Argentina, as the same of LATAM countries certifies the elimination of polio in 1990. Acute flaccid paralysis (AFP) surveillance is a key strategy for monitoring the progress of poliomyelitis eradication in the world. The aim of this study was to describe the epidemiological pattern of patients reported with AFP. A cross-sectional study was carried out from January 2000 to December 2016 at the “R. Gutierrez” Children`s Hospital. All children aged <15 years who met the WHO definition for AFP were included. Stool samples were sent to the national reference laboratory to be tested for enteroviruses (non-polio enterovirus, poliovirus, Sabin, Sabin-derived)in compliance with the AFP protocol. A total of 174 cases were included; median age 62 months (IQR: 29–108); 53.5% males. No seasonality pattern was observed; 137(79%) stool samples were tested and no wild poliovirus was isolated. The median time between the onset of the paralysis and the admission was 4 days (IQR 2–9); the most common prodromal symptoms were: fever(39%),respiratory infection (35%), digestive (31%), myalgia (34%) and meningeal (5%). Symmetric paralysis (78%) without progression was the most frequent clinical presentation. The median length of stay at the hospital was 9 days (IQR 1-17). None of the patients was diagnosed as having polio vaccine related paralysis. Guillain-Barre syndrome was the most frequent final diagnosis (n = 72) followed by transverse myelitis (n = 14), botulism (n = 12) and encephalitis (n = 6). Between years 2000 and 2016 a total of eight cases of non-polio enterovirus (NPEV) were found: 6 cases of acute myelitis (AFM) associated to D68 enterovirus, clustered in winter 2016. Five of them were detected by PCR in nasopharyngeal aspirates and only one in stool samples. All of them present motor sequels. Epidemiological surveillance of AFP allows ruling out poliovirus infection and detect other flaccid paralysis etiologies. In 2016 D-68 enterovirus AFM outbreak was detected in Argentina when conducting AFP routine surveillance. Nasopharyngeal aspirates, in AFM suspected cases, must be part of the study AFP protocol. All authors: No reported disclosures.

This report describes the results of human enterovirus (HEV) detection and characterization using cell culture, polymerase chain reaction and molecular typing in 2167 samples obtained from acute flaccid paralysis, aseptic meningitis and acute encephalitis patients, from 1991 to 1998 in Argentina. HEV were isolated in 130 out of 666 cases (19.5%) and 36 out of 666 (5.4%). HEV RNA was detected in 28.8% (231/801) and 3.0% (21/700) of the patients with meningitis and encephalitis, respectively. Children with ages ranging from 1 to 9 years accounted for 75.3% of the meningitis cases and from 1 to 4 years for 58% of acute flaccid paralysis patients. Echovirus 4 (E4), E9, E30 and E17 were identified from meningitis outbreaks. Coxsackievirus A2 (CAV2), CBV2, CBV5, E7, E11, E19, E24, E29 and enterovirus 71 were recovered only from sporadic cases. Three different serotypes were identified in encephalitis patients: E4, E7 and E24. A total of 28 different serotypes of non-polio enteroviruses were detected from acute flaccid paralysis cases. The information here presented contributes to improving our knowledge about enteroviruses epidemiology in Argentina and their relationship with different neurological diseases. This study provides valuable data that could be useful to further research.

El presente estudio describe los resultados de la investigacion de los enterovirus humanos (HEV) mediante cultivo celular y reaccion en cadena de la polimerasa y su tipificacion molecular en 2167 casos de paralisis flaccida aguda, meningitis aseptica y encefalitis aguda, obtenidos entre 1991 y 1998 en la Argentina. La frecuencia de deteccion de HEV en paralisis flaccida aguda fue 19.5% (130/666) y de poliovirus Sabin 5.4% (36/666). La tasa de deteccion de HEV en los casos de meningitis fue 28.8% (231/801) y en encefalitis 3.0% (21/ 700). El grupo etario mas afectado por las meningitis fue entre 1 y 9 anos (75.3%) y en los casos de paralisis flaccida aguda, de 1 a 4 anos (58%). En muestras de brotes de meningitis se identifico echovirus (E) 4, E9, E30 y E17, y en casos esporadicos virus coxsackie A (CAV) 2, B (CBV) 2 y CBV5, E7, E11, E19, E24 y E29, y enterovirus (EV) 71. Finalmente, en casos de encefalitis se detecto E4, E7 y E24. En casos de paralisis flaccida aguda se identificaron 28 serotipos distintos de enterovirus no polio. En la Argentina y en otros paises latinoamericanos existe escasa informacion acerca de la circulacion de los HEV y su relacion con diversas enfermedades neurologicas. Este estudio proporciona informacion que puede servir como base para posteriores investigaciones.