More than 100 human enteroviruses are classified into species A-D. Most enterovirus infections are asymptomatic but clinical manifestations can include meningitis, gastroenteritis, myocarditis and acute flaccid paralysis (AFP), a polio-like illness. The National Enterovirus Reference Laboratory, based within the Victorian Infectious Diseases Reference Laboratory, was established in 1994 and has played a major role in monitoring the polio-free status of the Oceania region including Australia, the Pacific Islands and Papua New Guinea. The laboratory routinely tests faecal specimens from cases of AFP in children less than 15 years of age for the isolation and characterisation of enteroviruses including poliovirus.
From 2005 to 2014, a total of 1154 samples were received from 565 AFP cases in Oceania. Overall, 44 different serotypes of enterovirus were identified by virus isolation and/or RT-PCR from 23.7% (134/565) cases. The three most common enteroviruses associated with AFP cases in Oceania were enterovirus A71 9.0% (12/134), coxsackievirus A24 5.2% (7/134) and the newly described enterovirus C96 5.2% (7/134). Differences were noted with respect to the distribution of species A, B and C enteroviruses within Papua New Guinea, the Pacific Islands and Australia. With the introduction of direct PCR screening and sequencing methods, a number of non-cultivable enteroviruses were identified, along with seven newly described enteroviruses and a previously undescribed enterovirus.