Features of the etiological structure of non-polio enterovirus infection in children in the pre-pandemic and post-pandemic periods

BACKGROUND: Regional features of the etiological structure of nonpolio enterovirus infection (NPEVI) in children in the pre- and post-pandemic periods must be registered.

AIM: To determine the features of the etiological structure of NPEVI in children in the pre- and post-pandemic periods in the Khanty–Mansiysk Autonomous Okrug.

MATERIALS AND METHODS: Statistical observation data for 2013–2022 and results of molecular genetic studies of the structure of NPEVI in children in the pre- and post-pandemic periods were analyzed.

RESULTS: The tendency of the incidence of NPEVI in the Khanty–Mansiysk Autonomous Okrug to increase in the pre-COVID-19 pandemic and a predominance of children aged <6 years has been established. In the study period up to 2019 (pre-pandemic), enteroviruses Coxsackie A6 in combination with E A71 were dominant, for which the calculated trends of the short-term forecast were confirmed in 2022. In the same year, these enteroviruses were the most common causes of focal diseases with exanthemic forms of NPEVI. In 2022, the circulation of eight more enteroviruses genovariants was recorded, among which Coxsackie A10 EV prevailed (20.5% of cases), which caused the majority of enterovirus vesicular pharyngitis cases. Enterovirus meningitis was registered in 5 (11.4%) children with the release of ECHO 6, ECHO 9, and Coxsackie A9, which were not noted in other clinical forms and circulated irregularly and in smaller numbers during the pre-pandemic period than in post-pandemic period (2022).

CONCLUSIONS: The analysis of the monitoring data of the NPEVI in Khanty–Mansiysk Autonomous Okrug revealed a trend of a gradual increase in incidence in children, which must be considered when organizing epidemiological surveillance of NPEVI. The completeness of the registration of NPEVI cases with mandatory genotyping of the detected enterovirus strains will allow to more accurately determine the spectrum of strains endemic to this territory, assess the probability of their spread, forecast about the true level of morbidity, and conduct appropriate scientifically based antiepidemic and preventive measures among children with NPEVI in Khanty–Mansiysk Autonomous Okrug.