Emerging Non-Polio Enteroviruses recognized in the framework of the Acute Flaccid Paralyses (AFP) surveillance system in Northern Italy, 2016–2018

BackgroundAcute Flaccid Paralyses Surveillance (AFPS) monitors the emergence of polioviruses and can track Non-Polio Enteroviruses (NPEVs). We report AFPS activity in Lombardy region (Northern Italy) from 2016 to 2018.MethodsFecal respiratory samples were collected children <15 years who met WHO definition an AFP case, analyzed by virus isolation cell cultures (RD/L20B) a one-step real-time RT-PCR assay specific for 5?-noncoding-region NPEV. NPEV-positive specimens further sequencing fragment VP1 gene.Results36 cases (89 stool 32 samples) reported with incidence 1.1/100’000, 0.9/100’000, 0.6/100’000 2016, 2017, 2018, respectively. Poliovirus was not identified, whereas NPEVs detected 19.4% (7/36) cases. The presence one Echovirus-25 (2016), two EV- D68 (2016 2018), EV-A71 Echovirus-30 (2016) sharing high nucleotide identity Europe identified.ConclusionThe absence polio confirmed. unpredicted detection emerging EV-D68, EV-A71, E-30 sequence similarity viruses involved latest outbreaks, provided valuable up-to-date information, emphasizing importance monitoring through AFPS.