During the five-year period between 1994 and 1998, a total of 217 clinical
samples were assessed for the isolation of enteroviruses at the Enterovirus
Reference Centre for South Greece. Fourteen enterovirus strains belonging
to different serotypes were isolated. These field strains were detected by
cell culture in appropriate cell lines. They were subsequently identified b
y neutralizing antibodies with the LBM (Lim-Benyesh Melnick) mixed antisera
pools up to 1995 and RIVM (National Institute of Public Health and the Env
ironment, Bilthoven, The Netherlands) pools from 1996 onwards. The isolated
viruses included two strains of poliovirus type 2 Sabin-like, three strain
s of poliovirus type 1 non-Sabin-like, one Coxsackie B2 (CBV2) strain, one
Coxsackie B5 (CBV5) strain, one Echo 5 (ECV5) strain, one Echo 7 (ECV7) str
ain, three Coxsackie A16 (CAV16) strains, and two currently enteroviral str
ains unidentified by RIVM pools. Reverse transcription-polymerase chain rea
ction (RT-PCR) using poliovirus-specific primers or poliovirus type-specifi
c primers and enterovirus specific primers from the highly conserved 5'-UTR
, the latter followed by RFLP, was also applied in 6 clinical isolates (3 s
trains of poliovirus type 1 non-Sabin-like, 1 polio type 2 Sabin-like, and
2 non-identified by RIVM pools enteroviruses). The advantages and the drawb
acks of these assays against the conventional ones are discussed here. The
isolations and the subsequent identification of the strains were carried ou
t from fecal samples of clinical cases that included hand-foot-and-mouth di
sease, meningitis, and acute flaccid paralysis. The reappearance of non-Sab
in-like poliovirus strains in Greece in 1996 after 14 years is considered t
o have an important medical and clinical value. (C) 2000 Wiley-Liss. Inc.