicates a current wave of activity in Wales

Total Hip Arthroplasty in the Nonparalytic Limb of Residual Poliomyelitis Patients: A Propensity Score Matched Study

Evaluation of 17 years of MERIN (Meningitis and Encephalitis register in Lower Saxony, Germany) surveillance system: participants acceptability survey, completeness and timeliness of data

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