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Fonseca MC, Pupo-Meriño M, García-González LA, Muné M, Resik S, Norder H, Sarmiento L. Molecular Characterization of Coxsackievirus A24v from Feces and Conjunctiva Reveals Epidemiological Links. Microorganisms 2021; 9:531. [PMID: 33807540 PMCID: PMC7998715 DOI: 10.3390/microorganisms9030531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v), the main causative agent of acute hemorrhagic conjunctivitis (AHC), can be isolated from both the eyes and lower alimentary tract. However, the molecular features of CVA24v in feces is not well-documented. In this study, we compared the VP1 and 3C sequences of CVA24v strains isolated from feces during AHC epidemics in Cuba in 1997, 2003, and 2008-2009 with those obtained from conjunctival swabs during the same epidemic period. The sequence analyses of the 3C and VP1 region of stool isolates from the three epidemics showed a high degree of nucleotide identity (ranging from 97.3-100%) to the corresponding conjunctival isolates. The phylogenetic analysis showed that fecal CVA24v isolates from the 1997 and 2003 Cuban outbreaks formed a clade with CVA24v strains isolated from conjunctival swabs in Cuba and other countries during the same period. There were three amino acid changes (3C region) and one amino acid change (VP1 region) in seven CVA24v strains isolated sequentially over 20 days from fecal samples of one patient, suggesting viral replication in the intestine. Despite these substitutions, the virus from the conjunctival swab and fecal samples were genetically very similar. Therefore, fecal samples should be considered as a reliable alternative sample type for the routine molecular diagnosis and molecular epidemiology of CVA24v, also during outbreaks of AHC.
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Affiliation(s)
- Magilé C. Fonseca
- Virology Department, Center for Research Diagnosis, and Reference, Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba; (M.M.); (S.R.)
| | - Mario Pupo-Meriño
- Departamento de Bioinformática, Universidad de las Ciencias Informáticas (UCI), Habana 19370, Cuba;
| | - Luis A. García-González
- Centro de Estudios de Matemática Computacional, Universidad de las Ciencias Informáticas (UCI), Habana 19370, Cuba;
- Departamento de Ciencias de la Computación, Centro de Investigación Científica y de Educación Superior de Ensenada, 22860 Ensenada, Mexico
| | - Mayra Muné
- Virology Department, Center for Research Diagnosis, and Reference, Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba; (M.M.); (S.R.)
| | - Sonia Resik
- Virology Department, Center for Research Diagnosis, and Reference, Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba; (M.M.); (S.R.)
| | - Heléne Norder
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden;
- Department of Clinical Microbiology, Region Västra Götaland, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Luis Sarmiento
- Immunovirology Unit, Department of Clinical Sciences, Skåne University Hospital, Lund University, 22185 Malmo, Sweden
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Fonseca MC, Pupo-Meriño M, García-González LA, Resik S, Hung LH, Muné M, Rodríguez H, Morier L, Norder H, Sarmiento L. Molecular evolution of coxsackievirus A24v in Cuba over 23-years, 1986-2009. Sci Rep 2020; 10:13761. [PMID: 32792520 PMCID: PMC7427094 DOI: 10.1038/s41598-020-70436-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/21/2020] [Indexed: 12/29/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v) is a major causative agent of acute hemorrhagic conjunctivitis outbreaks worldwide, yet the evolutionary and transmission dynamics of the virus remain unclear. To address this, we analyzed and compared the 3C and partial VP1 gene regions of CVA24v isolates obtained from five outbreaks in Cuba between 1986 and 2009 and strains isolated worldwide. Here we show that Cuban strains were homologous to those isolated in Africa, the Americas and Asia during the same time period. Two genotypes of CVA24v (GIII and GIV) were repeatedly introduced into Cuba and they arose about two years before the epidemic was detected. The two genotypes co-evolved with a population size that is stable over time. However, nucleotide substitution rates peaked during pandemics with 4.39 × 10-3 and 5.80 × 10-3 substitutions per site per year for the 3C and VP1 region, respectively. The phylogeographic analysis identified 25 and 19 viral transmission routes based on 3C and VP1 regions, respectively. Pandemic viruses usually originated in Asia, and both China and Brazil were the major hub for the global dispersal of the virus. Together, these data provide novel insight into the epidemiological dynamics of this virus and possibly other pandemic viruses.
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Affiliation(s)
- Magilé C Fonseca
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba.
| | - Mario Pupo-Meriño
- Departamento de Bioinformática, Centro de Matemática Computacional, Universidad de las Ciencias Informáticas (UCI), Havana, Cuba
| | - Luis A García-González
- Departamento de Ciencias de la Computación, Centro de Investigación Científica y de Educación Superior de Ensenada, Ensenada, Baja California, México
| | - Sonia Resik
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Lai Heng Hung
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Mayra Muné
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Hermis Rodríguez
- Cell Culture Laboratory, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Havana, Cuba
| | - Luis Morier
- Department of Microbiology and Virology, Biology Faculty, Havana University, Havana, Cuba
| | - Heléne Norder
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Luis Sarmiento
- Immunovirology Unit, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
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Enfissi A, Joffret ML, Delaune D, Delpeyroux F, Rousset D, Bessaud M. Coxsackievirus A24 Variant Associated with Acute Haemorrhagic Conjunctivitis Cases, French Guiana, 2017. Intervirology 2018; 60:271-275. [DOI: 10.1159/000489339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/17/2018] [Indexed: 12/14/2022] Open
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Tropism, intracerebral distribution, and transduction efficiency of HIV- and SIV-based lentiviral vectors after injection into the mouse brain: a qualitative and quantitative in vivo study. Histochem Cell Biol 2017; 148:313-329. [PMID: 28397143 PMCID: PMC5539277 DOI: 10.1007/s00418-017-1569-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 01/04/2023]
Abstract
Lentiviruses are suitable to transfer potential therapeutic genes into non-replicating cells such as neurons, but systematic in vivo studies on transduction of neural cells within the complete brain are missing. We analysed the distribution of transduced cells with respect to brain structure, virus tropism, numbers of transduced neurons per brain, and influence of the Vpx or Vpr accessory proteins after injection of vectors based on SIVsmmPBj, HIV-2, and HIV-1 lentiviruses into the right striatum of the mouse brain. Transduced cells were found ipsilaterally around the injection canal, in corpus striatum and along corpus callosum, irrespective of the vector type. All vectors except HIV-2SEW transduced also single cells in the olfactory bulb, hippocampus, and cerebellum. Vector HIV-2SEW was the most neuron specific. However, vectors PBjSEW and HIV-1SEW transduced more neurons per brain (means 41,299 and 32,309) than HIV-2SEW (16,102). In the presence of Vpx/Vpr proteins, HIV-2SEW(Vpx) and HIV-1SEW(Vpr) showed higher overall transduction efficiencies (30,696 and 27,947 neurons per brain) than PBjSEW(Vpx) (6636). The distances of transduced cells from the injection canal did not differ among the viruses but correlated positively with the numbers of transduced neurons. The presence of Vpx/Vpr did not increase the numbers of transduced neurons. Parental virus type and the vector equipment seem to influence cellular tropism and transduction efficiency. Thus, precision of injection and choice of virus pseudotype are not sufficient when targeted lentiviral vector transduction of a defined brain cell population is required.
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Zhang L, Zhao N, Huang X, Jin X, Geng X, Chan TC, Liu S. Molecular epidemiology of acute hemorrhagic conjunctivitis caused by coxsackie A type 24 variant in China, 2004-2014. Sci Rep 2017; 7:45202. [PMID: 28332617 PMCID: PMC5362916 DOI: 10.1038/srep45202] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/21/2017] [Indexed: 11/09/2022] Open
Abstract
To understand control interventions, the molecular epidemiology of acute hemorrhagic conjunctivitis (AHC) was investigated from 2004 to 2014.A total of 613,485 AHC cases (annualized cases 55,771) with two deaths were included. Our findings showed that AHC was reported in all provinces, predominantly in Southern and Eastern China. The incidence rates were highest in 2007 (5.65/100,000) and 2010 (21.78/100,000) respectively. A clear seasonal pattern was identified with a peak from August to October. AHC cases occurred in all age groups; however, five to 14 years was the predominant group [23.06%, 133, 510/578,909]. The median age was 24 years (one month~97 years). The median duration from onset to diagnosis was 1.5 days, and there was no difference between the <15, 15~60 and >60-year-old patients [p = 0.0653]. The phylogenetic analysis of 100 nonstructural proteins (3C) and 84 structural proteins (VP1) revealed that AHC outbreaks were caused by Coxsackievirus A24 variant. Genotypes G4-c5a, G4-c5b, and G4-c3 co-circulated with both temporal and geographical overlaps. In conclusion, despite the overall steady decline in the number of AHC cases since the peak in 2010, it still remains a serious public health problem in Southern and Eastern China that targets on the school aged children under 15 years old.
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Affiliation(s)
- Li Zhang
- Eye Center of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Na Zhao
- National Research Center for Wildlife Borne Diseases, Key Lab of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Xiaodan Huang
- Eye Center of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xiuming Jin
- Eye Center of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xingyi Geng
- Emergency Offices, Jinan Centre for Disease Control and Prevention, Jinan, Shandong Province, China
| | - Ta-Chien Chan
- Center for Geographic Information Science, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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Shaukat S, Angez M, Mahmood T, Alam MM, Sharif S, Khurshid A, Rana MS, Zaidi SSZ. Molecular characterization of echovirus 13 uncovering high genetic diversity and identification of new genotypes in Pakistan. INFECTION GENETICS AND EVOLUTION 2016; 48:102-108. [PMID: 28011278 DOI: 10.1016/j.meegid.2016.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 11/15/2016] [Accepted: 12/18/2016] [Indexed: 11/26/2022]
Abstract
Echovirus 13 (E-13) is reported worldwide and is mostly related to aseptic meningitis but it is also isolated from cases of acute flaccid paralysis (AFP). Unfortunately, all studies conducted on non polio enterovirus in Pakistan only confirm E-13 isolation based on microneutralization assay but there is lack of molecular epidemiological data on this serotype. In this study, 113 stool samples were collected from AFP patients during 2008-2010. An enterovirus primer mediated real-time reverse transcriptase polymerase chain reaction, a standard microneutralization assay and sequencing of viral protein 1 gene (VP1) identified the predominant serotype E-13. For molecular characterization, genetic relationship between 12 clinical isolates of echovirus 13 was investigated by partial sequencing of viral protein 1 gene. These strains, combined with related sequences from GenBank were divided phylogenetically into two different genogroups A and B (>30% divergence) and were found genetically distinct from the circulating strains in the world. Additionally, phylogenic grouping pattern revealed that the study strains clustered into three distinct subgroups (A3, A7 and B3) having >23% nucleotide divergence representing three new genotypes. The genotype A7 seems to be restricted geographically. In conclusion, the current study provides an overview of the molecular epidemiology and evolution of E-13 in the country. This study strongly suggests that enterovirus surveillance system should be established in the country to determine the temporal and geographical trends and disease pattern of different enterovirus serotypes in the community.
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Affiliation(s)
- Shahzad Shaukat
- Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan; Department of Biotechnology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan.
| | - Mehar Angez
- Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan.
| | - Tariq Mahmood
- Department of Plant Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan.
| | - Muhammad Masroor Alam
- Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan.
| | - Salmaan Sharif
- Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan.
| | - Adnan Khurshid
- Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan.
| | - Muhammad Suleman Rana
- Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan.
| | - Syed Sohail Zahoor Zaidi
- Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan.
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Yen YC, Chu PH, Lu PL, Lin YC, Shi YY, Chou LC, Wang CF, Lin YY, Su HJ, Lin CC, Zeng JY, Tyan YC, Ke GM, Chu PY. Phylodynamic Characterization of an Ocular-Tropism Coxsackievirus A24 Variant. PLoS One 2016; 11:e0160672. [PMID: 27529556 PMCID: PMC4987047 DOI: 10.1371/journal.pone.0160672] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/13/2016] [Indexed: 01/22/2023] Open
Abstract
Recent phylodynamic studies have focused on using tree topology patterns to elucidate interactions among the epidemiological, evolutionary, and demographic characteristics of infectious agents. However, because studies of viral phylodynamics tend to focus on epidemic outbreaks, tree topology signatures of tissue-tropism pathogens might not be clearly identified. Therefore, this study used a novel Bayesian evolutionary approach to analyze the A24 variant of coxsackievirus (CV-A24v), an ocular-tropism agent of acute hemorrhagic conjunctivitis. Analyses of the 915-nucleotide VP1 and 690-nt 3Dpol regions of 21 strains isolated in Taiwan and worldwide during 1985-2010 revealed a clear chronological trend in both the VP1 and 3Dpol phylogenetic trees: the emergence of a single dominant cluster in each outbreak. The VP1 sequences included three genotypes: GI (prototype), GIII (isolated 1985-1999), and GIV (isolated after 2000); no VP1 sequences from GII strains have been deposited in GenBank. Another five genotypes identified in the 3Dpol region had support values >0.9. Geographic and demographic transitions among CV-A24v clusters were clearly identified by Bayes algorithm. The transmission route was mapped from India to China and then to Taiwan, and each prevalent viral population declined before new clusters emerged. Notably, the VP1 and 3Dpol genes had high nucleotide sequence similarities (94.1% and 95.2%, respectively). The lack of co-circulating lineages and narrow tissue tropism affected the CV-A24v gene pool.
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Affiliation(s)
- Yung-Chang Yen
- Department of Ophthalmology, Chi Mei Medical Center, Liou-Ying, Tainan, Taiwan
- Department of Nursing, Min Hwei College of Health Care Management, Tainan, Taiwan
| | - Pei-Huan Chu
- Division of Cardiology, Department of Medicine, Wei Gong Memorial Hospital, Miaoli, Taiwan
| | - Po-Liang Lu
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yung-Cheng Lin
- Institute of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan
| | - Yong-Ying Shi
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Chiu Chou
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chu-Feng Wang
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Ying Lin
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Ju Su
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chien-Ching Lin
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jing-Yun Zeng
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Chang Tyan
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Guan-Ming Ke
- Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Neipu, Pingtung, Taiwan
| | - Pei-Yu Chu
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Langford MP, Anders EA, Burch MA. Acute hemorrhagic conjunctivitis: anti-coxsackievirus A24 variant secretory immunoglobulin A in acute and convalescent tear. Clin Ophthalmol 2015; 9:1665-73. [PMID: 26392747 PMCID: PMC4574852 DOI: 10.2147/opth.s85358] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The purpose of this paper is to present the clinical course of a laboratory-acquired case of acute hemorrhagic conjunctivitis (AHC) caused by coxsackievirus A24 variant (CA24v). Also, the anti-CA24v neutralizing activity and anti-CA24v immunoglobulin (Ig) G and secretory IgA (sIgA) in acute and convalescent tears and/or sera are presented. Case A 60-year-old male presented with acute-onset left eyelid edema, tearing, conjunctival erythema, pain, foreign body sensation, and subconjunctival hemorrhage 24 hours after suspected laboratory exposure. Bilateral conjunctivitis presented 24 hours later and resolved in 10 days. Methods Tear and blood samples were collected for virus isolation and neutralizing assays. CA24v-reactive IgG and sIgA in tear and/or serum samples were detected by immunofluorescent antibody analysis of ethanol-fixed virus-infected cells. Results Peak tear neutralization titers (1,000–1,500 U/mL) against the isolated virus occurred 1 day post-onset (po) of AHC. Tear neutralization titers became undetectable by the sixth day as serum neutralization titers became detectable on the ninth day po (60 U/mL), peaked by 21 days (3,000 U/mL), declined by 1 year to 200 U/mL, and remained at 30 U/mL 5 years po. Antibody to human IgG, IgA, and secretory component (sIgA) reacted with CA24v-infected cells treated with pooled acute tears collected 1–4 days po. Predominantly, sIgA was detected in CA24v-infected cells treated with tears collected 4 years and 5 years post-AHC, while convalescent serum contained predominantly anti-CA24v IgG. Conclusion AHC was confirmed by CA24v isolation, tear anti-CA24v neutralizing activity, and seroconversion. The detection of CA24v-reactive IgG, sIgA, and neutralizing activity in tears collected 1–4 days po of AHC supports plasma extravasation of IgG and suggests a defensive role for tear anti-CA24v sIgA. The results suggest that immunofluorescent antibody analysis of tears for persistent anti-CA24v sIgA may be useful in epidemiological monitoring of AHC.
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Affiliation(s)
- Marlyn P Langford
- Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Edwin A Anders
- Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Maxwell A Burch
- Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
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Epidemic outbreak of acute haemorrhagic conjunctivitis caused by coxsackievirus A24 in Thailand, 2014. Epidemiol Infect 2015; 143:3087-93. [PMID: 25824006 DOI: 10.1017/s0950268815000643] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Acute haemorrhagic conjunctivitis outbreaks are often attributed to viral infection. In 2014, an unprecedented nationwide outbreak of infectious conjunctivitis occurred in Thailand, which affected >300 000 individuals over 3 months. To identify and characterize the virus responsible for the epidemic, eye swab specimens from 119 patients were randomly collected from five different provinces. Conserved regions in the enteroviral 5'-UTR and adenovirus hexon gene were analysed. Enterovirus was identified in 71·43% (85/119) of the samples, while no adenovirus was detected. From enterovirus-positive samples, the coxsackievirus A24 variant (70·59%, 84/119) and echovirus (0·84%, 1/119) were identified. Additional sequencing of full-length VP1 and 3C genes and subsequent phylogenetic analysis revealed that these clinical isolates form a new lineage cluster related to genotype IV-C5. In summary, the coxsackievirus A24 variant was identified as an aetiological agent for the recent acute haemorrhagic conjunctivitis outbreak in Thailand.
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Nidaira M, Kuba Y, Saitoh M, Taira K, Maeshiro N, Mahoe Y, Kyan H, Takara T, Okano S, Kudaka J, Yoshida H, Oishi K, Kimura H. Molecular evolution of VP3, VP1, 3C(pro) and 3D(pol) coding regions in coxsackievirus group A type 24 variant isolates from acute hemorrhagic conjunctivitis in 2011 in Okinawa, Japan. Microbiol Immunol 2014; 58:227-38. [PMID: 24517637 DOI: 10.1111/1348-0421.12141] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/03/2014] [Accepted: 02/06/2014] [Indexed: 11/28/2022]
Abstract
A large acute hemorrhagic conjunctivitis (AHC) outbreak occurred in 2011 in Okinawa Prefecture in Japan. Ten strains of coxsackievirus group A type 24 variant (CA24v) were isolated from patients with AHC and full sequence analysis of the VP3, VP1, 3C(pro) and 3D(pol) coding regions performed. To assess time-scale evolution, phylogenetic analysis was performed using the Bayesian Markov chain Monte Carlo method. In addition, similarity plots were constructed and pairwise distance (p-distance) and positive pressure analyses performed. A phylogenetic tree based on the VP1 coding region showed that the present strains belong to genotype 4 (G4). In addition, the present strains could have divided in about 2010 from the same lineages detected in other countries such as China, India and Australia. The mean rates of molecular evolution of four coding regions were estimated at about 6.15 to 7.86 × 10(-3) substitutions/site/year. Similarity plot analyses suggested that nucleotide similarities between the present strains and a prototype strain (EH24/70 strain) were 0.77-0.94. The p-distance of the present strains was relatively short (<0.01). Only one positive selected site (L25H) was identified in the VP1 protein. These findings suggest that the present CA24v strains causing AHC are genetically related to other AHC strains with rapid evolution and emerged in around 2010.
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Affiliation(s)
- Minoru Nidaira
- Okinawa Prefectural Institute of Health and Environment, 2085 Ozato, Nanjo-Shi, Okinawa, 901-1202
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Kiyota N, Kushibuchi I, Kobayashi M, Tsukagoshi H, Ryo A, Nishimura K, Hirata-Saito A, Harada S, Arakawa M, Kozawa K, Noda M, Kimura H. Genetic analysis of the VP4/VP2 coding region in human rhinovirus species C in patients with acute respiratory infection in Japan. J Med Microbiol 2013; 62:610-617. [DOI: 10.1099/jmm.0.049072-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Naoko Kiyota
- Kumamoto Prefectural Institute of Public Health and Environmental Sciences, Uto-shi, Kumamoto 869-0425, Japan
| | - Izumi Kushibuchi
- Tochigi Prefectural Institute of Public Health, Utsunomiya-shi, Tochigi 329-1196, Japan
| | - Miho Kobayashi
- Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi-shi, Gunma 371-0052, Japan
| | - Hiroyuki Tsukagoshi
- Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi-shi, Gunma 371-0052, Japan
| | - Akihide Ryo
- Department of Molecular Biodefence Research, Yokohama City University Graduate School of Medicine, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Koichi Nishimura
- Kumamoto Prefectural Institute of Public Health and Environmental Sciences, Uto-shi, Kumamoto 869-0425, Japan
| | - Asumi Hirata-Saito
- Tochigi Prefectural Institute of Public Health, Utsunomiya-shi, Tochigi 329-1196, Japan
| | - Seiya Harada
- Kumamoto Prefectural Institute of Public Health and Environmental Sciences, Uto-shi, Kumamoto 869-0425, Japan
| | - Mika Arakawa
- Tochigi Prefectural Institute of Public Health, Utsunomiya-shi, Tochigi 329-1196, Japan
| | - Kunihisa Kozawa
- Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi-shi, Gunma 371-0052, Japan
| | - Masahiro Noda
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Hirokazu Kimura
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Musashimurayama-shi, Tokyo 208-0011, Japan
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12
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De W, Huanying Z, Hui L, Corina M, Xue G, Leng L, Hanri Z, Ling F, Yanling M, Huiqiong Z, Huan Z, Jing K, Caiyun L, Yoshida H, Changwen K. Phylogenetic and molecular characterization of coxsackievirus A24 variant isolates from a 2010 acute hemorrhagic conjunctivitis outbreak in Guangdong, China. Virol J 2012; 9:41. [PMID: 22336176 PMCID: PMC3305440 DOI: 10.1186/1743-422x-9-41] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 02/15/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Acute hemorrhagic conjunctivitis is a common disease in China. As a notifiable disease, cases are registered by ophthalmologists on the AHC surveillance system. An AHC outbreak caused by CA24v was observed in Guangdong Province in 2007 by the National Disease Supervision Information Management System. Three years later, a larger outbreak occurred in Guangdong during the August-October period (2010). To characterize the outbreak and compare the genetic diversity of CA24v, which was determined to be the cause of the outbreak, the epidemiology and the molecular characterization of CA24v were analyzed in this study. RESULTS A total of 69,635 cases were reported in the outbreak. 73.5% of index cases originated from students, children in kindergarten and factory workers, with the ≦ 9 age group at the highest risk. The male to female ratio was 1.84:1 among 0-19 years. 56 conjunctival swabs were collected to identify the causative agent from five cities with the AHC outbreak. 30 virus strains were isolated, and two of the genomes had the highest identity values (95.8%) with CA24v genomes. Four CA24v genotypes were identified by phylogenetic analysis for the VP1 and 3C regions. CA24v which caused the outbreak belonged to genotype IV. Furthermore, full nucleotide sequences for four representative isolates in 2010 and 2007 were determined and compared. 20 aa mutations, two nt insertions and one nt deletion were observed in the open reading frame, with 5'- and 3'- UTR respectively between them. CONCLUSIONS CA24v was determined to be the pathogen causing the outbreak and belongs to genotype IV. VP1 is more informative than 3C(Pro) for describing molecular epidemiology and we hypothesize that accumulative mutations may have promoted the outbreak.
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Affiliation(s)
- Wu De
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zheng Huanying
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Li Hui
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | | | - Guo Xue
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Liu Leng
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zeng Hanri
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Fang Ling
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Mo Yanling
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zhou Huiqiong
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zhang Huan
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Kou Jing
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Long Caiyun
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Hiromu Yoshida
- National Institute of Infectious Diseases Gakuen, Tokyo, 2080011, Japan
| | - Ke Changwen
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
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13
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Fonseca MC, Sarmiento L, Resik S, Pereda N, Rodríguez H, Kourí V, Martínez PA, Piñón A, Limonta D, Más P, Hung LH. Isolation of Coxsackievirus A24 variant from patients with hemorrhagic conjunctivitis in Cuba, 2008-2009. J Clin Virol 2011; 53:77-81. [PMID: 22074932 DOI: 10.1016/j.jcv.2011.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 10/12/2011] [Accepted: 10/14/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND An outbreak of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009. OBJECTIVE To determinate the etiological agent associated with the Cuban outbreaks of acute hemorrhagic conjunctivitis during 2008 and 2009. STUDY DESIGN Conjunctival swabs and/or faecal samples from 382 patients with clinical diagnosis suggestive of acute hemorrhagic conjunctivitis were subject to viral culture in HEp-2 human laryngeal epidermoid carcinoma cells. Positive samples were identified by a specific Coxsackievirus A24 variant PCR and the 3C protease region of 16 isolates was sequenced for phylogenetic analysis. RESULTS Enterovirus cytopathic effect was observed in 138 cases (36%). A higher percent of CA24v was recovered from faecal samples, 19 out of 45 cases (42.2%), than from conjunctival swabs, 127 out of 355 samples (35.8%). All isolates were identified as Coxsackievirus A24 variant. Phylogenetic analysis revealed that 2008 and 2009 Cuban outbreaks were caused by the same virus strains and that isolates were closely related to those from Taiwan (2006-2007), China (2007-2008) and Singapore (2005) with a bootstrap value of 71%. CONCLUSIONS Outbreaks of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009 were caused by Coxsackievirus A24 variant. The faecal-oral route is another mode of transmission of CA24v in the acute hemorrhagic conjunctivitis outbreaks. Phylogenetic analysis of Cuban CA24v strains involved in an acute hemorrhagic conjunctivitis outbreak in 2008 and 2009 confirms a new introduction of the CA24 variant into the Americas from South-east Asia.
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Affiliation(s)
- Magilé C Fonseca
- Department of Virology, Pedro Kourí Tropical Medicine Institute (IPK), Autopista Novia del Mediodía km. 6 1/2, Marianao 13, Havana, Cuba.
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14
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Fares W, Rezig D, Seghier M, Ben Yahia A, Touzi H, Triki H. Phylogenetic analysis of complete VP1 sequences of echoviruses 11 and 6: high genetic diversity and circulation of genotypes with a wide geographical and temporal range. J Med Microbiol 2011; 60:1017-1025. [DOI: 10.1099/jmm.0.028795-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Wasfi Fares
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis, Tunisia
| | - Dorra Rezig
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis, Tunisia
| | - Mohamed Seghier
- Laboratory of Enteroviruses, National Laboratory for Poliomyelitis, Institut Pasteur d’Algérie, Algeria
| | - Ahlem Ben Yahia
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis, Tunisia
| | - Henda Touzi
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis, Tunisia
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15
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[Enteroviruses responsible for acute hemorrhagic conjunctivitis]. Med Mal Infect 2010; 40:212-8. [PMID: 19836177 DOI: 10.1016/j.medmal.2009.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 06/03/2009] [Accepted: 09/09/2009] [Indexed: 11/23/2022]
Abstract
Acute hemorrhagic conjunctivitis (AHC) is an epidemic form of highly contagious conjunctivitis, characterized by conjunctival hemorrhages. The first AHC outbreak was described in 1969 in Ghana, West Africa, and was called Apollo disease, from the Apollo landing on the moon. This outbreak was caused by Enterovirus 70 (EV70) together with a Coxsackievirus A24 (CVA24v) variant, which are the major etiological agents involved in AHC outbreaks worldwide. AHC is known to be directly transmitted by close person-to-person contact or indirectly through soiled ophthalmological materials or unsafe recreational water. Recently, a possible airborne virus spread was suggested which could explain the high transmission rate of the disease. In the absence of a specific antiviral therapy, a rapid diagnosis of the causative agent is required to distinguish AHC due to enteroviruses from other ocular infectious diseases, for there are active drugs, or to quickly implement proper public health measures to limit the extension of the outbreak. However, virus identification remains difficult and time-consuming. Moreover, virological diagnosis is difficult to implement in developing countries where AHC has recently become a major problem for public health.
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16
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Chu PY, Ke GM, Chang CH, Lin JC, Sun CY, Huang WL, Tsai YC, Ke LY, Lin KH. Molecular epidemiology of coxsackie A type 24 variant in Taiwan, 2000-2007. J Clin Virol 2009; 45:285-91. [PMID: 19473877 DOI: 10.1016/j.jcv.2009.04.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 03/27/2009] [Accepted: 04/20/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND Epidemics of acute hemorrhagic conjunctivitis (AHC) caused by a coxsackievirus A24 variant (CA24v) appeared in Taiwan in 2000-2002 and again in 2006-2007. OBJECTIVE To analyze the molecular epidemiology of CA24v in recent outbreaks in Taiwan. STUDY DESIGN A 510bp fragment of 3C(pro) region was analyzed in 30 CA24v isolates during 2000-2007. Phylogenetic tree was constructed along with 130 CA24v isolates available from the GenBank. Moreover, the 235bp of 3'VP1 region was similarly analyzed in 15 randomly selected strains isolated during 1985-2007. Phylogenetic dendrogram was constructed for the 3'VP1 region in 105 CA24v strains worldwide. Genetic distances were calculated using Kimura 2-parameter model, and phylogenetic trees were constructed by neighbor-joining method. RESULTS The 3C(pro) dendrogram depicted genotype IV (GIV), a new genotype that can be further divided into three clusters (C1-C3). The 2000-2002 outbreaks were caused by genotype IV-cluster 1 (GIV-C1) and GIV-C2. Strains isolated in the 2006-2007 outbreak belong to GIV-C3, also in the same cluster as Singapore strains from 2005. Analysis on 3'VP1 revealed only GI, GIII and GIV in line with the classification in 3C(pro) dendrogram. All genotype IV strains were also divided into three clusters, though the GIV-C 2' were isolated from broader geographic areas and over a longer period of time. CONCLUSIONS Analysis of the 3C(pro) region is more insightful than the 3'VP1 region in the molecular epidemiology of CA24v. The 3C(pro) dendrogram accurately and chronologically identified all stains involved in the worldwide outbreaks.
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Affiliation(s)
- Pei-Yu Chu
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
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17
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Molecular and immunocytochemical identification of coxsackievirus A-24 variant from the acute haemorrhagic conjunctivitis outbreak in Taiwan in 2007. Eye (Lond) 2009; 24:131-6. [PMID: 19218990 DOI: 10.1038/eye.2009.8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AIMS Acute haemorrhagic conjunctivitis (AHC) is a highly contagious conjunctivitis associated with enteroviruses. Coxsackie A-24 variant (CA-24v) and enterovirus-70 (EV-70) are the two major causative agents. During October 2007, an epidemic of AHC occurred in Taiwan, affecting more than 11 000 people. The aim of this study was to determine the aetiological agent associated with the outbreak in patients diagnosed with AHC and treated at the Cathay General Hospital, Taipei (CGHT) and Cathay General Hospital Sijhih (CGHS), Taiwan during October 2007. METHODS Virus isolates were obtained from six patients (four from CGHS and two from CGH), and a total of seven specimens (one throat and one rectal, and five eye swabs) were collected. The specimens were inoculated onto the MRC-5 cell lines. The viral isolation was confirmed by performing real-time reverse transcription-polymerase chain reaction (RT-PCR) and indirect immunofluorescence assay (IFA). RESULTS The conjunctival, throat, and rectal swabs collected in this study were all tested positive for a variant of CA-24. All seven viral isolates were characterized as a variant of CA-24 and confirmed by IFA and real-time RT-PCR. CONCLUSIONS The findings suggest that the outbreak of AHC that occurred during October 2007 in the northern area of Taiwan was caused by a variant of coxsackie A-24. Further phylogenic analysis is underway to further classify this CA-24v strain.
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18
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Wu D, Ke CW, Mo YL, Sun LM, Li H, Chen QX, Zou LR, Fang L, Huang P, Zhen HY. Multiple outbreaks of acute hemorrhagic conjunctivitis due to a variant of coxsackievirus A24: Guangdong, China, 2007. J Med Virol 2008; 80:1762-8. [PMID: 18712817 DOI: 10.1002/jmv.21288] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Acute hemorrhagic conjunctivitis (AHC) is usually caused by enterovirus 70, coxsackievirus A24(CA24v) and adenoviruses. Several outbreaks of AHC caused by a CA24v have occurred since it was imported into China in 1971. Multiple outbreaks of AHC reappeared in 10 cities of Guangdong during June to November in 2007. The epidemic began in the June, and spread extensively, with a peak in the September. A total of 31,659 cases were reported to center for disease control and prevention of Guangdong, it was estimated that the number of actual AHC was >200 thousands. Forty conjunctival swab specimens were collected from the cases diagnosed clinically with AHC. (RT)-PCR testing on these conjunctival specimens revealed the presence of an enterovirus, and this was confirmed by 16 isolates. We demonstrated the most likely etiological agent for the multiple outbreaks was a variant of coxsackievirus A24 by molecular typing using a partial VP1 sequence. Sequence comparison and phylogenetic analyses of the VP1 and 3Cpro gene regions were performed by Neighbor-joining method, the strains from different outbreaks and different geographical areas within Guangdong had no sequence divergence in 2007. The representative isolates from mainland of China including Hangzhou, Ningbo, Beijing, Yunnan, Liaoning, and Henan were analyzed in this study. Phylogenetic analysis revealed theses isolates were located in different clusters, a close phylogenetic and chronological relationship with Singaporean, South Korean and Thailand isolates had been observed. This confirms CA24v circulated in China's mainland has not evolved independently, but co-evolved with the isolates of Southeast Asia.
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Affiliation(s)
- De Wu
- Institute of Microbiology, Center for Diseases Control and Prevention of Guangdong, Xingang Xilu, Guangzhou City, Guangdong Province, The People's Republic of China.
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19
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Molecular characterization of a coxsackievirus A24 variant that caused an outbreak of acute haemorrhagic conjunctivitis in Spain, 2004. J Clin Virol 2008; 43:323-7. [PMID: 18786853 DOI: 10.1016/j.jcv.2008.07.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2007] [Revised: 07/30/2008] [Accepted: 07/30/2008] [Indexed: 11/20/2022]
Abstract
BACKGROUND Coxsackievirus A24 variant is one of the major etiological agents involved in acute haemorrhagic conjunctivitis. STUDY DESIGN An outbreak of acute hemorrhagic conjunctivitis occurred in the Southeast of Spain between September and November 2004. Cellular and molecular methods were used to identify and characterize the viral agent associated with the epidemic. RESULTS Enterovirus was detected in the conjunctival swabs of 35 patients. None of the viruses isolated could be typed by conventional neutralization assays; however, amplification and sequencing of the 3'-end VP1 region of 19 of the samples identified coxsackievirus A24 variant as the serotype causing the outbreak. Phylogenetic analysis of the 5'-half VP1 region of the genome revealed that Spanish sequences, like other strains isolated during outbreaks of hemorrhagic conjunctivitis in American and African countries in 2003 and 2004, were closely related to the isolates detected in Korea (2002), thus proving their worldwide spread. CONCLUSIONS This is the first report of an epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Spain. Molecular typing in combination with phylogenetic analysis is useful to study the enterovirus epidemiology associated with epidemics.
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20
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Yeo DSY, Seah SGK, Chew JSW, Lim EAS, Liaw JCW, Loh JP, Tan BH. Molecular identification of coxsackievirus A24 variant, isolated from an outbreak of acute hemorrhagic conjunctivitis in Singapore in 2005. Arch Virol 2007; 152:2005-16. [PMID: 17680326 DOI: 10.1007/s00705-007-1032-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2007] [Accepted: 06/14/2007] [Indexed: 11/29/2022]
Abstract
An outbreak of acute hemorrhagic conjunctivitis (AHC) was reported in Singapore military camps in the year 2005. A total of 103 conjunctival swab specimens were collected from military personnel diagnosed clinically with AHC. PCR testing on these conjunctival specimens revealed the presence of an enterovirus, and this was confirmed by virus isolation. Molecular typing using a partial VP1 gene confirmed a variant of coxsackievirus A24 (CA24v) as the most likely etiological agent for the outbreak. Full-length genome sequencing was carried out on 2 selected virus strains, DSO-26SIN05 and DSO-52SIN05. Sequence comparison and phylogenetic analyses of the VP4, VP1 and 3Cpro gene regions were performed, clustering the Singapore CA24v strains with viruses originating from Asia in the post-2000 era. In addition, we report evolution rates of 4.2 x 10(-3) and 1.0 x 10(-3) nucleotide/year, respectively, for the VP4 capsid and 3Cpro gene regions. Our result shows a focal evolutionary point around 1965-1966, suggesting that the CA24v virus has been evolving constantly since its emergence in Singapore, nearly 40 years ago.
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Affiliation(s)
- D S-Y Yeo
- Detection and Diagnostics Laboratory, DSO National Laboratories, Defence Medical and Environmental Research Institute, Singapore
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21
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Gopalkrishna V, Patil PR, Kolhapure RM, Bilaiya H, Fulmali PV, Deolankar RP. Outbreak of acute hemorrhagic conjunctivitis in Maharashtra and Gujarat states of India, caused by Coxsackie virus A-24 variant. J Med Virol 2007; 79:748-53. [PMID: 17457917 DOI: 10.1002/jmv.20886] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Acute hemorrhagic conjunctivitis is associated with enteroviruses. Among these, Coxsackie A-24 variant (CA-24) and Enterovirus-70 (EV-70) are known to cause epidemics and pandemics. An outbreak of acute hemorrhagic conjunctivitis occurred in August-September 2003 in Maharashtra and Gujarat states of India. The present investigation was carried out to determine the viral etiological agent associated with the epidemic. Virus isolates were obtained from 11 eye swabs of conjunctivitis patients using HeLa/ Hep-2 cell lines. The isolates were characterized by serological and mouse pathogenecity tests, RT-PCR using enterovirus common primers (VP4-VP2), CA-24 specific primers (3C-proteinase region), EV-70 primers (VP-3) followed by sequencing, and phylogenetic analysis. The virus was characterized as a Coxsackie A-24 variant (CA-24v) and none of the isolates were found to be positive for EV-70. Sequencing of the PCR products derived from all the 11 isolates revealed 98.4% (SE 0.20) nucleotide identity within the Indian strains and 98.6% (0.50) and 94.4% (0.30) nucleotide identity respectively with the West Indies and Asian strains reported worldwide. The findings suggest that the outbreak of acute hemorrhagic conjunctivitis that occurred in Maharashtra and Gujarat states of India during August-September 2003 was caused by the Coxsackie A-24 variant (CA-24v).
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Animals
- Cell Line, Tumor
- Child
- Child, Preschool
- Conjunctivitis, Acute Hemorrhagic/epidemiology
- Conjunctivitis, Acute Hemorrhagic/virology
- Coxsackievirus Infections/epidemiology
- Coxsackievirus Infections/virology
- Disease Models, Animal
- Disease Outbreaks
- Enterovirus C, Human/classification
- Enterovirus C, Human/genetics
- Enterovirus C, Human/isolation & purification
- Enterovirus C, Human/pathogenicity
- Eye/virology
- Female
- Humans
- India/epidemiology
- Male
- Mice
- Middle Aged
- Phylogeny
- RNA, Viral/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Sequence Analysis, DNA
- Serotyping
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22
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Triki H, Rezig D, Bahri O, Ayed NB, Yahia AB, Sadraoui A, Ayed S. Molecular characterisation of a coxsackievirus A24 that caused an outbreak of acute haemorrhagic conjunctivitis, Tunisia 2003. Clin Microbiol Infect 2007; 13:176-182. [PMID: 17328730 DOI: 10.1111/j.1469-0691.2006.01618.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study reports the genetic characteristics of coxsackievirus A24 isolates from Tunisia, including a coxsackievirus A24 variant (CVA24v) that caused an outbreak of acute haemorrhagic conjunctivitis (AHC) between September and November 2003. The virus genome was detected by PCR from conjunctival swabs obtained from patients with AHC. Four virus isolates were obtained from PCR-positive samples and were serotyped by sequence analysis of the VP1 and VP4 genomic region and by seroneutralisation. Phylogenetic analysis of the VP1, VP4 and 3C genomic regions was performed. Other Tunisian CVA24 isolates from paralytic cases and healthy individuals were also amplified, sequenced and included in the phylogenetic analysis. The epidemic strain belonged to the CVA24 serotype. Phylogenetic analysis of the 3C region of the genome revealed a strong relationship between the Tunisian epidemic strain and strains that caused outbreaks in Korea (2002) and Guadeloupe and French Guiana (2003). Phylogenetic analysis of the VP1 and VP4 regions showed a clear distinction between serotype CVA24 isolates from conjunctivitis and non-conjunctivitis cases. This is the first study to report an outbreak of AHC caused by CVA24v in the North African region.
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Affiliation(s)
- H Triki
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis.
| | - D Rezig
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis
| | - O Bahri
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis
| | - N Ben Ayed
- Institute of Ophthalmology Hedi Rais, Tunisia
| | - A Ben Yahia
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis
| | - A Sadraoui
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis
| | - S Ayed
- Institute of Ophthalmology Hedi Rais, Tunisia
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23
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Lévêque N, Lahlou Amine I, Tcheng R, Falcon D, Rivat N, Dussart P, Muyembe JJ, Chomel JJ, Norder H, Eugene M, Lina B. Rapid diagnosis of acute hemorrhagic conjunctivitis due to coxsackievirus A24 variant by real-time one-step RT-PCR. J Virol Methods 2007; 142:89-94. [PMID: 17328967 DOI: 10.1016/j.jviromet.2007.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Revised: 12/28/2006] [Accepted: 01/18/2007] [Indexed: 11/22/2022]
Abstract
Coxsackievirus A24 variant is, together with enterovirus 70 and adenoviruses, the major etiological agent involved in acute hemorrhagic conjunctivitis outbreaks worldwide. However, the standard virus isolation method followed by serotyping or VP1 region sequencing is time-consuming. A rapid method for the detection of coxsackievirus A24 variant from conjunctival swab specimens would be useful in the context of explosive and extensive outbreaks. A one-step real-time RT-PCR assay based on TaqMan technology was thus developed and assessed on 36 conjunctival swabs from outbreaks of conjunctivitis in Morocco in 2004 due to a coxsackievirus A24 variant and in Corsica in 2006 due to adenovirus type 3, and 83 virus strains including 41 coxsackievirus A24 variant collected in French Guiana and Guadeloupe in 2003, in the Democratic Republic of the Congo in 2003, in Morocco in 2004 and 42 other virus species genetically close or known to be responsible for conjunctivitis. All the conjunctival swabs from coxsackievirus A24 variant related outbreak and the 41 coxsackievirus A24 variant strains were tested positive by the RT-PCR assay within 4h. This novel single-tube real-time RT-PCR assay is sensitive and specific, and consists in a reliable and faster alternative to the viral culture for recent and future acute hemorrhagic conjunctivitis outbreaks caused by coxsackievirus A24 variant.
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Affiliation(s)
- Nicolas Lévêque
- Laboratoire de Virologie, Centre National de Référence des Entérovirus, Hôpital E. Herriot, Hospices Civils de Lyon, France.
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24
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Lévêque N, Amine IL, Amine IL, Cartet G, Hammani AB, Khazraji YC, Lina B, Muyembe JJ, Norder H, Chomel JJ. Two outbreaks of acute hemorrhagic conjunctivitis in Africa due to genotype III coxsackievirus A24 variant. Eur J Clin Microbiol Infect Dis 2007; 26:199-202. [PMID: 17294159 DOI: 10.1007/s10096-007-0265-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Reported here are two outbreaks of acute hemorrhagic conjunctivitis that occurred in the Democratic Republic of the Congo and in Morocco in the summers of 2003 and 2004, respectively, with a large impact on public health. Virus was isolated from the conjunctival swabs of 30 Congolese and 20 Moroccan patients. Enterovirus-specific cytopathic effect was observed in all samples. None of the strains could be typed using a conventional neutralization assay with the Melnick intersecting pools; however, by sequencing the VP1 region, the viruses could be identified as coxsackie A24 variants. Phylogenetic analysis of the 3C protease region revealed that these strains were closely related to each other as well as to genotype III isolates detected in Korea in 2002, thus proving their worldwide spread. This is the first report of an epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Africa since 1987 and the first ever from Morocco.
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Affiliation(s)
- N Lévêque
- Centre National de Référence des Entérovirus, Hôpital E. Herriot, Hospices Civils de Lyon, Lyon, France.
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Dussart P, Cartet G, Huguet P, Lévêque N, Hajjar C, Morvan J, Vanderkerckhove J, Ferret K, Lina B, Chomel JJ, Norder H. Outbreak of acute hemorrhagic conjunctivitis in French Guiana and West Indies caused by coxsackievirus A24 variant: Phylogenetic analysis reveals Asian import. J Med Virol 2005; 75:559-65. [PMID: 15714481 DOI: 10.1002/jmv.20304] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
An outbreak of acute hemorrhagic conjunctivitis occurred in French Guiana between April and July 2003, with approximately 6,000 cases in the two major cities Kourou and Cayenne. Since acute hemorrhagic conjunctivitis is not a notifiable disease in France, there was no registration of the number of cases. Therefore, these were estimated by comparing the consumption of antibiotic eye drops and ophthalmic ointments during 2002 and 2003. The outbreak rapidly spread into the Caribbean Islands, causing an outbreak in Guadeloupe in October. Viral isolates from conjunctival swabs of 16 patients were confirmed to be enterovirus by PCR directed to the 5' UTR of the genome. The isolates could not be neutralized by the Melnick intersecting pools, but were shown to be CV-A24 variant by limited sequencing within the VP1 and 3C regions of 12 strains. Phylogenetic analysis revealed that they were similar to the genotype III strains causing outbreaks in Korea 2002 and Malaysia 2003. The previous outbreak of conjunctivitis caused by CV-A24 in the Caribbean in the 1980s was also introduced from Asia, and disappeared after 3 years. This new introduction from Asia and its rapid spread into the Caribbean, where the infection disappeared after a few months, indicates that the CV-A24 variant has a different epidemiological pattern in this region compared to South East Asia, since it has not established an endemic infection. It had to be reintroduced from Asia, where it has been circulating since the 1970s.
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Affiliation(s)
- Philippe Dussart
- Laboratoire de Virologie, Institut Pasteur de la Guyane, French Guiana
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Oh MD, Park S, Choi Y, Kim H, Lee K, Park W, Yoo Y, Kim EC, Choe K. Acute hemorrhagic conjunctivitis caused by coxsackievirus A24 variant, South Korea, 2002. Emerg Infect Dis 2003; 9:1010-2. [PMID: 12967504 PMCID: PMC3020616 DOI: 10.3201/eid0908.030190] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In summer 2002, a nationwide outbreak of acute hemorrhagic conjunctivitis occurred in South Korea. The etiologic agent was confirmed as coxsackievirus A24 variant (CA24v) by virus isolation and sequencing of a part of the VP1 gene. Phylogentic analysis, based on the protease 3C sequences, showed that the Korean isolates were clustered into a lineage distinct from the CA24v isolates reported in previous outbreaks in Asia.
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Affiliation(s)
- Myoung-don Oh
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sangwon Park
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youngju Choi
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hongbin Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kiduk Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wanbum Park
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youngae Yoo
- Hamchun Eye Clinic, Seoul, Republic of Korea
| | - Eui-Chong Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Kangwon Choe
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Seoul National University Hospital, Seoul, Republic of Korea
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Chang CH, Lin KH, Sheu MM, Huang WL, Wang HZ, Chen CW. The change of etiological agents and clinical signs of epidemic viral conjunctivitis over an 18-year period in southern Taiwan. Graefes Arch Clin Exp Ophthalmol 2003; 241:554-560. [PMID: 12768288 DOI: 10.1007/s00417-003-0680-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2002] [Revised: 03/18/2003] [Accepted: 03/26/2003] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Epidemic viral conjunctivitis is a highly contagious eye disease that occurs worldwide and is caused mainly by adenoviruses and enteroviruses. An 18-year analysis of the changes of pathogens and clinical signs in a subtropical and densely populated island presents certain special features. METHODS We retrospectively analyzed the clinical information and laboratory records of the conjunctivitis patients with positive conjunctival swabs from 1980 to 1997. RESULTS The positive rate of laboratory diagnosis of epidemic conjunctivitis was 50.0% (1,233/2,467). From 1980 to 1994, the predominant causative agent of adenoviral keratoconjunctivitis was adenovirus type 8 (Ad8), with six genotypes being evolved. Three of the new Ad8 genotypes each caused a new epidemic. After 1995 the predominant adenoviral pathogens shifted to Ad37 and Ad19, and no more Ad8 was isolated. Enterovirus type 70 (EV70) was isolated from four outbreaks of acute hemorrhagic conjunctivitis (AHC) from 1980 to 1984, but rarely in later years. Coxsackievirus A type 24 variant (CA24v), which first appeared in 1985, appeared later as the causes of four major epidemics of AHC from 1985 to 1994. The overall clinical symptoms of viral conjunctivitis were more severe in the 1990s than in the 1980s. CONCLUSION In southern Taiwan, outbreaks of adenoviral keratoconjunctivitis caused by new genomic variants could be associated with the long-term endemic co-circulation of Ad8, Ad19, and Ad37, while epidemics of CA24v AHC were caused mainly by introduction of new viral strains from neighboring countries. The aggravation of host symptoms in the 1990s needs further investigation and close follow-up.
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MESH Headings
- Adenovirus Infections, Human
- Conjunctivitis, Acute Hemorrhagic/complications
- Conjunctivitis, Acute Hemorrhagic/epidemiology
- Conjunctivitis, Acute Hemorrhagic/virology
- Conjunctivitis, Viral/complications
- Conjunctivitis, Viral/epidemiology
- Conjunctivitis, Viral/physiopathology
- Conjunctivitis, Viral/virology
- Disease Outbreaks
- Enterovirus Infections
- Humans
- Keratitis/complications
- Keratitis/virology
- Keratoconjunctivitis, Infectious/complications
- Keratoconjunctivitis, Infectious/epidemiology
- Keratoconjunctivitis, Infectious/virology
- Lymphatic Diseases/complications
- Lymphatic Diseases/virology
- Retrospective Studies
- Severity of Illness Index
- Taiwan/epidemiology
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Affiliation(s)
- Cheng-Hsien Chang
- Department of Ophthalmology, College of Medicine, Kaohsiung Medical University, 100 Shih-chuan 1st Road, Kaohsiung, Taiwan
| | - Kuei-Hsiang Lin
- Department of Clinical Laboratory, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Min-Muh Sheu
- Department of Ophthalmology, College of Medicine, Kaohsiung Medical University, 100 Shih-chuan 1st Road, Kaohsiung, Taiwan
| | | | - Huei-Zu Wang
- Department of Ophthalmology, College of Medicine, Kaohsiung Medical University, 100 Shih-chuan 1st Road, Kaohsiung, Taiwan
| | - Chen-Wu Chen
- Department of Ophthalmology, College of Medicine, Kaohsiung Medical University, 100 Shih-chuan 1st Road, Kaohsiung, Taiwan
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Hwang KP, Chu PY, Tung YC, Wang HL, Yueh YY, Wu YC, Chin C, Lin KH. Molecular epidemiological study of dengue virus type 1 in Taiwan. J Med Virol 2003; 70:404-9. [PMID: 12767004 DOI: 10.1002/jmv.10410] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Taiwan has experienced several major outbreaks of dengue (DEN) virus since 1981. The predominant virus type involved has been dengue virus type one (DEN-1), which first appeared in 1987. To understand the molecular epidemiology of this virus, 15 strains of DEN-1 isolated during 1987-1991 and 1994-1995, including 11 epidemic strains, two sporadic strains, and two imported strains have been studied. Fragments of 490 nucleotides (nt) from the E/NS1 junction were amplified by reverse transcription-polymerase chain reaction and the nt sequences were determined. Of the 490 nt of the E/NS1 junction, 240 nt (nt 2282-2521) were aligned and compared. Nucleotide substitutions were found at 54 positions among 15 isolates. Most nt changes were synonymous substitutions, and only three amino acid changes were found. A total of 61 strains isolated worldwide were analyzed by the Neighbor-joining method, and separated phylogenetically into three distinct genotypes, I-III. Genotype I comprised isolates from Japan and Hawaii collected in the 1940s. Genotype II included most strains isolated from Asia in 1977-1995. Genotype III consisted of isolates from three continents in 1964-1995: Asia, the Americas, and Africa. Genotype III was divided further into two subgenotypes, IIIA and IIIB. Most recent isolates from Taiwan, except for the sporadic strain isolated in 1995, were similar genetically and have been classified as Genotype II.
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Affiliation(s)
- Kao-Pin Hwang
- Department of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan
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