A 5-year study of human parechoviruses in children living in bad sanitation conditions and non-polio acute flaccid paralysis children from Greece

In Greece, data for human parechoviruses (HPeVs) are scarce and our aim was to conduct a large scale study to determine for the first time their occurrence. Under the spectrum of surveillance, we retrospectively screened stool specimens obtained from 71 children with acute flaccid paralysis (AFP) symptoms and from 311 individuals in high-risk population groups such as children living in bad sanitation conditions for HPeVs presence by rRT-PCR targeting the 5′ UTR. All positive samples were then genotyped by targeting the HPeVs VP1 region. Totally, 15/311 (5%) stool samples from children living in bad sanitation conditions and 4/71 (6%) from the non polio AFP children were positive for HPeVs. Sequencing analysis revealed that genotypes HPeV1 (n = 4/15), HPeV5 (n = 2/15), and HPeV6 (n = 2/15) were circulating among Roma children population whereas HPeV1 (n = 1/4) and HPeV5 (n = 1/4) were circulating in children with AFP-like symptoms. We did not obtain a seasonality motive among HPeV1 or HPeV5 genotypes whereas HPeV6 was detected only in July. Phylogenetic analysis showed that Greek HPeVs strains are clustered together with HPeV strains circulating in other European countries during the same period. We describe the presence of HPeVs in Greece, and we enforce that their diagnosis should be considered in children with neurological outcome such as non-polio AFP.