{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T04:18:01Z","timestamp":1769833081866,"version":"3.49.0"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T00:00:00Z","timestamp":1614384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>This report is an overview of enterovirus (EV) detection in Tunisian polio-suspected paralytic cases (acute flaccid paralysis (AFP) cases), healthy contacts and patients with primary immunodeficiencies (PID) during an 11-year period. A total of 2735 clinical samples were analyzed for EV isolation and type identification, according to the recommended protocols of the World Health Organization. Three poliovirus (PV) serotypes and 28 different nonpolio enteroviruses (NPEVs) were detected. The NPEV detection rate was 4.3%, 2.8% and 12.4% in AFP cases, healthy contacts and PID patients, respectively. The predominant species was EV-B, and the circulation of viruses from species EV-A was noted since 2011. All PVs detected were of Sabin origin. The PV detection rate was higher in PID patients compared to AFP cases and contacts (6.8%, 1.5% and 1.3% respectively). PV2 was not detected since 2015. Using nucleotide sequencing of the entire VP1 region, 61 strains were characterized as Sabin-like. Among them, six strains of types 1 and 3 PV were identified as pre-vaccine-derived polioviruses (VDPVs). Five type 2 PV, four strains belonging to type 1 PV and two strains belonging to type 3 PV, were classified as iVDPVs. The data presented provide a comprehensive picture of EVs circulating in Tunisia over an 11-year period, reveal changes in their epidemiology as compared to previous studies and highlight the need to set up a warning system to avoid unnoticed PVs.<\/jats:p>","DOI":"10.3390\/v13030380","type":"journal-article","created":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T20:55:44Z","timestamp":1614459344000},"page":"380","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Circulation and Molecular Epidemiology of Enteroviruses in Paralyzed, Immunodeficient and Healthy Individuals in Tunisia, a Country with a Polio-Free Status for Decades"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5616-0204","authenticated-orcid":false,"given":"Anissa","family":"Chouikha","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"},{"name":"Research Laboratory, LR20IPT02, Pasteur Institute of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorra","family":"Rezig","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"},{"name":"Research Laboratory, LR20IPT02, Pasteur Institute of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Driss","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichrak","family":"Abdelkhalek","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahlem","family":"Ben Yahia","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henda","family":"Touzi","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zina","family":"Meddeb","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Essia","family":"Ben Farhat","sequence":"additional","affiliation":[{"name":"National Program of Immunization Basic Health Care Division, Ministry of Health Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahrez","family":"Yahyaoui","sequence":"additional","affiliation":[{"name":"National Program of Immunization Basic Health Care Division, Ministry of Health Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henda","family":"Triki","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1068, Tunisia"},{"name":"Research Laboratory, LR20IPT02, Pasteur Institute of Tunis, Tunis 1006, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/B978-0-444-53488-0.00018-3","article-title":"Enterovirus\/Picornavirus infections","volume":"123","author":"Jubelt","year":"2014","journal-title":"Handb. 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