Distribution of non-polio enteroviruses and molecular characteristics of coxsackievirus B5 isolated from environmental sewage in Shanghai, 2015–2018

ObjectiveTo understand the distribution of non-polio enterovirus (NPEV) isolated from environmental sewage in Minghang and Jiading district of Shanghai from 2015 to 2018, and explore the circulation and evolution of coxsackievirus B5 (Cox B5) in environmental sewage, healthy children and acute flaccid paralysis (AFP) cases.

MethodsThe sewage plants in Minhang and Jiading were selected as long-term surveillance sites. Sewage samples were collected monthly from two sewage plants for concentration and enrichment. The supernatant was collected and inoculated with human rhabdomyosarcoma and Hep-2 cells for virus isolation. VP1 region was obtained by RT-PCR and sequenced.

ResultsA total of 84 sewage samples were collected, in which 242 NPEV strains were isolated, and 19 genotypes were detected. Cox B5 was a genotype with high proportion, accounting for 18.18% (44/242). Cox B5 formed three transmission chains of two genotypes, namely C3, C4 and D3 genotypes. C3 was the predominant genotype in Shanghai, while the D3 genotype was a new transmission chain during 2016–2018.

ConclusionFrom 2015 to 2018, the predominant genotypes of NPEV were ECHO11, Cox B5, Cox B3 and ECHO6 in environmental sewage in Shanghai. Cox B5 co-circulated in environmental sewage, healthy children and AFP cases. NPEV related disease surveillance system has not been established in China. Environmental sewage surveillance can be used as an important supplementary method for case surveillance.