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Ivanova OE, Eremeeva TP, Morozova NS, Mikhailova YM, Kozlovskaya LI, Baikova OY, Shakaryan AK, Krasota AY, Korotkova EA, Yakovchuk EV, Shustova EY, Lukashev AN. Non-Polio Enteroviruses Isolated by Acute Flaccid Paralysis Surveillance Laboratories in the Russian Federation in 1998-2021: Distinct Epidemiological Features of Types. Viruses 2024; 16:135. [PMID: 38257835 PMCID: PMC10819661 DOI: 10.3390/v16010135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
More than 100 types of non-polio enteroviruses (NPEVs) are ubiquitous in the human population and cause a variety of symptoms ranging from very mild to meningitis and acute flaccid paralysis (AFP). Much of the information regarding diverse pathogenic properties of NPEVs comes from the surveillance of poliovirus, which also yields NPEV. The analysis of 265 NPEV isolations from 10,433 AFP cases over 24 years of surveillance and more than 2500 NPEV findings in patients without severe neurological lesions suggests that types EV-A71, E13, and E25 were significantly associated with AFP. EV-A71 was also significantly more common among AFP patients who had fever at the onset and residual paralysis compared to all AFP cases. In addition, a significant disparity was noticed between types that were common in humans (CV-A2, CVA9, EV-A71, E9, and E30) or in sewage (CVA7, E3, E7, E11, E12, and E19). Therefore, there is significant evidence of non-polio viruses being implicated in severe neurological lesions, but further multicenter studies using uniform methodology are needed for a definitive conclusion.
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Affiliation(s)
- Olga E. Ivanova
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
- Department of Organization and Technology of Production of Immunobiological Preparations, Institute for Translational Medicine and Biotechnology, First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia
| | - Tatiana P. Eremeeva
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
| | - Nadezhda S. Morozova
- The Federal Budgetary Health Institution “Federal Center of Hygiene and Epidemiology” of the Federal Office for Inspectorate in the Field of Customers and Human Well-Being Protection”(FBHI FCH&E), 117105 Moscow, Russia
| | - Yulia M. Mikhailova
- The Federal Budgetary Health Institution “Federal Center of Hygiene and Epidemiology” of the Federal Office for Inspectorate in the Field of Customers and Human Well-Being Protection”(FBHI FCH&E), 117105 Moscow, Russia
| | - Liubov I. Kozlovskaya
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
- Department of Organization and Technology of Production of Immunobiological Preparations, Institute for Translational Medicine and Biotechnology, First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia
| | - Olga Y. Baikova
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
| | - Armen K. Shakaryan
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
- Department of Childrenʹs Infectious Diseases, Pediatric Faculty, Pirogov Russian National Research Medical University, 119121 Moscow, Russia
| | - Alexandr Y. Krasota
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
- Belozersky Institute of Physical-Chemical Biology, Lomonosov Moscow State University, 119899 Moscow, Russia
| | - Ekaterina A. Korotkova
- Belozersky Institute of Physical-Chemical Biology, Lomonosov Moscow State University, 119899 Moscow, Russia
| | - Elizaveta V. Yakovchuk
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
| | - Elena Y. Shustova
- Federal State Autonomous Scientific Institution “Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences” (Institute of Poliomyelitis) (FSASI “Chumakov FSC R&D IBP RAS”), 108819 Moscow, Russia (E.V.Y.); (E.Y.S.)
| | - Alexander N. Lukashev
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector-Borne Diseases, First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia
- Research Institute for Systems Biology and Medicine, 117246 Moscow, Russia
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2
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Kilaru P, Hill D, Anderson K, Collins MB, Green H, Kmush BL, Larsen DA. Wastewater Surveillance for Infectious Disease: A Systematic Review. Am J Epidemiol 2022; 192:305-322. [PMID: 36227259 PMCID: PMC9620728 DOI: 10.1093/aje/kwac175] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 08/25/2022] [Accepted: 10/05/2022] [Indexed: 02/07/2023] Open
Abstract
Wastewater surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be a valuable source of information regarding SARS-CoV-2 transmission and coronavirus disease 2019 (COVID-19) cases. Although the method has been used for several decades to track other infectious diseases, there has not been a comprehensive review outlining all of the pathogens that have been surveilled through wastewater. Herein we identify the infectious diseases that have been previously studied via wastewater surveillance prior to the COVID-19 pandemic. Infectious diseases and pathogens were identified in 100 studies of wastewater surveillance across 38 countries, as were themes of how wastewater surveillance and other measures of disease transmission were linked. Twenty-five separate pathogen families were identified in the included studies, with the majority of studies examining pathogens from the family Picornaviridae, including polio and nonpolio enteroviruses. Most studies of wastewater surveillance did not link what was found in the wastewater to other measures of disease transmission. Among those studies that did, the value reported varied by study. Wastewater surveillance should be considered as a potential public health tool for many infectious diseases. Wastewater surveillance studies can be improved by incorporating other measures of disease transmission at the population-level including disease incidence and hospitalizations.
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Affiliation(s)
- Pruthvi Kilaru
- Department of Public Health, Syracuse University, Syracuse, New York, United States,Des Moines University College of Osteopathic Medicine, Des Moines, Iowa, United States
| | - Dustin Hill
- Department of Public Health, Syracuse University, Syracuse, New York, United States,Graduate Program in Environmental Science, State University of New York College of Environmental Science and Forestry, Syracuse, New York, United States
| | - Kathryn Anderson
- Department of Medicine, State University of New York Upstate Medical University, Syracuse, New York, United States
| | - Mary B Collins
- Department of Environmental Studies, State University of New York College of Environmental Science, Syracuse, New York, United States
| | - Hyatt Green
- Department of Environmental Biology, State University of New York College of Environmental Science, Syracuse, New York, United States
| | - Brittany L Kmush
- Department of Public Health, Syracuse University, Syracuse, New York, United States
| | - David A Larsen
- Correspondence to Dr. Dave Larsen, Department of Public Health, Syracuse University, 430C White Hall, Syracuse, NY 13244 ()
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3
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Keeren K, Böttcher S, Diedrich S. Enterovirus Surveillance (EVSurv) in Germany. Microorganisms 2021; 9:2005. [PMID: 34683328 PMCID: PMC8538599 DOI: 10.3390/microorganisms9102005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 01/22/2023] Open
Abstract
The major aim of the enterovirus surveillance (EVSurv) in Germany is to prove the absence of poliovirus circulation in the framework of the Global Polio Eradication Program (GPEI). Therefore, a free-of-charge enterovirus diagnostic is offered to all hospitals for patients with symptoms compatible with a polio infection. Within the quality proven laboratory network for enterovirus diagnostic (LaNED), stool and cerebrospinal fluid (CSF) samples from patients with suspected aseptic meningitis/encephalitis or acute flaccid paralysis (AFP) are screened for enterovirus (EV), typing is performed in all EV positive sample to exclude poliovirus infections. Since 2006, ≈200 hospitals from all 16 German federal states have participated annually. On average, 2500 samples (70% stool, 28% CSF) were tested every year. Overall, the majority of the patients studied are children <15 years. During the 15-year period, 53 different EV serotypes were detected. While EV-A71 was most frequently detected in infants, E30 dominated in older children and adults. Polioviruses were not detected. The German enterovirus surveillance allows monitoring of the circulation of clinically relevant serotypes resulting in continuous data about non-polio enterovirus epidemiology.
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Affiliation(s)
- Kathrin Keeren
- Secretary of the National Commission for Polio Eradication in Germany, Robert Koch Institute, 13353 Berlin, Germany;
| | - Sindy Böttcher
- National Reference Centre for Poliomyelitis and Enteroviruses, Robert Koch Institute, 13353 Berlin, Germany;
| | | | - Sabine Diedrich
- National Reference Centre for Poliomyelitis and Enteroviruses, Robert Koch Institute, 13353 Berlin, Germany;
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Larivé O, Brandani J, Dubey M, Kohn T. An integrated cell culture reverse transcriptase quantitative PCR (ICC-RTqPCR) method to simultaneously quantify the infectious concentrations of eight environmentally relevant enterovirus serotypes. J Virol Methods 2021; 296:114225. [PMID: 34216645 DOI: 10.1016/j.jviromet.2021.114225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
Enterovirus (EV) infectivity is typically measured as a bulk parameter, yet EV serotypes vary in their susceptibility to natural and engineered stressors. Here we developed an integrated cell culture reverse transcriptase quantitative PCR (ICC-RTqPCR) method to simultaneously and specifically quantify the infectious concentrations of eight EV serotypes commonly encountered in sewage (coxsackieviruses A9, B1, B2, B3, B4 and B5, and echoviruses 25 and 30). The method uses two cell lines for virus replication and serotype-specific qPCR primers for quantification. Primers were designed to target multiple environmental strains of a given serotype and displayed high specificity. The ICC-RTqPCR method exhibited a linear calibration range between 50 and 1000 (echoviruses) or 5000 (coxsackieviruses) infectious units per mL. Over this range, measurements were not influenced by the presence of non-target serotypes, and calibration slopes were reproducible for different virus batches and cell ages. The ICC-RTqPCR method was able to accurately quantify the infectious concentration of a virus after inactivation by heat, and the concentration of a virus within a wastewater matrix. This method will be valuable to assess the differing fates of EV serotypes in natural or engineered systems, and to portray the associated changes in EV population composition.
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Affiliation(s)
- Odile Larivé
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland
| | - Jade Brandani
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland
| | - Manupriyam Dubey
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland
| | - Tamar Kohn
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland.
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Korukluoglu G, Ozdemirer U, Bayrakdar F, Unal Z, Cosgun Y, Atak T, Karademirtok H, Ata I, Kara F. Detection of non-polio and polio enteroviruses in Acute Flaccid Paralysis surveillance in Turkey. Acta Microbiol Immunol Hung 2021; 68:92-98. [PMID: 33646138 DOI: 10.1556/030.2021.01353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/18/2021] [Indexed: 11/19/2022]
Abstract
Poliomyelitis was a disease feared worldwide, striking suddenly and paralysing mainly children for life. Monitoring of suspected cases of poliomyelitis is carried out with Acute Flaccid Paralysis (AFP) surveillance in Turkey. This study examines national data of AFP surveillance and the epidemiology of enteroviruses (EV) in Turkey from 2000 to 2019 and gives an overview of the detected serotypes of EVs. A total of 13,640 samples collected from patients with 5216 AFP pre-diagnosed cases (2 samples from each patient) and 3,208 contacts, during a 20-year period (2000-2019) were investigated. All isolated polioviruses were tested for their wild or vaccine origin according to the WHO recommended protocol by PCR and sequencing analysis were performed. Enterovirus positivity was detected in a total of 915 cases, which were identified as 204 Sabin-like polio virus (SLPV) and 711 non-polio enterovirus (NPEV). Of the 204 SLPV, 141 (69.1%) AFP were detected in patients and 63 (30.9%) were detected in samples taken from their contacts. Of the 711 NPEVs, 516 (72.5%) were from AFP cases and 195 (27.5%) were detected in samples taken from their contacts. It is concluded that the reason for the higher detection rate of NPEV in samples from AFP pre-diagnosed cases is attributed to the polio vaccination rates reaching 97% between 2008 and 2019 in Turkey. The most frequently detected NPEV serotypes were Coxackie A24, B3, and Echo 30. This retrospective study is the first comprehensive study in Turkey to evaluate the results of the AFP surveillance in the last 20 years.
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Affiliation(s)
- Gulay Korukluoglu
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Umit Ozdemirer
- 2Ministry of Health, General Directorate of Public Health, Vaccine Preventable Diseases Department, Ankara, Turkey
| | - Fatma Bayrakdar
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Zehra Unal
- 3Izmir Public Health Laboratory, Provincial Health Directorate, Izmir, Turkey
| | - Yasemin Cosgun
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Tunca Atak
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Hulya Karademirtok
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Isil Ata
- 2Ministry of Health, General Directorate of Public Health, Vaccine Preventable Diseases Department, Ankara, Turkey
| | - Fatih Kara
- 4Ministry of Health, General Directorate of Public Health, Ankara, Turkey
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6
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Mathew S, Al Khatib HA, Al Ansari K, Nader J, Nasrallah GK, Younes NN, Coyle PV, Al Thani AA, Al Maslamani MA, Yassine HM. Epidemiology Profile of Viral Meningitis Infections Among Patients in Qatar (2015-2018). Front Med (Lausanne) 2021; 8:663694. [PMID: 34222280 PMCID: PMC8241925 DOI: 10.3389/fmed.2021.663694] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Little is known about the etiology of meningitis in the MENA region, including Qatar. Viral agents are considered the major cause for meningitis worldwide. Here, we present primary data about the etiology and clinical and demographic characteristics of viral meningitis (VM) in Qatar between 2015 and 2018. Methods: We retrospectively collected data from Hamad Medical Corporation (HMC), which provides about 80% of healthcare services in Qatar. Data were collected for the period between 2015 and 2018. During this time period, 6,705 specimens were collected from patients with suspected meningitis attending HMC and primary healthcare centers. These specimens were tested for a panel of viruses using the “FTD Viral meningitis” multiplex real-time PCR kit that detects Adenovirus (ADV), Human herpesvirus 1&2 (HSV1 and HSV2), Epstein–Barr virus (EBV), Enteroviruses (EV), Cytomegalovirus (CMV), Varicella zoster virus (VZV), and Parechovirus (PV). Results: Only 10.9% (732/6,705) of all suspected meningitis cases were caused by viral agents. 60.9% of the reported cases were males, compared to 39.1% in females. Most of the infections (73.9%) were reported in children younger than 10 years of age. EV were identified as the main causative agent (68.7%), followed by EBV (7.5%) and ADV (6.8%). Other viral agents including VZV, PV, HSV-1, and HSV-2 were also detected with a lower frequency. Confirmed VM were more prevalent among Qatari subjects compared to other nationalities. We observed no specific seasonality of viral agents, but a slight rise was recorded during the spring seasons (March to June). Fever (59.4%, 435/732) and acute central nervous system (CNS) infection (15.6%, 114/732) were initial symptoms of most cases. Conclusion: This is the first report about the molecular epidemiology of VM in Qatar. In line with the international records, our data showed that EV is responsible for 68.7% of Qatar's VM cases. Further studies are needed to genotype and serotype the identified viruses.
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Affiliation(s)
- Shilu Mathew
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
| | | | | | - Gheyath K Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Nadin N Younes
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
| | | | - Asmaa A Al Thani
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Hadi M Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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7
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Rocha LCD, Estofolete CF, Milhim BHGDA, Augusto MT, Zini N, Silva GCDD, Ferraz-Junior HC, Brienze VMS, Liso E, Cunha MS, Sabino EC, da Costa AC, Nogueira ML, Luchs A, Terzian ACB. Enteric viruses circulating in undiagnosed central nervous system infections at tertiary hospital in São José do Rio Preto, São Paulo, Brazil. J Med Virol 2021; 93:3539-3548. [PMID: 32579291 DOI: 10.1002/jmv.26216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/15/2020] [Accepted: 06/20/2020] [Indexed: 12/18/2022]
Abstract
Enterovirus (EV) is commonly associated with central nervous system (CNS) syndromes. Recently, gastroenteric viruses, including rotavirus (RVA), human astrovirus (HAstV), and norovirus (NoV), have also been associated with CNS neurological disorders. The aim of the present study was to investigate the presence of EV, RVA, HAst, and NoV associated to CNS infections with undiagnosed etiology in Northwest region of São Paulo State, Brazil, and to conduct the molecular characterization of the positive samples detected. A total of 288 cerebrospinal fluid samples collected from July to December 2017 were tested for EV and NoV by quantitative real-time polymerase chain reaction (RT-qPCR), HAstV by conventional RT-PCR, and RVA by enzyme-linked immunosorbent assay. Positive-EV samples were inoculated in cells lines, amplified by RT-PCR and sequenced. RVA, NoV, and HAstV were not detected. EV infection was detected in 5.5% (16/288), and five samples successful genotyped: echovirus 3 (E3) (1/5), coxsackie virus A6 (CVA6) (1/5), and coxsackie virus B4 (CVB4) (3/5). Meningitis was the main syndrome observed (12/16; 75%). CVA6, CVB4, and E3 were identified associated with aseptic meningitis. Reports of CVA6 associated with aseptic meningitis are rare, E3 had not been previously reported in Brazil, and epidemiological data on CVB4 in the country is virtually unknown. The present investigation illustrates the circulation of diverse EV types in a small regional sample set and in a short period of time, highlighting the importance of an active EV surveillance system in CNS infections. Enhanced understanding of undiagnosed CNS infections will assist in public health and health care planning.
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Affiliation(s)
| | | | | | | | - Nathalia Zini
- São José do Rio Preto School of Medicine (FAMERP), São Paulo, Brazil
| | | | | | | | | | - Mariana Sequetin Cunha
- Vector Borne Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | - Ester Cerdeira Sabino
- LIM/46, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Adriana Luchs
- Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
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8
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do Socorro Fôro Ramos E, Rosa UA, de Oliveira Ribeiro G, Villanova F, de Pádua Milagres FA, Brustulin R, Dos Santos Morais V, Bertanhe M, Marcatti R, Araújo ELL, Witkin SS, Delwart E, Luchs A, da Costa AC, Leal É. High Heterogeneity of Echoviruses in Brazilian Children with Acute Gastroenteritis. Viruses 2021; 13:v13040595. [PMID: 33807396 PMCID: PMC8067319 DOI: 10.3390/v13040595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 01/07/2023] Open
Abstract
Echoviruses (E) are a diverse group of viruses responsible for various pathological conditions in humans including aseptic meningitis, myocarditis, and acute flaccid paralysis. The detection and identification of echovirus genotypes in clinical samples is challenging due to its high genetic diversity. Here, we report the complete genome sequences of nine echoviruses, obtained by next-generation sequencing of 238 fecal samples from individuals with gastroenteritis in regions of Brazil. Detected viruses were classified into six genotypes: Three E1 sequences (BRA/TO-028, BRA/TO-069 and BRA/TO-236), one E3 (BRA/TO-018), one E11 (BRA/TO-086), one E20 (BRA/TO-016), two E29 (BRA/TO-030 and BRA/TO-193), and one E30 sequence (BRA/TO-032). Phylogenetic analysis indicated that the echoviruses E1 and E29 circulating in Brazil are divergent from strains circulating worldwide. The genotype diversity identified in our study may under-represent the total echovirus diversity in Brazil because of the small sample size and the restricted geographical distribution covered by the survey.
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Affiliation(s)
- Endrya do Socorro Fôro Ramos
- Laboratório de Diversidade Viral, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem 66075-000, Pará, Brazil
| | - Ulisses Alves Rosa
- Laboratório de Diversidade Viral, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem 66075-000, Pará, Brazil
| | - Geovani de Oliveira Ribeiro
- Laboratório de Diversidade Viral, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem 66075-000, Pará, Brazil
| | - Fabiola Villanova
- Laboratório de Diversidade Viral, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem 66075-000, Pará, Brazil
| | - Flávio Augusto de Pádua Milagres
- Secretaria de Saúde do Tocantins, Palmas 77453-000, Tocantins, Brazil
- Laboratório Central de Saúde Pública do Tocantins (LACEN/TO), Palmas 77016-330, Tocantins, Brazil
| | - Rafael Brustulin
- Secretaria de Saúde do Tocantins, Palmas 77453-000, Tocantins, Brazil
| | - Vanessa Dos Santos Morais
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Mayara Bertanhe
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Roberta Marcatti
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Emerson Luiz Lima Araújo
- General Coordination of Public Health Laboratories of the Strategic Articulation, Department of the Health Surveillance Secretariat of the Ministry of Health (CGLAB/DAEVS/SVS-MS), Brasília 70719-040, Federal District, Brazil
| | - Steven S Witkin
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Eric Delwart
- Vitalant Research Institute, 270 Masonic Avenue, San Francisco, CA 94143, USA
- Department Laboratory Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Adriana Luchs
- Laboratório de Doenças Entéricas, Centro de Virologia, Instituto Adolfo Lutz, São Paulo 01246-000, Brazil
| | - Antonio Charlys da Costa
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Élcio Leal
- Laboratório de Diversidade Viral, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem 66075-000, Pará, Brazil
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9
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Bujaki E, Farkas Á, Rigó Z, Takács M. Distribution of enterovirus genotypes detected in clinical samples in Hungary, 2010-2018. Acta Microbiol Immunol Hung 2020; 67:201-208. [PMID: 33295885 DOI: 10.1556/030.2020.01200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/08/2020] [Indexed: 01/01/2023]
Abstract
This report provides the findings of a retrospective surveillance study on the emergence and circulation of enteroviruses with their associated clinical symptoms over a nine-year period detected at the National Enterovirus Reference Laboratory in Hungary between 2010-2018.Enterovirus (EV) detection and genotyping were performed directly from clinical samples. From 4,080 clinical specimens 25 EV types were identified with a median age of patients of 5 years and 68% of all cases affected children aged 10 years or younger, although infections occurred in all age-groups. In 130 cases neurological symptoms were recorded, in 123 cases the infection presented in skin related signs including hand, foot, and mouth disease (HFMD), herpangina and rash. In 2010 EV-A71 was found to cause the majority of diagnosed EV infections while in 2011 and from 2014-2018, Coxsackievirus (CV)-A6 was identified most often. Echovirus E6 accounted for the most cases in 2012 and Echovirus 30 dominated in 2013. EV-D68 was identified only in 2010 and 2013.Widespread circulation of several EV-A and EV-B viruses with occasional occurrence of EV-C and EV-D was detected. The ability of EVs to cause severe infections in sporadic cases and regular outbreaks highlight the importance of continued monitoring of circulating EV types.
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Affiliation(s)
- Erika Bujaki
- 1Department of Virology, National Public Health Center, Budapest, Hungary
| | - Ágnes Farkas
- 1Department of Virology, National Public Health Center, Budapest, Hungary
| | - Zita Rigó
- 1Department of Virology, National Public Health Center, Budapest, Hungary
| | - Mária Takács
- 1Department of Virology, National Public Health Center, Budapest, Hungary
- 2Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
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10
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Compagnoli Carmona RDC, Caetano Machado B, Aparecida de Sousa C, Vieira HR, Moraes Alves MR, Farias de Souza KA, de Souza Gregório D, Costa Vilanova B, Sampaio Tavares Timenetsky MDC. Distribution of species enterovirus B in patients with central nervous system infections in São Paulo State, Brazil. J Med Virol 2020; 92:3849-3856. [PMID: 32492248 DOI: 10.1002/jmv.26131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/13/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023]
Abstract
Enteroviruses (EV) are most common cause of central nervous system (CNS) infection, mainly aseptic meningitis. In Brazil, data available concerning the distribution of EV types are scarce. The aim of this study was to describe of types EV in patients with infection of the CNS in São Paulo State. This retrospective study was conducted in clinical samples collected from patients with infections of the CNS from 2004 to 2014. We investigated the presence of EV by virus isolation in cell culture. The samples that showed cytopathic effect in the cell culture were submitted by indirect immunofluorescence assay, reverse transcription polymerase chain reaction and VP1 partial sequencing to identification of EV isolated. A total of 176 EV isolated in cell culture was detected and typed in 14.5% (n = 176/1215) of clinical samples analyzed; corresponding to 71.0% of AM, and 19.3% of encephalitis and meningoencephalitis. Echoviruses (E) were isolated most frequently, with 155 strains (88.1%), Coxsackievirus B (CV-B), with 20 cases (11.4%), CV-A, with 01 case (0.6%). E-6 was the most commonly identified followed in decreasing order by E-30; E-18; CV-B5; E-4; E-11; CV-B2 and E-9; E-7; CV-A9, CV-B1, CV-B3, CV-B4, E-13, E-14, and E-21. EV detected were classified as belonging to the species enterovirus B. EV were detected in all the period of the year with the highest rate in the spring and summer months. Data obtained in this study contribute to the knowledge about EV circulation implicated in CNS infections over a 11-year period in São Paulo State, Brazil.
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Affiliation(s)
| | | | | | - Heloisa Rosa Vieira
- Enteric Diseases Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil
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11
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Sciandra I, Falasca F, Maida P, Tranquilli G, Di Carlo D, Mazzuti L, Melengu T, Giannelli G, Antonelli G, Turriziani O. Seroprevalence of group B Coxsackieviruses: Retrospective study in an Italian population. J Med Virol 2020; 92:3138-3143. [PMID: 32531866 DOI: 10.1002/jmv.26096] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/17/2020] [Accepted: 05/25/2020] [Indexed: 12/21/2022]
Abstract
Group B Coxsackieviruses (CVB) include six serotypes (B1-6) responsible for a wide range of clinical diseases. Since no recent seroepidemiologic data are available in Italy, the study aim was to investigate CVB seroprevalence in a wide Italian population. The study retrospectively included 2459 subjects referring to a large academic hospital in Rome (Italy) in the period 2004-2016. Seroprevalence rates and neutralizing antibodies (nAb) titers were evaluated in relation to years of observation and subjects' characteristics. Positivity for at least one serotype was detected in 69.1% of individuals. Overall, the prevalent serotype was B4, followed by B3 (33.3%), B5 (26.2%), B1 (12.7%), B2 (11.0%), and B6 (1.7%). For B2, a significant decrease in seroprevalence over years was observed. Positivity to at least one virus was 25.2% in children aged 0 to 2 years, but significantly increased in preschool (3-5 years) (50.3%) and school (6-10 years) children (70.4%). Higher nAb responses for B3 and B4 were observed in children aged 3 to 5 years. A high overall CVB prevalence was found. Type-specific variations in prevalence over time probably reflect the fluctuations in circulation typical of Enteroviruses. Children are at greater risk for CVB infection given the high number of seronegative subjects aged 0 to 10 years.
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Affiliation(s)
- Ilaria Sciandra
- National Institute of Gastroenterology "S. de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Francesca Falasca
- Virology Unit, Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Paola Maida
- Infectious Diseases Unit, Department of Public Health and Infectious Disease, Sapienza University, Rome, Italy
| | - Giulia Tranquilli
- Virology Unit, Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Daniele Di Carlo
- Virology Unit, Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Laura Mazzuti
- Virology Unit, Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Taulant Melengu
- Virology Unit, Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology "S. de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Guido Antonelli
- Virology Unit, Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Ombretta Turriziani
- Virology Unit, Department of Molecular Medicine, Sapienza University, Rome, Italy
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12
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Contribution of Enteroviruses to Acute Central Nervous System or Systemic Infections in Northern Italy (2015-2017): Is It Time to Establish a National Laboratory-Based Surveillance System? BIOMED RESEARCH INTERNATIONAL 2020; 2020:9393264. [PMID: 32685546 PMCID: PMC7352123 DOI: 10.1155/2020/9393264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 06/18/2020] [Indexed: 11/17/2022]
Abstract
Background Enteroviruses (EVs) can cause infections and outbreaks of mild to severe diseases, such as central nervous system (CNS) and systemic infections. The contribution of EVs to acute CNS/systemic infections requiring hospitalization was assessed by analysing data extracted from virology laboratory database. Methods Real-life data obtained from two molecular virology laboratories located in Northern Italy were retrieved from databases and analysed retrospectively. The queries used to extract the data were (i) requests for EV-RNA detection in clear cerebrospinal fluid (CSF) specimens collected from hospitalized patients with suspected acute CNS (including aseptic meningitis, encephalitis, and acute flaccid myelitis/paralysis) or systemic infections (sepsis-like illness or fever (≥ 38°C) of unknown origin), (ii) CSF samples collected from January 1st, 2015, to December 31st, 2017. Results 582 requests of EV-RNA detection in CSF samples collected from as many patients of any age were recorded. EV-RNA was detected in 4.5% of the CSF samples; 92.3% of EV-positive cases were patients < 15 years, 58.3% of whom were < 3 months. EVs circulated all-year-round, and the highest EV-positive rates were observed from May to August. The risk of EV infection and the relative illness ratio value among children < 1 − year − old were significantly higher than those observed for older patients. Conclusions EV surveillance should be carried out for all pediatric patients < 15 years and especially children less than 1 year of age with clinically suspected CNS infection/systemic infections. The implementation of a laboratory-based surveillance established for analysing the virological data provided by laboratories that routinely perform EV molecular testing may enable us to determine the impact of EVs that can cause infections requiring hospitalization.
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13
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Bartholomeus E, De Neuter N, Lemay A, Pattyn L, Tuerlinckx D, Weynants D, Van Lede K, van Berlaer G, Bulckaert D, Boiy T, Vander Auwera A, Raes M, Van der Linden D, Verhelst H, Van Steijn S, Jonckheer T, Dehoorne J, Joos R, Jansens H, Suls A, Van Damme P, Laukens K, Mortier G, Meysman P, Ogunjimi B. Diagnosing enterovirus meningitis via blood transcriptomics: an alternative for lumbar puncture? J Transl Med 2019; 17:282. [PMID: 31443725 PMCID: PMC6708255 DOI: 10.1186/s12967-019-2037-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/18/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Meningitis can be caused by several viruses and bacteria. Identifying the causative pathogen as quickly as possible is crucial to initiate the most optimal therapy, as acute bacterial meningitis is associated with a significant morbidity and mortality. Bacterial meningitis requires antibiotics, as opposed to enteroviral meningitis, which only requires supportive therapy. Clinical presentation is usually not sufficient to differentiate between viral and bacterial meningitis, thereby necessitating cerebrospinal fluid (CSF) analysis by PCR and/or time-consuming bacterial cultures. However, collecting CSF in children is not always feasible and a rather invasive procedure. METHODS In 12 Belgian hospitals, we obtained acute blood samples from children with signs of meningitis (49 viral and 7 bacterial cases) (aged between 3 months and 16 years). After pathogen confirmation on CSF, the patient was asked to give a convalescent sample after recovery. 3' mRNA sequencing was performed to determine differentially expressed genes (DEGs) to create a host transcriptomic profile. RESULTS Enteroviral meningitis cases displayed the largest upregulated fold change enrichment in type I interferon production, response and signaling pathways. Patients with bacterial meningitis showed a significant upregulation of genes related to macrophage and neutrophil activation. We found several significantly DEGs between enteroviral and bacterial meningitis. Random forest classification showed that we were able to differentiate enteroviral from bacterial meningitis with an AUC of 0.982 on held-out samples. CONCLUSIONS Enteroviral meningitis has an innate immunity signature with type 1 interferons as key players. Our classifier, based on blood host transcriptomic profiles of different meningitis cases, is a possible strong alternative for diagnosing enteroviral meningitis.
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Affiliation(s)
- Esther Bartholomeus
- Center of Medical Genetics, University of Antwerp/Antwerp University Hospital, Edegem, Belgium.,AUDACIS, Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing, University of Antwerp, Antwerp, Belgium
| | - Nicolas De Neuter
- AUDACIS, Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing, University of Antwerp, Antwerp, Belgium.,Adrem Data Lab, Department of Mathematics and Computer Science, University of Antwerp, Antwerp, Belgium.,Biomedical Informatics Research Network Antwerp (Biomina), University of Antwerp, Antwerp, Belgium
| | - Annelies Lemay
- Department of Paediatrics, AZ Turnhout, Turnhout, Belgium
| | - Luc Pattyn
- Department of Paediatrics, AZ Turnhout, Turnhout, Belgium
| | - David Tuerlinckx
- Université Catholique de Louvain/CHU UCL Namur, Site Dinant, Service de Pédiatrie, Dinant, Belgium
| | - David Weynants
- Department of Paediatrics, CHU ULC Namur Ste Elisabeth, Namur, Belgium
| | - Koen Van Lede
- Department of Paediatrics, AZ Nikolaas, Sint-Niklaas, Belgium
| | - Gerlant van Berlaer
- Department of Emergency Medicine/Pediatric Care, University Hospital Brussels, Jette, Belgium
| | - Dominique Bulckaert
- Department of Emergency Medicine/Pediatric Care, University Hospital Brussels, Jette, Belgium
| | - Tine Boiy
- Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium
| | | | - Marc Raes
- Department of Paediatrics, Jessa Hospital, Hasselt, Belgium
| | - Dimitri Van der Linden
- Paediatric Infectious Diseases, Department of Paediatrics, CHU ULC Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Helene Verhelst
- Department of Paediatric Rheumatology, University Hospital, Ghent, Belgium
| | | | - Tijl Jonckheer
- Department of Paediatrics, GZA Sint-Vincentius, Antwerp, Belgium
| | - Joke Dehoorne
- Department of Paediatric Rheumatology, University Hospital, Ghent, Belgium
| | - Rik Joos
- Department of Paediatric Rheumatology, University Hospital, Ghent, Belgium.,Antwerp Center for Paediatric Rheumatology and AutoInflammatory Diseases, Antwerp, Belgium
| | - Hilde Jansens
- Department of Laboratory Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Arvid Suls
- Center of Medical Genetics, University of Antwerp/Antwerp University Hospital, Edegem, Belgium.,AUDACIS, Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing, University of Antwerp, Antwerp, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Kris Laukens
- AUDACIS, Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing, University of Antwerp, Antwerp, Belgium.,Adrem Data Lab, Department of Mathematics and Computer Science, University of Antwerp, Antwerp, Belgium.,Biomedical Informatics Research Network Antwerp (Biomina), University of Antwerp, Antwerp, Belgium
| | - Geert Mortier
- Center of Medical Genetics, University of Antwerp/Antwerp University Hospital, Edegem, Belgium
| | - Pieter Meysman
- AUDACIS, Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing, University of Antwerp, Antwerp, Belgium.,Adrem Data Lab, Department of Mathematics and Computer Science, University of Antwerp, Antwerp, Belgium.,Biomedical Informatics Research Network Antwerp (Biomina), University of Antwerp, Antwerp, Belgium
| | - Benson Ogunjimi
- AUDACIS, Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing, University of Antwerp, Antwerp, Belgium. .,Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium. .,Antwerp Center for Paediatric Rheumatology and AutoInflammatory Diseases, Antwerp, Belgium. .,Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium. .,Antwerp Center for Translational Immunology and Virology (ACTIV), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, 00323/8213251, Antwerp, Belgium. .,Department of Pediatrics, University Hospital Brussels, Jette, Belgium.
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14
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Han Z, Zhang Y, Huang K, Wang J, Tian H, Song Y, Yang Q, Yan D, Zhu S, Yao M, Wang X, Xu W. Two Coxsackievirus B3 outbreaks associated with hand, foot, and mouth disease in China and the evolutionary history worldwide. BMC Infect Dis 2019; 19:466. [PMID: 31126252 PMCID: PMC6534883 DOI: 10.1186/s12879-019-4107-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 05/17/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Coxsackievirus B3 (CV-B3) is usually associated with aseptic meningitis and myocarditis; however, the association between CV-B3 and hand, foot, and mouth disease (HFMD) has not been clearly demonstrated, and the phylogenetic dynamics and transmission history of CV-B3 have not been well summarized. METHOD Two HFMD outbreaks caused by CV-B3 were described in Hebei Province in 2012 and in Shandong Province in 2016 in China. To analyze the epidemiological features of two CV-B3 outbreaks, a retrospective analysis was conducted. All clinical specimens from CV-B3 outbreaks were collected and disposed according to the standard procedures supported by the WHO Global Poliovirus Specialized Laboratory. EV genotyping and phylogenetic analysis were performed to illustrate the genetic characteristics of CV-B3 in China and worldwide. RESULTS Two transmissible lineages (lineage 2 and 3) were observed in Northern China, which acted as an important "reservoir" for the transmission of CV-B3. Sporadic exporting and importing of cases were observed in almost all regions. In addition, the global sequences of CV-B3 showed a tendency of geographic-specific clustering, indicating that geographic-driven adaptation plays a major role in the diversification and evolution of CV-B3. CONCLUSIONS Overall, our study indicated that CV-B3 is a causative agent of HFMD outbreak and revealed the phylogenetic dynamics of CV-B3 worldwide, as well as provided an insight on CV-B3 outbreaks for effective intervention and countermeasures.
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Affiliation(s)
- Zhenzhi Han
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China.
| | - Keqiang Huang
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Jianxing Wang
- Shandong Center for Disease Control and Prevention, Jinan City, Shandong Province, People's Republic of China
| | - Huifang Tian
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People's Republic of China
| | - Yang Song
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Qian Yang
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Dongmei Yan
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Mingxiao Yao
- Shandong Center for Disease Control and Prevention, Jinan City, Shandong Province, People's Republic of China
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan City, Shandong Province, People's Republic of China
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People's Republic of China.,Anhui University of Science and Technology, Hefei City, Anhui Province, People's Republic of China
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15
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N’Guyen Y, Lebreil AL, Simphal P, Pietrement C, Bednarek N, Orquevaux P, Gretteau PA, Andreoletti L. Impact of Enterovirus Molecular Assay Turnaround Time on Hospitalization Length During an Echovirus 30 Meningitis Outbreak, France, Fall 2014. Open Virol J 2019. [DOI: 10.2174/1874357901913010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The impact of Enterovirus Real Time-Polymerase Chain Reaction assay (EV RT-PCR) on hospitalization lengths of patients with aseptic meningitis has been investigated but the impact of early EV RT-PCR results released on time before patient discharge remains unclear during Echovirus meningitis outbreaks.
Objective:
To assess a potential correlation between EV RT-PCR turn-around time and hospitalization lengths during an Echovirus meningitis outbreak.
Method:
Eighteen patients demonstrating a positive EV RT-PCR assay performed on Cerebrospinal Fluid (CSF) samples collected between October 1st 2014 and December 31st 2014 were retrospectively included. Viral protein 1 (VP1) gene region was amplified and sequenced using a classical Sanger sequencing reaction. Clinical data were retrospectively collected from patient’s records. Quantitative variables expressed as median values and ranges were compared using Mann Whitney U test. Correlations were performed using simple regression analysis.
Results:
Phylogenetic VP1 sequence analyses identified that the outbreak was related to an Echovirus 30 strain in 7 out of the 10 cases with available sequencing data. The three remaining sequences analyses evidenced Echovirus 14, 9 and 7 strains. Hospitalization length was statistically shorter in children without comorbidity (n=5) than in adult patients (n=10) or neonates and children with comorbidity (n=3) (p=0.003 and 0.01 respectively), whereas EV RT-PCR turnaround time was not statistically different between these groups. Correlation between hospitalization length and EV RT-PCR turnaround time was poor (R2=0.06), especially in adults (R2=0.01)
Conclusion:
Our data indicated that EV RT-PCR turnaround time was not correlated to hospitalization length during a short Echovirus meningitis outbreak.
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16
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Delogu R, Battistone A, Buttinelli G, Fiore S, Fontana S, Amato C, Cristiano K, Gamper S, Simeoni J, Frate R, Pellegrinelli L, Binda S, Veronesi L, Zoni R, Castiglia P, Cossu A, Triassi M, Pennino F, Germinario C, Balena V, Cicala A, Mercurio P, Fiore L, Pini C, Stefanelli P. Poliovirus and Other Enteroviruses from Environmental Surveillance in Italy, 2009-2015. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:333-342. [PMID: 29948963 DOI: 10.1007/s12560-018-9350-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/08/2018] [Indexed: 06/08/2023]
Abstract
Within the initiatives for poliomyelitis eradication by WHO, Italy activated an environmental surveillance (ES) in 2005. ES complements clinical Acute Flaccid Paralysis (AFP) surveillance for possible polio cases, detects poliovirus circulation in environmental sewage, and is used to monitor transmission in communities. In addition to polioviruses, the analyses comprised: (i) the monitoring of the presence of non-polio enteroviruses in sewage samples and (ii) the temporal and geographical distribution of the detected viruses. From 2009 to 2015, 2880 sewage samples were collected from eight cities participating in the surveillance. Overall, 1479 samples resulted positive for enteroviruses. No wild-type polioviruses were found, although four Sabin-like polioviruses were detected. The low degree of mutation found in the genomes of these four isolates suggests that these viruses have had a limited circulation in the population. All non-polio enteroviruses belonged to species B and the most frequent serotype was CV-B5, followed by CV-B4, E-11, E-6, E-7, CV-B3, and CV-B2. Variations in the frequency of different serotypes were also observed in different seasons and/or Italian areas. Environmental surveillance in Italy, as part of the 'WHO global polio eradication program', is a powerful tool to augment the polio surveillance and to investigate the silent circulation or the re-emergence of enteroviruses in the population.
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Affiliation(s)
- Roberto Delogu
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy.
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
| | - Andrea Battistone
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Gabriele Buttinelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fiore
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fontana
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Concetta Amato
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Karen Cristiano
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Sabine Gamper
- Comprensorio Sanitario di Bolzano, Servizio Igiene e Sanità Pubblica, Bolzano, Italy
| | - Josef Simeoni
- Comprensorio Sanitario di Bolzano, Servizio Igiene e Sanità Pubblica, Bolzano, Italy
| | | | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Paolo Castiglia
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Cossu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Viviana Balena
- Hygiene Unit, Department DIMO, University of Bari, Bari, Italy
| | | | | | - Lucia Fiore
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Pini
- National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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17
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Lafolie J, Labbé A, L'Honneur AS, Madhi F, Pereira B, Decobert M, Adam MN, Gouraud F, Faibis F, Arditty F, Marque-Juillet S, Guitteny MA, Lagathu G, Verdan M, Rozenberg F, Mirand A, Peigue-Lafeuille H, Henquell C, Bailly JL, Archimbaud C. Assessment of blood enterovirus PCR testing in paediatric populations with fever without source, sepsis-like disease, or suspected meningitis: a prospective, multicentre, observational cohort study. THE LANCET. INFECTIOUS DISEASES 2018; 18:1385-1396. [PMID: 30389482 PMCID: PMC7164799 DOI: 10.1016/s1473-3099(18)30479-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/04/2018] [Accepted: 07/17/2018] [Indexed: 01/24/2023]
Abstract
Background Enteroviruses are the most frequent cause of acute meningitis and are seen increasingly in sepsis-like disease and fever without source in the paediatric population. Detection of enterovirus in cerebrospinal fluid (CSF) specimens by PCR is the gold standard diagnostic test. Our aim was to assess a method of detecting enterovirus in blood specimens by PCR. Methods We did a prospective, multicentre, observational study at 35 French paediatric and emergency departments in 16 hospitals. We recruited newborn babies (aged ≤28 days) and infants (aged >28 days to ≤2 years) with fever without source, sepsis-like disease, or suspected meningitis, and children (aged >2 years to ≤16 years) with suspected meningitis, who were admitted to a participating hospital. We used a standardised form to obtain demographic, clinical, and laboratory data, which were anonymised. Enterovirus PCR testing was done in blood and CSF specimens. Findings Between June 1, 2015, and Oct 31, 2015, and between June 1, 2016, and Oct 31, 2016, we enrolled 822 patients, of whom 672 had enterovirus PCR testing done in blood and CSF specimens. Enterovirus was detected in 317 (47%) patients in either blood or CSF, or both (71 newborn babies, 83 infants, and 163 children). Detection of enterovirus was more frequent in blood samples than in CSF specimens of newborn babies (70 [99%] of 71 vs 62 [87%] of 71; p=0·011) and infants (76 [92%] of 83 vs 62 [75%] of 83; p=0·008), and was less frequent in blood samples than in CSF specimens of children (90 [55%] of 163 vs 148 [91%] of 163; p<0·0001). Detection of enterovirus was more frequent in blood samples than in CSF specimens of infants aged 2 years or younger with fever without source (55 [100%] of 55 vs 41 [75%] of 55; p=0·0002) or with sepsis-like disease (16 [100%] of 16 vs nine [56%] of 16; p=0·008). Detection of enterovirus was less frequent in blood than in CSF of patients with suspected meningitis (165 [67%] of 246 vs 222 [90%] of 246; p<0·0001). Interpretation Testing for enterovirus in blood by PCR should be an integral part of clinical practice guidelines for infants aged 2 years or younger. This testing could decrease the length of hospital stay and reduce exposure to antibiotics for low-risk patients admitted to the emergency department with febrile illness. Funding University Hospital Clermont-Ferrand.
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Affiliation(s)
- Jérémy Lafolie
- Université Clermont Auvergne, Centre National de la Recherche Scientifique (CNRS), Laboratory Microorganisms: Genome and Environment (LMGE), Clermont-Ferrand, France; Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence Entérovirus Parechovirus, Clermont-Ferrand, France
| | - André Labbé
- Service de Pédiatrie, Clermont-Ferrand, France
| | - Anne Sophie L'Honneur
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Virologie, Paris, France
| | - Fouad Madhi
- Centre Hospitalier Intercommunal Créteil, Service de Pédiatrie Générale, Créteil, France
| | - Bruno Pereira
- Délégation Recherche Clinique and Innovation, Méthodologie, Biostatistique, Data-management, Clermont-Ferrand, France
| | - Marion Decobert
- Groupe Hospitalier Nord Essonne, Service de Pédiatrie et Néonatologie, Orsay, France
| | - Marie Noelle Adam
- Centre Hospitalier Sud Francilien, Laboratoire de Microbiologie, Corbeil Essonnes, France
| | - François Gouraud
- Grand Hôpital de l'Est Francilien, Service de Pédiatrie, Meaux, France
| | | | - Francois Arditty
- Centre Hospitalier de Versailles André Mignot, Service de Pédiatrie, Le Chesnay, France
| | | | | | | | | | - Flore Rozenberg
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Virologie, Paris, France
| | - Audrey Mirand
- Université Clermont Auvergne, Centre National de la Recherche Scientifique (CNRS), Laboratory Microorganisms: Genome and Environment (LMGE), Clermont-Ferrand, France; Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence Entérovirus Parechovirus, Clermont-Ferrand, France
| | - Hélène Peigue-Lafeuille
- Université Clermont Auvergne, Centre National de la Recherche Scientifique (CNRS), Laboratory Microorganisms: Genome and Environment (LMGE), Clermont-Ferrand, France; Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence Entérovirus Parechovirus, Clermont-Ferrand, France
| | - Cécile Henquell
- Université Clermont Auvergne, Centre National de la Recherche Scientifique (CNRS), Laboratory Microorganisms: Genome and Environment (LMGE), Clermont-Ferrand, France; Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence Entérovirus Parechovirus, Clermont-Ferrand, France
| | - Jean-Luc Bailly
- Université Clermont Auvergne, Centre National de la Recherche Scientifique (CNRS), Laboratory Microorganisms: Genome and Environment (LMGE), Clermont-Ferrand, France
| | - Christine Archimbaud
- Université Clermont Auvergne, Centre National de la Recherche Scientifique (CNRS), Laboratory Microorganisms: Genome and Environment (LMGE), Clermont-Ferrand, France; Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence Entérovirus Parechovirus, Clermont-Ferrand, France.
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18
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Khediri Z, Vauloup-Fellous C, Benachi A, Ayoubi JM, Mandelbrot L, Picone O. Adverse effects of maternal enterovirus infection on the pregnancy outcome: a prospective and retrospective pilot study. Virol J 2018; 15:70. [PMID: 29661198 PMCID: PMC5902830 DOI: 10.1186/s12985-018-0978-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 04/03/2018] [Indexed: 11/10/2022] Open
Abstract
Background Enteroviruses account for about one billion infections worldwide each year, the majority remain asymptomatic. Data on enterovirus infections during pregnancy appear to be very rare. Several cases have been reported in the literature of fetal and neonatal complications attributed to these viruses, but prospective data on these infections during pregnancy are not available. Objective To estimate the prevalence of enterovirus infections in febrile syndromes in pregnant women, and in case of in utero fetal death (IUFD). Methods Ttri-centric observational cohort study. We performed prospective inclusion for patients with fever during a four-month period. We also analyzed the amniotic fluid in patients with unexplained IUFD retrospectively during a five-year period. Investigations of enteroviruses are made by RT-PCR from routine biological samples (amniocentesis, RT-PCR in maternal blood or CSF). Results Prospectively, 33 patients were included during the study period. We have identified 4 cases of confirmed enterovirus infection (12.4%). We have recorded a severe form of perinatal enterovirus infection involving the vital prognosis of the newborn. In the retrospective cohort of 75 IUFD cases, we had only one case of enterovirus-positive RT-PCR in amniotic fluid during 5 years, meaning a frequency of 1.3%. We did not had any positive EV case in case of early miscarriage, but the limited number of inclusions cannot help us to conclude. Conclusion Enteroviruses are probably an underestimated cause of obstetric and neonatal complications. Investigation of enterovirus by PCR should be discussed during pregnancy and peripartum in case of febrile syndrome with no obvious bacterial cause, and unexplained IUFD.
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Affiliation(s)
- Z Khediri
- Service de gynécologie et obstétrique and Risk in pregnancy university department, Hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92700, Colombes, France.,Université Paris-Diderot, 75013, Paris, France
| | - C Vauloup-Fellous
- Inserm U1193, virologie, WHO Rubella NRL, National Reference Laboratory for Maternofetal Rubella Infections, AP-HP, hôpital Paul-Brousse, groupe hospitalier universitaire Paris-Sud, université Paris-Sud, 94804, Villejuif, France.,Groupe de Recherche sur les Infections Pendant la Grossesse (GRIG), Vélizy, France
| | - A Benachi
- Department of Obstetrics, Gynecology and Reproductive Medicine and Centre, maladies rares : hernie de coupole diaphragmatique, hôpital Antoine-Béclère, AP-HP, université Paris Sud, 157, rue de la Porte-de-Trivaux, 92140, Clamart, France
| | - J M Ayoubi
- Department of obstetrics and gynecology, hôpital Foch, 92120, Suresnes, France.,EA2493, UFR des sciences de la santé Simone-Veil, université Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - L Mandelbrot
- Service de gynécologie et obstétrique and Risk in pregnancy university department, Hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92700, Colombes, France.,IAME (Infection, Antimicrobials, Modelling, Evolution), INSERM, UMR 1137 - UFR de Médecine Paris 7 Denis Diderot, 16 rue Henri Huchard, B.P. 416 - 75870, Paris cedex 18, France.,Groupe de Recherche sur les Infections Pendant la Grossesse (GRIG), Vélizy, France
| | - O Picone
- Service de gynécologie et obstétrique and Risk in pregnancy university department, Hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92700, Colombes, France. .,IAME (Infection, Antimicrobials, Modelling, Evolution), INSERM, UMR 1137 - UFR de Médecine Paris 7 Denis Diderot, 16 rue Henri Huchard, B.P. 416 - 75870, Paris cedex 18, France.
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19
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Meister S, Verbyla ME, Klinger M, Kohn T. Variability in Disinfection Resistance between Currently Circulating Enterovirus B Serotypes and Strains. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:3696-3705. [PMID: 29466658 DOI: 10.1021/acs.est.8b00851] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The susceptibility of waterborne viruses to disinfection is known to vary between viruses and even between closely related strains, yet the extent of this variation is not known. Here, different enteroviruses (six strains of coxsackievirus B5, two strains of coxsackievirus B4 and one strain of coxackievirus B1) were isolated from wastewater and inactivated by UV254, sunlight, free chlorine (FC), chlorine dioxide (ClO2), and heat. Inactivation kinetics of these isolates were compared with those of laboratory enterovirus strains (CVB5 Faulkner and echovirus 11 Gregory) and MS2 bacteriophage. FC exhibited the greatest (10-fold) variability in inactivation kinetics between different strains, whereas inactivation by UV254 differed only subtly. The variability in inactivation kinetics was greater between serotypes than it was among the seven strains of the CVB5 serotype. MS2 was a conservative surrogate of enterovirus inactivation by UV254, sunlight, or heat but frequently underestimated the disinfection requirements for FC and ClO2. Similarly, laboratory strains did not always reflect the inactivation behavior of the environmental isolates. Overall, there was considerable variability in inactivation kinetics among and within enteroviruses serotypes, as well as between laboratory and environmental isolates. We therefore recommend that future disinfection studies include a variety of serotypes and environmental isolates.
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Affiliation(s)
- Simon Meister
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering , École Polytechnique Fédérale de Lausanne (EPFL) , CH-1015 Lausanne , Switzerland
| | - Matthew E Verbyla
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering , École Polytechnique Fédérale de Lausanne (EPFL) , CH-1015 Lausanne , Switzerland
| | - Marius Klinger
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering , École Polytechnique Fédérale de Lausanne (EPFL) , CH-1015 Lausanne , Switzerland
| | - Tamar Kohn
- Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering , École Polytechnique Fédérale de Lausanne (EPFL) , CH-1015 Lausanne , Switzerland
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20
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Mirand A, le Sage FV, Pereira B, Cohen R, Levy C, Archimbaud C, Peigue-Lafeuille H, Bailly JL, Henquell C. Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014-2015. Emerg Infect Dis 2018; 22:1884-1893. [PMID: 27767012 PMCID: PMC5088007 DOI: 10.3201/eid2211.160590] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [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
Outbreaks can be detected by syndromic surveillance, rapid enterovirus testing, and genotyping. The clinical impact of enteroviruses associated with hand, foot and mouth disease (HFMD) is unknown outside Asia, and the prevalence of enterovirus A71 (EV-A71) in particular might be underestimated. To investigate the prevalence of enterovirus serotypes and the clinical presentations associated with HFMD in France, we conducted prospective ambulatory clinic–based surveillance of children during April 2014–March 2015. Throat or buccal swabs were collected from children with HFMD and tested for the enterovirus genome. Physical examinations were recorded on a standardized form. An enterovirus infection was detected in 523 (79.3%) of 659 children tested. Two epidemic waves occurred, dominated by coxsackievirus (CV) A6, which was detected in 53.9% of enterovirus-infected children. CV-A6 was more frequently related to atypical HFMD manifestations (eruptions extended to limbs and face). Early awareness and documentation of HFMD outbreaks can be achieved by syndromic surveillance of HFMD by ambulatory pediatricians and rapid enterovirus testing and genotyping.
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MESH Headings
- Adolescent
- Age Factors
- Child
- Child, Preschool
- Disease Outbreaks
- Enterovirus A, Human/classification
- Enterovirus A, Human/genetics
- Female
- France/epidemiology
- Hand, Foot and Mouth Disease/diagnosis
- Hand, Foot and Mouth Disease/epidemiology
- Hand, Foot and Mouth Disease/history
- Hand, Foot and Mouth Disease/virology
- History, 21st Century
- Humans
- Infant
- Infant, Newborn
- Male
- Molecular Typing
- Phylogeny
- Population Surveillance
- Prospective Studies
- RNA, Viral
- Serogroup
- Symptom Assessment
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21
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Gao F, Bian L, Hao X, Hu Y, Yao X, Sun S, Chen P, Yang C, Du R, Li J, Zhu F, Mao Q, Liang Z. Seroepidemiology of coxsackievirus B5 in infants and children in Jiangsu province, China. Hum Vaccin Immunother 2017; 14:74-80. [PMID: 29049009 DOI: 10.1080/21645515.2017.1384107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Coxsackievirus B5 (CV-B5) is associated with various human diseases such as viral encephalitis, aseptic meningitis, paralysis, herpangina, and hand, foot and mouth disease (HFMD). However, there is currently no effective vaccine against CV-B5.The seroepidemiologic characteristics of CV-B5 remained unknown. A cohort study was carried out in 176 participants aged 6-35 months from January 2012 to January 2014. The serum samples were collected and tested for CV-B5 neutralizing antibodies (NtAbs) four times during these two years. The confirmed enterovirus cases were recorded through the surveillance system, and their throat or rectal swabs were collected for pathogen detection. According to the changes of CV-B5 NtAbs, two CV-B5 epidemics were detected among these participants during the two-year follow-up. Sixty-seven cases out of all participants had seroconversion in CV-B5 NtAbs. During the first epidemic from March 2012 to September 2012, CV-B5 seropositivity rate increased significantly (6.8%, 12/176 vs. 21.6%, 38/176, P = 0.000). The seroconversion rate and geometric mean fold-increase (GMFI) were 18.2% (32/176) and 55.7, respectively; During the second epidemic from September 2012 to January 2014, CV-B5 seropositivity rate also increased (21.6%, 38/176 vs. 38.6%, 68/176, P = 0.000), and the seroconversion rate and GMFI were 19.9% (35/176) and 46.5, respectively. Only one case had CV-B5 associated HFMD during the two-year follow-up, and CV-B5 from the throat swab isolate was GI.D3 subtype, which belonged to the major pandemic strain in mainland China. CV-B5 infection was common in infants and children in Jiangsu province, China. Therefore, it's necessary to strengthen the surveillance on CV-B5 and to understand the epidemic characteristics of CV-B5 infection.
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Affiliation(s)
- Fan Gao
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Lianlian Bian
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Xiaotian Hao
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Yalin Hu
- b Hualan Biological Engineering Inc , Xinxiang , Henan , P. R. China
| | - Xin Yao
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Shiyang Sun
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Pan Chen
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Ce Yang
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Ruixiao Du
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Jingxin Li
- c Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu , P. R. China
| | - Fengcai Zhu
- c Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu , P. R. China
| | - Qunying Mao
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
| | - Zhenglun Liang
- a Division Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , P. R. China
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22
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Kyriakopoulou Z, Amoutzias GD, Dimitriou TG, Tsakogiannis D, Mossialos D, Markoulatos P. Intra- and inter-serotypic recombinations in the 5΄ UTR-VP4 region of Echovirus 30 strains. Arch Virol 2017; 163:365-375. [DOI: 10.1007/s00705-017-3600-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/06/2017] [Indexed: 12/23/2022]
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23
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Chen P, Wu X, Su Y, Hao X, Mao Q, Liang Z. Development of a pseudovirus based assay for measuring neutralizing antibodies against coxsackievirus B5. J Virol Methods 2017; 246:21-26. [PMID: 28435072 PMCID: PMC7113871 DOI: 10.1016/j.jviromet.2017.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/15/2017] [Accepted: 04/16/2017] [Indexed: 11/29/2022]
Abstract
Coxsackievirus B5 (CV-B5), an important Coxsackie B virus from genus Enteroviruse within the family Picornaviridae, has also been isolated from Hand, Foot, and Mouth Disease (HFMD) patients, and often associated with neurological manifestations. In this study, we found out that Coxsackievirus B3 (CV-B3) replicon RNA could be encapsidated with CV-B5 capsid to assemble infectious CV-B5 pseudovirus. We then utilized this single round infection system of CV-B5 to develop a neutralizing antibody quantification assay. This pseudovirus neutralization assay showed superiority in biosafety, sensibility, quantitativity, efficiency and high throughput, and would facilitate the epidemiological studies and vaccine development of CV-B5.
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Affiliation(s)
- Pan Chen
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences, Beijing 100050, China; National Institutes for Food and Drug Control, Beijing 100050, China
| | - Xing Wu
- National Institutes for Food and Drug Control, Beijing 100050, China
| | - Yao Su
- National Institutes for Food and Drug Control, Beijing 100050, China
| | - Xiaotian Hao
- National Institutes for Food and Drug Control, Beijing 100050, China
| | - Qunying Mao
- National Institutes for Food and Drug Control, Beijing 100050, China
| | - Zhenglun Liang
- National Institutes for Food and Drug Control, Beijing 100050, China.
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Characterization of group B coxsackieviruses isolated from non-polio acute flaccid paralysis patients in Pakistan: vital assessment before polio eradication. Epidemiol Infect 2017; 145:2473-2481. [PMID: 28738914 DOI: 10.1017/s0950268817001522] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Pakistan is at the verge of polio eradication but isolation of non-polio enteroviruses (NPEVs) from acute flaccid paralysis (AFP) cases may result in serious or even fatal outcome. Many enteroviruses share similar symptoms and epidemiology as is the case with poliovirus and coxsackievirus (CV). The present study was designed to genetically characterize coxsackievirus B (CV-B) serotypes isolated from non-polio acute flaccid paralytic children, as well as to understand their probable role in paralysis. A total of 63 (20·1%) out of 313 stool samples during 2013 were found positive for NPEVs in rhabdomyosarcoma cells. Only 24 (38·0%) NPEVs were typed as CV-B by microneutralization assay and were further characterized by sequencing of the viral protein 1 (VP1) gene. Molecular phylogenetic analyses classified the study strains into six coxsackievirus B serotypes (coxsackievirus B1 to B6) with their respective prototype strains with evidence of epidemiological linkage and distinct clusters. Moreover, four major differences were found within the amino acid sequences of BC-loop in VP1 of CV-B strains. In conclusion, this study presented the molecular evolutionary genetic overview and distinct phylogenetic pattern of CV-B isolates from AFP cases in Pakistan, and explored the possible link between CV-B infections and AFP cases. Furthermore, our data reveal that these viruses might contribute to the incidence of paralysis in population and there is need of time to establish an enterovirus surveillance system for better understanding of epidemiological and virological characteristics of NPEV infections associated with AFP cases in the country.
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Tangermann RH, Lamoureux C, Tallis G, Goel A. The critical role of acute flaccid paralysis surveillance in the Global Polio Eradication Initiative. Int Health 2017; 9:156-163. [DOI: 10.1093/inthealth/ihx016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 05/12/2017] [Indexed: 01/01/2023] Open
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Benschop KS, Geeraedts F, Beuvink B, Spit SA, Fanoy EB, Claas EC, Pas SD, Schuurman R, Verweij JJ, Bruisten SM, Wolthers KC, Niesters HG, Koopmans M, Duizer E. Increase in ECHOvirus 6 infections associated with neurological symptoms in the Netherlands, June to August 2016. ACTA ACUST UNITED AC 2017; 21:30351. [PMID: 27719751 PMCID: PMC5069425 DOI: 10.2807/1560-7917.es.2016.21.39.30351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/29/2016] [Indexed: 11/20/2022]
Abstract
The Dutch virus-typing network VIRO-TypeNed reported an increase in ECHOvirus 6 (E-6) infections with neurological symptoms in the Netherlands between June and August 2016. Of the 31 cases detected from January through August 2016, 15 presented with neurological symptoms. Ten of 15 neurological cases were detected in the same province and the identified viruses were genetically related. This report is to alert medical and public health professionals of the circulation of E-6 associated with neurological symptoms.
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Affiliation(s)
- Kimberley Sm Benschop
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Méreaux J, Picone O, Vauloup-Fellous C, Khediri Z, Benachi A, Mandelbrot L, Ayoubi JM. [Enterovirus infection during pregnancy: Underestimated cause of fetal and neonatal complications?]. ACTA ACUST UNITED AC 2017; 45:231-237. [PMID: 28373042 DOI: 10.1016/j.gofs.2017.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/10/2017] [Indexed: 12/27/2022]
Abstract
Enteroviruses are responsible for about one billion infections every year in the world. The clinical expression is in the vast majority asymptomatic cases (90%). Its consequences during pregnancy are rarely described. From the Medline database, we selected and analyzed 34 articles ranging from 1965 to 2015, to analyse the current knowledge of enterovirus infection consequences during pregnancy. We found that enterovirus infections may be the cause of fetal loss. The enterovirus infections during the 2nd and 3rd trimester may also lead to in utero fetal anomalies and death, but also to severe neonatal infections. PCR enterovirus detection should be performed during pregnancy and the peripartum in case of unexplained fever, specific fetal anomalies or unexplained fetal demise.
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Affiliation(s)
- J Méreaux
- Department of obstetrics and gynecology, hôpital Foch, 92120 Suresnes, France
| | - O Picone
- EA2493, UFR des sciences de la santé Simone-Veil, université Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France; Risk in pregnancy university department, 75006 Paris, France; Service de gynécologie et obstétrique, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92700 Colombes, France; Université Paris-Diderot, 75013 Paris, France; Inserm CESP, 94276 Le Kremlin-Bicêtre cedex, France.
| | - C Vauloup-Fellous
- Inserm U1193, virologie, WHO Rubella NRL, National Reference Laboratory for Maternofetal Rubella Infections, AP-HP, hôpital Paul-Brousse, groupe hospitalier universitaire Paris-Sud, université Paris-Sud, 94804 Villejuif, France
| | - Z Khediri
- Risk in pregnancy university department, 75006 Paris, France; Service de gynécologie et obstétrique, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92700 Colombes, France; Université Paris-Diderot, 75013 Paris, France; Inserm CESP, 94276 Le Kremlin-Bicêtre cedex, France
| | - A Benachi
- Department of Obstetrics, Gynecology and Reproductive Medicine and Centre, maladies rares : hernie de coupole diaphragmatique, hôpital Antoine-Béclère, AP-HP, université Paris Sud, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France
| | - L Mandelbrot
- Risk in pregnancy university department, 75006 Paris, France; Service de gynécologie et obstétrique, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92700 Colombes, France; Université Paris-Diderot, 75013 Paris, France; Inserm CESP, 94276 Le Kremlin-Bicêtre cedex, France
| | - J-M Ayoubi
- Department of obstetrics and gynecology, hôpital Foch, 92120 Suresnes, France; EA2493, UFR des sciences de la santé Simone-Veil, université Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France
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Schuffenecker I, Mirand A, Josset L, Henquell C, Hecquet D, Pilorgé L, Petitjean-Lecherbonnier J, Manoha C, Legoff J, Deback C, Pillet S, Lepiller Q, Mansuy JM, Marque-Juillet S, Antona D, Peigue-Lafeuille H, Lina B. Epidemiological and clinical characteristics of patients infected with enterovirus D68, France, July to December 2014. ACTA ACUST UNITED AC 2017; 21:30226. [PMID: 27195770 DOI: 10.2807/1560-7917.es.2016.21.19.30226] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/05/2016] [Indexed: 11/20/2022]
Abstract
In 2014, the United States (US) experienced a nationwide outbreak of enterovirus D68 (EV-D68) infection with 1,152 cases reported mainly in hospitalised children with severe asthma or bronchiolitis. Following the US alert, 11 laboratories of the French enterovirus (EV) surveillance network participated in an EV-D68 survey. A total of 6,229 respiratory samples, collected from 1 July to 31 December 2014, were screened for EV-D68 resulting in 212 EV-D68-positive samples. These 212 samples corresponded to 200 EV-D68 cases. The overall EV-D68 positivity rates among respiratory samples were of 5% (184/3,645) and 1.1% (28/2,584) in hospitalised children and adults respectively. The maximum weekly EV-D68 positivity rates were of 16.1% for children (n = 24/149; week 43) and 2.6% for adults (n = 3/115; week 42). Of 173 children with EV-D68 infection alone, the main symptoms were asthma (n = 83; 48.0%) and bronchiolitis (n = 37; 21.4%). One child developed acute flaccid paralysis (AFP) following EV-D68-associated pneumonia. Although there was no significant increase in severe respiratory tract infections reported to the French public health authorities, 10.7% (19/177) of the EV-D68 infected children and 14.3% (3/21) of the EV-D68 infected adults were hospitalised in intensive care units. Phylogenetic analysis of the viral protein 1 (VP1) sequences of 179 EV-D68 cases, revealed that 117 sequences (65.4%), including that of the case of AFP, belonged to the B2 variant of clade B viruses. Continuous surveillance of EV-D68 infections is warranted and could benefit from existing influenza-like illness and EV surveillance networks.
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Affiliation(s)
- Isabelle Schuffenecker
- Centre National de Référence des Enterovirus et Parechovirus, Laboratoire de Virologie, Hospices Civils de Lyon, Lyon, France
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Laboratory Surveillance of Polio and Other Enteroviruses in High-Risk Populations and Environmental Samples. Appl Environ Microbiol 2017; 83:AEM.02872-16. [PMID: 28039136 DOI: 10.1128/aem.02872-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/19/2016] [Indexed: 11/20/2022] Open
Abstract
In the context of poliomyelitis eradication, a reinforced supplementary laboratory surveillance of enteroviruses was implemented in Greece. Between 2008 and 2014, the Hellenic Polioviruses/Enteroviruses Reference Laboratory performed detailed supplementary surveillance of circulating enteroviruses among healthy individuals in high-risk population groups, among immigrants from countries in which poliovirus is endemic, and in environmental samples. In total, 722 stool samples and 179 sewage water samples were included in the study. No wild-type polioviruses were isolated during these 7 years of surveillance, although two imported vaccine polioviruses were detected. Enterovirus presence was recorded in 25.3 and 25.1% of stool and sewage water samples, respectively. Nonpolio enteroviruses isolated from stool samples belonged to species A, B, or C; coxsackievirus A24 was the most frequently identified serotype. Only enteroviruses of species B were identified in sewage water samples, including four serotypes of echoviruses and four serotypes of coxsackie B viruses. Phylogenetic analysis revealed close genetic relationships among virus isolates from sewage water samples and stool samples, which in most cases fell into the same cluster. To the best of our knowledge, this is the first study to compare enterovirus serotypes circulating in fecal specimens of healthy individuals and environmental samples, emphasizing the burden of enterovirus circulation in asymptomatic individuals at high risk. Given that Greece continues to receive a large number of short-term arrivals, students, migrants, and refugees from countries in which poliovirus is endemic, it is important to guarantee high-quality surveillance in order to maintain its polio-free status until global eradication is achieved.IMPORTANCE This article summarizes the results of supplementary poliovirus surveillance in Greece and the subsequent characterization of enteroviral circulation in human feces and the environment. The examination of stool samples from healthy refugees and other individuals in "high-risk" groups for poliovirus enables the identification of enterovirus cases and forms the basis for further investigation of the community-level risk of viral transmission. In addition, the examination of composite human fecal samples through environmental surveillance links poliovirus and nonpoliovirus isolates from unknown individuals to populations served by the sewage or wastewater system. Supplementary surveillance is necessary to comply with the prerequisites imposed by the World Health Organization for monitoring the emergence of vaccine-derived polioviruses, reemergence of wild polioviruses, or disappearance of all vaccine-related strains in order for countries such as Greece to maintain their polio-free status and contribute to global poliovirus eradication.
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Seppälä E, Sillanpää S, Nurminen N, Huhtala H, Toppari J, Ilonen J, Veijola R, Knip M, Sipilä M, Laranne J, Oikarinen S, Hyöty H. Human enterovirus and rhinovirus infections are associated with otitis media in a prospective birth cohort study. J Clin Virol 2016; 85:1-6. [PMID: 27780081 DOI: 10.1016/j.jcv.2016.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/16/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Human enteroviruses (HEVs) and rhinoviruses (HRVs) have been linked to acute otitis media (AOM). OBJECTIVES The present study evaluates the aforementioned association in a birth cohort setting. STUDY DESIGN The cohort included 286 healthy infants (191 boys) followed from birth up to the age of 2 years in the Type 1 Diabetes Prediction and Prevention study in Finland. Stool samples were collected monthly and analyzed for the presence of HRV and HEV RNA using RT-PCR. Clinical symptoms were recorded by a questionnaire every 3-6 months. RESULTS Altogether 610 AOM episodes were reported during the follow-up. 9.8% of the stool samples were positive for HRV and 6.8% for HEV. HRV positivity peaked at the age of 3-6 months declining gradually after this age, whereas HEV positivity peaked later, at the age of 12-24 months. The risk of AOM was increased in children who were HEV positive at least once at the age of 6-12 months (OR 2.2 [95%CI 1.1-4.2], P=0.023) or who were HRV positive at least once at the age of 18-24 months (OR 2.3 [95%CI 1.0-5.2], P=0.042). Having an older sibling, short breast-feeding and maternal smoking during pregnancy were also significantly associated with AOM. CONCLUSIONS HRV and HEV infections are frequent during the first months of life. The observed trend for increased risk of AOM in HRV and HEV positive children is in line with the results from hospital series suggesting that these viruses may play an independent role in the pathogenesis of AOM.
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Affiliation(s)
- Elina Seppälä
- School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland.
| | - Saara Sillanpää
- Department of Anatomy, School of Medicine, University of Tampere, Finland; Department of Otorhinolaryngology, Head and Neck Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Finland
| | - Noora Nurminen
- School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland
| | - Heini Huhtala
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Jorma Toppari
- Department of Physiology, University of Turku, Turku, Finland; Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Riitta Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Tampere Center for Child Health Research, Tampere University Hospital, Tampere, Finland
| | - Markku Sipilä
- Department of Otorhinolaryngology, Head and Neck Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Finland
| | - Jussi Laranne
- Department of Otorhinolaryngology, Head and Neck Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Finland
| | - Sami Oikarinen
- School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland
| | - Heikki Hyöty
- School of Medicine, University of Tampere, Lääkärinkatu 1, FIN-33520, Tampere, Finland; Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland
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Severe Enterovirus Infections in Hospitalized Children in the South of England: Clinical Phenotypes and Causative Genotypes. Pediatr Infect Dis J 2016; 35:723-7. [PMID: 26882165 PMCID: PMC4985250 DOI: 10.1097/inf.0000000000001093] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Most enterovirus surveillance studies lack detailed clinical data, which limits their clinical usefulness. This study aimed to describe the clinical spectrum and outcome of severe enterovirus infections in children, and to determine whether there are associations between causative enterovirus genotypes and clinical phenotypes. METHODS Retrospective analysis of microbiological and clinical data from a tertiary children's hospital in the South of England over a 17-month period (2012-2013). RESULTS In total, 30 patients were identified, comprising sepsis (n = 9), myocarditis (n = 8), meningitis (n = 8) and encephalitis (n = 5). Cases with sepsis or myocarditis were significantly younger than those with central nervous system disease (median age 21 and 15 days vs. 79 days; P = 0.0244 and P = 0.0310, respectively). There was considerable diversity in the causative genotypes in each of the clinical phenotypes, with some predominance of echoviruses in the meningitis group, and coxsackie B viruses in the myocarditis group. Thirteen cases required mechanical ventilation, 11 cases inotropic support, 3 cases dialysis and 3 cases extracorporal membrane oxygenation. The overall mortality was 10% (sepsis group, n = 1; myocarditis group, n = 2). Of the survivors, 5 (19%) had long-term sequelae (myocardial dysfunction, n = 2; neurological sequelae, n = 3). Patients with encephalitis had the longest hospital stay (median: 16 days), compared with 9, 6 and 3 days in patients with myocarditis, sepsis and meningitis, respectively (P = 0.005). CONCLUSIONS Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality. The results show that there are currently no strong associations between clinical phenotypes and particular causative enterovirus genotypes in the South of England.
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Wieczorek M, Figas A, Krzysztoszek A. Enteroviruses Associated with Aseptic Meningitis in Poland, 2011–2014. Pol J Microbiol 2016; 65:231-235. [DOI: 10.5604/17331331.1204485] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2015] [Indexed: 11/13/2022] Open
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Abstract
PURPOSE OF REVIEW There are over 100 serotypes of human enteroviruses, which cause a spectrum of illnesses, including meningitis, encephalitis, paralysis, myocarditis and rash. Increasing incidence of hand-foot-and-mouth disease in the Asia-Pacific region and recent outbreaks of enterovirus-associated disease, such as severe respiratory illness in the United States in 2014, highlight the threat of these viruses to human health. RECENT FINDINGS We describe recent outbreaks of human enteroviruses and summarize knowledge gaps regarding their burden, spectrum of diseases and epidemiology. SUMMARY Reported outbreaks of respiratory, neurological, skin and eye diseases associated with human enteroviruses have increased in frequency and size in recent years. Improved molecular diagnostics and genetic sequence analysis are beginning to reveal the complex dynamics of individual serotypes and genotypes, and their contribution to these outbreaks. However, the biological mechanisms underlying their emergence and transmission dynamics remain elusive. They are likely to involve changes in the virus, such as fitness, antigenicity, virulence or tropism, and in the human population, such as levels of sanitation and of homotypic and heterotypic immunity. Improvements in surveillance, serological surveys and detailed genetic and antigenic characterization of viral populations would help to elucidate these mechanisms. This will be important for the design of outbreak control and vaccine development strategies.
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Molecular epidemiology of coxsackievirus B3 infection in Spain, 2004-2014. Arch Virol 2016; 161:1365-70. [DOI: 10.1007/s00705-016-2783-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/31/2016] [Indexed: 10/22/2022]
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Othman I, Mirand A, Slama I, Mastouri M, Peigue-Lafeuille H, Aouni M, Bailly JL. Enterovirus Migration Patterns between France and Tunisia. PLoS One 2015; 10:e0145674. [PMID: 26709514 PMCID: PMC4692522 DOI: 10.1371/journal.pone.0145674] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 12/06/2015] [Indexed: 02/03/2023] Open
Abstract
The enterovirus (EV) types echovirus (E-) 5, E-9, and E-18, and coxsackievirus (CV-) A9 are infrequently reported in human diseases and their epidemiologic features are poorly defined. Virus transmission patterns between countries have been estimated with phylogenetic data derived from the 1D/VP1 and 3CD gene sequences of a sample of 74 strains obtained in France (2000–2012) and Tunisia (2011–2013) and from the publicly available sequences. The EV types (E-5, E-9, and E-18) exhibited a lower worldwide genetic diversity (respective number of genogroups: 4, 5, and 3) in comparison to CV-A9 (n = 10). The phylogenetic trees estimated with both 1D/VP1 and 3CD sequence data showed variations in the number of co-circulating lineages over the last 20 years among the four EV types. Despite the low number of genogroups in E-18, the virus exhibited the highest number of recombinant 3CD lineages (n = 10) versus 4 (E-5) to 8 (E-9). The phylogenies provided evidence of multiple transportation events between France and Tunisia involving E-5, E-9, E-18, and CV-A9 strains. Virus spread events between France and 17 other countries in five continents had high probabilities of occurrence as those between Tunisia and two European countries other than France. All transportation events were supported by BF values > 10. Inferring the source of virus transmission from phylogenetic data may provide insights into the patterns of sporadic and epidemic diseases caused by EVs.
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Affiliation(s)
- Ines Othman
- University of Monastir, Faculty of Pharmacy, LR99-ES27, Monastir, Tunisia
- University of Carthage, Faculty of Sciences of Bizerte, Tunisia
| | - Audrey Mirand
- Université d’Auvergne, EPIE, EA 4843, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Service de Virologie, Centre National de Référence des Enterovirus–Parechovirus, Clermont-Ferrand, France
| | - Ichrak Slama
- University of Monastir, Faculty of Pharmacy, LR99-ES27, Monastir, Tunisia
- University of Carthage, Faculty of Sciences of Bizerte, Tunisia
| | - Maha Mastouri
- University of Monastir, Faculty of Pharmacy, LR99-ES27, Monastir, Tunisia
- Fattouma Bourguiba University Hospital, Laboratory of Microbiology, Monastir, Tunisia
| | - Hélène Peigue-Lafeuille
- Université d’Auvergne, EPIE, EA 4843, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Service de Virologie, Centre National de Référence des Enterovirus–Parechovirus, Clermont-Ferrand, France
| | - Mahjoub Aouni
- University of Monastir, Faculty of Pharmacy, LR99-ES27, Monastir, Tunisia
| | - Jean-Luc Bailly
- Université d’Auvergne, EPIE, EA 4843, Clermont-Ferrand, France
- * E-mail:
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Antiviral effect of emodin from Rheum palmatum against coxsakievirus B5 and human respiratory syncytial virus in vitro. ACTA ACUST UNITED AC 2015; 35:916-922. [PMID: 26670446 PMCID: PMC7089517 DOI: 10.1007/s11596-015-1528-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/10/2015] [Indexed: 12/11/2022]
Abstract
Viral infections are the major causes of morbidity and mortality in elderly people and young children throughout the world. The most common pathogens include coxsackie virus (CV) and respiratory syncytial virus (RSV). However, no antiviral agents with low toxicity and drug resistance are currently available in clinic therapy. The present study aimed to examine the antiviral activities of emodin (an ingredient of Rheum palmatum) against CVB5 and RSV infections, in an attempt to discover new antiviral agents for virus infection. The monomer emodin was extracted and isolated from Rheum palmatum. The antiviral activities of emodin on HEp-2 cells were evaluated, including virus replication inhibition, virucidal and anti-absorption effects, by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tet-razolium bromide (MTT) assay and plaque reduction assay (PRA). The kinetics of virus inhibition by emodin in a period of 14 h was further determined by plaque assay and quantitative real time PCR (qPCR). Cytokine (IFN-γ, TNF-α) mRNA expressions after emodin treatment (7.5, 15, 30 μmol/L) were also assessed by qPCR post-infection. The results showed that emodin had potent inhibitory activities against CVB5 and RSV, with the 50% effective concentration (EC50) ranging from 13.06 to 14.27 μmol/L and selectivity index (SI) being 5.38–6.41 μmol/L. However, emodin couldn’t directly inactivate the viruses or block their absorption to cells. It acted as a biological synthesis inhibitor against CVB4 and RSV in a concentration- and time-dependent manner, especially during the first 0–4 h post-infection. Moreover, emodin could decrease the mRNA expression of IFN-α but enhance TNF-γ expression significantly compared to the viral controls in vitro. Our results provide a molecular basis for development of emodin as a novel and safe antiviral agent for human enterovirus and respiratory virus infection in the clinical therapy.
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Vollbach S, Müller A, Drexler JF, Simon A, Drosten C, Eis-Hübinger AM, Panning M. Prevalence, type and concentration of human enterovirus and parechovirus in cerebrospinal fluid samples of pediatric patients over a 10-year period: a retrospective study. Virol J 2015; 12:199. [PMID: 26607060 PMCID: PMC4660665 DOI: 10.1186/s12985-015-0427-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/16/2015] [Indexed: 11/14/2022] Open
Abstract
Background Human enterovirus (EV) and parechovirus (HPeV) are significant causes of encephalitis and meningitis in children. The aim of this study was to determine the prevalence, type and viral RNA concentration of EV and HPeV in cerebrospinal fluid (CSF) samples in an unselected cohort of patients <18 years admitted to Bonn university hospital from 1998 to 2008. Methods A total of 327 CSF samples from 327 patients were retrospectively tested by real-time reverse-transcriptase PCR (RT-PCR) for EV and HPeV, and by real-time PCR for cytomegalovirus (CMV), herpes simplex virus 1/2 (HSV), and varizella zoster-virus (VZV). Samples had been submitted for routine virological work-up due to suspected meningitis or encephalitis and had been stored at −20 °C hereafter. Positive samples for EV and HPeV were sequenced within the gene encoding the VP1 region (EV), the VP2 and the VP3/VP1 junction region (HPeV). Results The overall prevalence was 4.3 % (14/327) for EV, 0.6 % (2/327) for HPeV, and 0.3 % (1/327) for HSV and VZV, respectively. CMV was not detected in this cohort. In children less than 3 months of age the prevalence was 7.7 % (2/26) for EV and 7.7 % (2/26) for HPeV, respectively. Frequency of EV detection ranged from 0 to 12 % per year and highest rates were observed from June to September. All typed EV belonged to species B. Both HPeV infections were detected in the fall of 2008 and were typed as HPeV genotype 3. Viral RNA concentrations were highest in patients with HPeV infection, followed by echovirus 30 and other EV. In total, 86 % (12/14) of EV infections presented as aseptic meningitis, whereas both HPeV infections presented as severe sepsis-like illness. Conclusions EV and HPeV were equally prevalent in children <3 months of age. Beyond the detection of EV and HPeV, the determination of viral RNA concentration and typing of EV and HPeV might prove beneficial for patient management and public health.
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Affiliation(s)
- Silke Vollbach
- Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
| | - Andreas Müller
- Department of Paediatrics, University of Bonn Medical Centre, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
| | - Jan Felix Drexler
- Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
| | - Arne Simon
- Department of Paediatrics, University of Bonn Medical Centre, Sigmund-Freud Str. 25, 53105, Bonn, Germany. .,Present address: Paediatric Oncology and Haematology, University of the Saarland, Homburg, Germany.
| | - Christian Drosten
- Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
| | - Anna Maria Eis-Hübinger
- Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
| | - Marcus Panning
- Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud Str. 25, 53105, Bonn, Germany. .,Institute of Virology, Medical Center - University of Freiburg, Hermann-Herder Str. 11, 79104, Freiburg, Germany.
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Lim MCY, Wang YF, Huang SW, Yang JY, Wang JR. High Incidence of Mammalian Orthoreovirus Identified by Environmental Surveillance in Taiwan. PLoS One 2015; 10:e0142745. [PMID: 26555962 PMCID: PMC4640864 DOI: 10.1371/journal.pone.0142745] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/25/2015] [Indexed: 12/21/2022] Open
Abstract
Wild poliovirus (WPV) persists in diverse locales worldwide, spreading outward from endemic areas. In response to the international threat of WPV transmission and changes in the national vaccination policy, we established an environmental surveillance system to monitor the circulation of wild and vaccine-related poliovirus in Taiwan. From July 2012 to December 2013, we collected sewage specimens every month from 10 sewage treatment plants located throughout Taiwan. The specimens were concentrated by the two-phase separation method and then inoculated into L20B, RD, and A549 cells for virus isolation. Viral isolates were identified and serotyped by immunofluorescence assay or molecular analysis. A total of 300 sewage samples were collected, and the results showed 163 samples (54.3%) were positive for virus, and 268 isolates were identified. Among these, 75 samples (25%) were positive for enterovirus (EV), but no poliovirus was found. In addition, 92 isolates were identified as enteroviruses and the most common serotypes were coxsackievirus B4, coxsackievirus B3, and coxsackievirus B2. Interestingly, 102 (34%) and 82 (27.3%) specimens were positive for mammalian orthoreovirus (MRV) and adenovirus, respectively. This study confirmed that sewage surveillance can be a useful additional modality for monitoring the possible presence of wild-type or vaccine-derived poliovirus in wastewater, and can indicate the current types of viruses circulating in the population. Furthermore, since MRV was found in children with acute necrotizing encephalopathy and meningitis, the high incidence of MRV detected by environmental surveillance warrants further investigation.
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Affiliation(s)
- Matthew C. Y. Lim
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Fang Wang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan
| | - Sheng-Wen Huang
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
| | - Jyh-Yuan Yang
- Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Jen-Ren Wang
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan
- * E-mail:
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Enterovirus meningitis in Tunisia (Monastir, Mahdia, 2011-2013): identification of virus variants cocirculating in France. Diagn Microbiol Infect Dis 2015; 84:116-22. [PMID: 26643063 DOI: 10.1016/j.diagmicrobio.2015.10.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 08/10/2015] [Accepted: 10/24/2015] [Indexed: 12/22/2022]
Abstract
Acute enterovirus (EV) meningitis is a frequent cause of hospitalisation, and over 100 EV serotypes may be involved. A total of 215 patients of all ages with meningitis signs were investigated in 2 Tunisian hospitals. Their cerebrospinal fluid (CSF) was analysed retrospectively for EVs with a TaqMan real-time RT-qPCR. The virus strains were typed, and their evolutionary relationships were determined by Bayesian phylogenetic methods. An EV genome was detected in 21/215 patients (9.8%). The CSF viral loads ranged from 3.27 to 5.63 log10 genome copies/mL. The strains were identified in 13/21 patients and assigned to EV-B types. Viruses identified in Tunisian patients were genetically related to variants detected in France. The viral loads were similar in Tunisian and French patients for most EV types. The phylogenetic data and viral loads determined in Tunisian and French patients suggest that close EV variants were involved in aseptic meningitis in the 2 countries over a same period.
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Huang HW, Chen YS, Chen JYF, Lu PL, Lin YC, Chen BC, Chou LC, Wang CF, Su HJ, Huang YC, Shi YY, Chen HL, Sanno-Duanda B, Huang TS, Lin KH, Tyan YC, Chu PY. Phylodynamic reconstruction of the spatiotemporal transmission and demographic history of coxsackievirus B2. BMC Bioinformatics 2015; 16:302. [PMID: 26390997 PMCID: PMC4578604 DOI: 10.1186/s12859-015-0738-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 09/11/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Studies regarding coxsackievirus (CV) tend to focus on epidemic outbreaks, an imbalanced topology is considered to be an indication of acute infection with partial cross-immunity. In enteroviruses, a clear understanding of the characteristics of tree topology, transmission, and its demographic dynamics in viral succession and circulation are essential for identifying prevalence trends in endemic pathogens such as coxsackievirus B2 (CV-B2). This study applied a novel Bayesian evolutionary approach to elucidate the phylodynamic characteristics of CV-B2. A dataset containing 51 VP1 sequences and a dataset containing 34 partial 3D(pol) sequencing were analyzed, where each dataset included Taiwan sequences isolated during 1988-2013. RESULTS Four and five genotypes were determined based on the 846-nucleotide VP1 and 441-nucleotide 3D(pol) (6641-7087) regions, respectively, with spatiotemporally structured topologies in both trees. Some strains with tree discordance indicated the occurrence of recombination in the region between the VP1 and 3D(pol) genes. The similarities of VP1 and 3D(pol) gene were 80.0%-96.8% and 74.7%-91.9%, respectively. Analyses of population dynamics using VP1 dataset indicated that the endemic CV-B2 has a small effective population size. The balance indices, high similarity, and low evolutionary rate in the VP1 region indicated mild herd immunity selection in the major capsid region. CONCLUSIONS Phylodynamic analysis can reveal demographic trends and herd immunity in endemic pathogens.
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Affiliation(s)
- Hui-Wen Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, ROC, Taiwan. .,Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, ROC, Taiwan.
| | - Yao-Shen Chen
- Division of Infectious Diseases, Kaohsiung Veterans General Hospital, Kaohsiung, ROC, Taiwan. .,Division of Microbiology, Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, ROC, Taiwan. .,Department of Internal Medicine, National Yang-Ming Medical University, Taipei, ROC, Taiwan.
| | - Jeff Yi-Fu Chen
- Department of Biotechnology, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan.
| | - Po-Liang Lu
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan. .,Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, ROC, Taiwan.
| | - Yung-Cheng Lin
- Institute of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, ROC, Taiwan.
| | - Bao-Chen Chen
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, ROC, Taiwan.
| | - Li-Chiu Chou
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, ROC, Taiwan.
| | - Chu-Feng Wang
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, ROC, Taiwan.
| | - Hui-Ju Su
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, ROC, Taiwan.
| | - Yi-Chien Huang
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan.
| | - Yong-Ying Shi
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan.
| | - Hsiu-Lin Chen
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, ROC, Taiwan. .,Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan.
| | - Bintou Sanno-Duanda
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan. .,Department of laboratory medicine, Edward Francis Small Teaching Hospital, Banjul, Gambia.
| | - Tsi-Shu Huang
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, ROC, Taiwan.
| | - Kuei-Hsiang Lin
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan.
| | - Yu-Chang Tyan
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Pei-Yu Chu
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, ROC, Taiwan. .,Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, ROC, Taiwan.
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Sporadic isolation of sabin-like polioviruses and high-level detection of non-polio enteroviruses during sewage surveillance in seven Italian cities, after several years of inactivated poliovirus vaccination. Appl Environ Microbiol 2015; 80:4491-501. [PMID: 24814793 DOI: 10.1128/aem.00108-14] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sewage surveillance in seven Italian cities between 2005 and 2008, after the introduction of inactivated poliovirus vaccination (IPV) in 2002, showed rare polioviruses, none that were wild-type or circulating vaccine-derived poliovirus (cVDPV), and many other enteroviruses among 1,392 samples analyzed. Two of five polioviruses (PV) detected were Sabin-like PV2 and three PV3, based on enzyme-linked immunosorbent assay (ELISA) and PCR results. Neurovirulence-related mutations were found in the 5'noncoding region (5'NCR) of all strains and, for a PV2, also in VP1 region 143 (Ile>Thr). Intertypic recombination in the 3D region was detected in a second PV2 (Sabin 2/Sabin 1) and a PV3 (Sabin 3/Sabin 2). The low mutation rate in VP1 for all PVs suggests limited interhuman virus passages, consistent with efficient polio immunization in Italy. Nonetheless, these findings highlight the risk of wild or Sabin poliovirus reintroduction from abroad. Non-polio enteroviruses (NPEVs) were detected, 448 of which were coxsackievirus B (CVB) and 294 of which were echoviruses (Echo). Fifty-six NPEVs failing serological typing were characterized by sequencing the VP1 region (nucleotides [nt] 2628 to 2976). A total of 448 CVB and 294 Echo strains were identified; among those strains, CVB2, CVB5, and Echo 11 predominated. Environmental CVB5 and CVB2 strains from this study showed high sequence identity with GenBank global strains. The high similarity between environmental NPEVs and clinical strains from the same areas of Italy and the same periods indicates that environmental strains reflect the viruses circulating in the population and highlights the potential risk of inefficient wastewater treatments. This study confirmed that sewage surveillance can be more sensitive than acute flaccid paralysis (AFP) surveillance in monitoring silent poliovirus circulation in the population as well as the suitability of molecular approaches to enterovirus typing.
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Kyriakopoulou Z, Bletsa M, Tsakogiannis D, Dimitriou TG, Amoutzias GD, Gartzonika C, Levidiotou-Stefanou S, Markoulatos P. Molecular epidemiology and evolutionary dynamics of Echovirus 3 serotype. INFECTION GENETICS AND EVOLUTION 2015; 32:305-12. [DOI: 10.1016/j.meegid.2015.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 02/25/2015] [Accepted: 03/09/2015] [Indexed: 01/06/2023]
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Li W, Zhang X, Chen X, Cheng YP, Wu YD, Shu Q, Chen XJ, Shang SQ. Epidemiology of childhood enterovirus infections in Hangzhou, China. Virol J 2015; 12:58. [PMID: 25884568 PMCID: PMC4403759 DOI: 10.1186/s12985-015-0294-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/04/2015] [Indexed: 11/25/2022] Open
Abstract
Background There are over 100 serotypes of enterovirus species A-D, which are the common cause of various symptoms in infants, such as meningitis, encephalitis and hand foot mouth disease (HFMD). This study aims to investigate the epidemiological characteristics of enteroviruses in Hangzhou, Zhejiang province, China, and to provide relevant information to guide public health responses and interventions. Methods Systematic surveillance was conducted on enterovirus infections. Samples were collected from children admitted to the inpatient wards and outpatient departments between January 2010 and December 2012 in the Children’s Hospital, Zhejiang University School of Medicine. Enteroviruses from all specimens were detected by RT-PCR using a commercialized detection kit. Results From 13026 samples collected and examined, 2673 (21.21%) were found positive for enteroviruses. The annual enterovirus-positive rate decreased from 32.78% in 2010 to 14.23% in 2012. Positivity rate for enteroviruses was highest among children aged less than 5 years. The monthly positivity rate for enterovirus infection ranged from 2.6% to 34.83%, with a peak in June and July. Serotypes causing severe symptoms such as HFMD including EV71 and CA16 were decreasing, while the proportion of unidentified EV serotypes causing herpangina and viral encephalitis were on the rise. Conclusions EV infection is highly prevalent among young children in Hangzhou, as it is in the most other parts of the world. Further surveillance using methods that can subtype all EVs is warranted to better monitor these infections and their etiology.
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Affiliation(s)
- Wei Li
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
| | - Xiao Zhang
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
| | - Xi Chen
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
| | - Yu-Ping Cheng
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
| | - Yi-Dong Wu
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
| | - Qiang Shu
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
| | - Xue-Jun Chen
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
| | - Shi-Qiang Shang
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng road, Hangzhou, 310003, China.
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Volle R, Archimbaud C, Couraud PO, Romero IA, Weksler B, Mirand A, Pereira B, Henquell C, Peigue-Lafeuille H, Bailly JL. Differential permissivity of human cerebrovascular endothelial cells to enterovirus infection and specificities of serotype EV-A71 in crossing an in vitro model of the human blood-brain barrier. J Gen Virol 2015; 96:1682-95. [PMID: 25711966 DOI: 10.1099/vir.0.000103] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Human cerebral microvascular endothelial cells (hCMEC/D3 cell line) form a steady polarized barrier when cultured in vitro on a permeable membrane. Their susceptibility to enterovirus (EV) strains was analysed to investigate how these viruses may cross the blood-brain barrier. A sample of 88 virus strains was selected on phylogenetic features amongst 43 epidemiologically relevant types of the four EV species A-D. The EV-A71 genome was replicated at substantial rates, whilst the infectious virus was released at extremely low but sustained rates at both barrier sides for at least 4 days. EV-A71 antigens were detected in a limited number of cells. The properties of the endothelial barrier (structure and permeability) remained intact throughout infection. The chronic EV-A71 infection was in sharp contrast to the productive infection of cytolytic EVs (e.g. echoviruses E-6 and E-30). The hCMEC/D3 barriers infected with the latter EVs exhibited elevated proportions of apoptotic and necrotic cells, which resulted in major injuries to the endothelial barriers with a dramatic increase of paracellular permeability and virus crossing to the abluminal side. The following intracellular rearrangements were also seen: early destruction of the actin cytoskeleton, remodelling of intracellular membranes and reorganization of the mitochondrion network in a small cluster near the perinuclear space.
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Affiliation(s)
- Romain Volle
- 1Clermont Université, Université d'Auvergne, EPIE, EA 4843, Clermont-Ferrand, France 2CHU Clermont-Ferrand, Service de Virologie, Clermont-Ferrand, France
| | - Christine Archimbaud
- 1Clermont Université, Université d'Auvergne, EPIE, EA 4843, Clermont-Ferrand, France 2CHU Clermont-Ferrand, Service de Virologie, Clermont-Ferrand, France
| | | | - Ignacio A Romero
- 5Department of Life, Health and Chemical Sciences, Open University, Milton Keynes, UK
| | | | - Audrey Mirand
- 1Clermont Université, Université d'Auvergne, EPIE, EA 4843, Clermont-Ferrand, France 2CHU Clermont-Ferrand, Service de Virologie, Clermont-Ferrand, France
| | - Bruno Pereira
- 3CHU Clermont-Ferrand, DRCI, Clermont-Ferrand, France
| | - Cécile Henquell
- 2CHU Clermont-Ferrand, Service de Virologie, Clermont-Ferrand, France
| | - Hélène Peigue-Lafeuille
- 1Clermont Université, Université d'Auvergne, EPIE, EA 4843, Clermont-Ferrand, France 2CHU Clermont-Ferrand, Service de Virologie, Clermont-Ferrand, France
| | - Jean-Luc Bailly
- 1Clermont Université, Université d'Auvergne, EPIE, EA 4843, Clermont-Ferrand, France 2CHU Clermont-Ferrand, Service de Virologie, Clermont-Ferrand, France
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45
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Janes VA, Minnaar R, Koen G, van Eijk H, Dijkman-de Haan K, Pajkrt D, Wolthers KC, Benschop KS. Presence of human non-polio enterovirus and parechovirus genotypes in an Amsterdam hospital in 2007 to 2011 compared to national and international published surveillance data: a comprehensive review. ACTA ACUST UNITED AC 2014; 19. [PMID: 25425513 DOI: 10.2807/1560-7917.es2014.19.46.20964] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Enteroviruses (EV) and human parechoviruses (HPeV) are endemic worldwide. These infections are a constant cause of hospitalisation and severe disease, predominantly in young children and infants. Coordinated monitoring and surveillance are crucial to control these infections. We have monitored EV and HPeV epidemiology in Amsterdam from 2007 to 2011 with real-time RT-PCR and direct genotyping, facilitating highly sensitive surveillance. Moreover, we conducted a literature survey of existing surveillance data for comparison. Only 14 studies were identified. While HPeV1 was most frequently detected in Amsterdam, EV-B viruses dominated nationally and internationally. Furthermore, the top 10 strains detected differed yearly and per study. However, detection and typing methods were too varied to allow direct comparison and comprehension of the worldwide distribution and circulation patterns of the different genotypes. This limited a direct response to anticipate peaks. Uniform European monitoring programmes are essential to aid prediction of outbreaks and disease management.
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Affiliation(s)
- V A Janes
- Emma Children s Hospital, Department of Paediatric Haematology, Immunology and Infectious Diseases, Academic Medical Center, Amsterdam, the Netherlands
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Soudée S, Schuffenecker I, Aberchih J, Josset L, Lina B, Baud O, Biran V. Infections néonatales à entérovirus en France en 2012. Arch Pediatr 2014; 21:984-9. [DOI: 10.1016/j.arcped.2014.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/12/2014] [Accepted: 06/24/2014] [Indexed: 11/26/2022]
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Sadeuh-Mba SA, Bessaud M, Joffret ML, Endegue Zanga MC, Balanant J, Mpoudi Ngole E, Njouom R, Reynes JM, Delpeyroux F, Rousset D. Characterization of Enteroviruses from non-human primates in cameroon revealed virus types widespread in humans along with candidate new types and species. PLoS Negl Trop Dis 2014; 8:e3052. [PMID: 25079078 PMCID: PMC4117447 DOI: 10.1371/journal.pntd.0003052] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 06/14/2014] [Indexed: 12/28/2022] Open
Abstract
Enteroviruses (EVs) infecting African Non-Human Primates (NHP) are still poorly documented. This study was designed to characterize the genetic diversity of EVs among captive and wild NHP in Cameroon and to compare this diversity with that found in humans. Stool specimens were collected in April 2008 in NHP housed in sanctuaries in Yaounde and neighborhoods. Moreover, stool specimens collected from wild NHP from June 2006 to October 2008 in the southern rain forest of Cameroon were considered. RNAs purified directly from stool samples were screened for EVs using a sensitive RT-nested PCR targeting the VP1 capsid coding gene whose nucleotide sequence was used for molecular typing. Captive chimpanzees (Pan troglodytes) and gorillas (Gorilla gorilla) were primarily infected by EV types already reported in humans in Cameroon and elsewhere: Coxsackievirus A13 and A24, Echovirus 15 and 29, and EV-B82. Moreover EV-A119, a novel virus type recently described in humans in central and west Africa, was also found in a captive Chimpanzee. EV-A76, which is a widespread virus in humans, was identified in wild chimpanzees, thus suggesting its adaptation and parallel circulation in human and NHP populations in Cameroon. Interestingly, some EVs harbored by wild NHP were genetically distinct from all existing types and were thus assigned as new types. One chimpanzee-derived virus was tentatively assigned as EV-J121 in the EV-J species. In addition, two EVs from wild monkeys provisionally registered as EV-122 and EV-123 were found to belong to a candidate new species. Overall, this study indicates that the genetic diversity of EVs among NHP is more important than previously known and could be the source of future new emerging human viral diseases.
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Affiliation(s)
| | - Maël Bessaud
- Institut Pasteur, Unité de Biologie des Virus Entériques, Paris, France
- INSERM, U994, Paris, France
| | - Marie-Line Joffret
- Institut Pasteur, Unité de Biologie des Virus Entériques, Paris, France
- INSERM, U994, Paris, France
| | | | - Jean Balanant
- Institut Pasteur, Unité de Biologie des Virus Entériques, Paris, France
- INSERM, U994, Paris, France
| | | | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Jean-Marc Reynes
- Service de Virologie, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Francis Delpeyroux
- Institut Pasteur, Unité de Biologie des Virus Entériques, Paris, France
- INSERM, U994, Paris, France
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48
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Volle R, Bailly JL, Mirand A, Pereira B, Marque-Juillet S, Chambon M, Regagnon C, Brebion A, Henquell C, Peigue-Lafeuille H, Archimbaud C. Variations in Cerebrospinal Fluid Viral Loads Among Enterovirus Genotypes in Patients Hospitalized With Laboratory-Confirmed Meningitis Due to Enterovirus. J Infect Dis 2014; 210:576-84. [DOI: 10.1093/infdis/jiu178] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Battistone A, Buttinelli G, Bonomo P, Fiore S, Amato C, Mercurio P, Cicala A, Simeoni J, Foppa A, Triassi M, Pennino F, Fiore L. Detection of Enteroviruses in Influent and Effluent Flow Samples from Wastewater Treatment Plants in Italy. FOOD AND ENVIRONMENTAL VIROLOGY 2014; 6:13-22. [PMID: 24277051 DOI: 10.1007/s12560-013-9132-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 11/11/2013] [Indexed: 05/21/2023]
Abstract
This study evaluated the presence and seasonal distribution of polio and other enteroviruses in four wastewater treatment plants in three cities in Italy, using different treatment systems. Detection of enteroviruses was carried out by virus isolation in cell cultures after concentration of water samples collected at both inlet and outlet of the treatment plants, following the methods described in the WHO guidelines. Viral serotypes isolated before and after water treatment were compared. Forty-eight non-polio enteroviruses were isolated from 312 samples collected at the inlet of the four wastewater treatment plants, 35 of which were Coxsackievirus type B (72.9 %) and 13 Echovirus (27.1 %). After treatment, 2 CVB3, 1 CVB5, and 1 Echo 6 were isolated. CVB3 and Echo 6 serotypes were also detected in samples collected at the inlet of the TP, in the same month and year. The high rate of detection of infectious enteroviruses in inlet sewage samples (30.1 %) indicates wide diffusion of these viruses in the populations linked to the collectors. The incomplete removal of infectious viruses following sewage treatment highlights possible risks for public health relate to treated waters discharge into the environment.
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Affiliation(s)
- Andrea Battistone
- CRIVIB, National Centre for Immunobiologicals Research and Evaluation, Viral Vaccines Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Gabriele Buttinelli
- CRIVIB, National Centre for Immunobiologicals Research and Evaluation, Viral Vaccines Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Paolo Bonomo
- CRIVIB, National Centre for Immunobiologicals Research and Evaluation, Viral Vaccines Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Stefano Fiore
- CRIVIB, National Centre for Immunobiologicals Research and Evaluation, Viral Vaccines Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Concetta Amato
- CRIVIB, National Centre for Immunobiologicals Research and Evaluation, Viral Vaccines Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Pietro Mercurio
- A.M.A.P. S.p.A. "Impianto di depurazione Acqua dei Corsari", Palermo, Italy
| | - Antonella Cicala
- A.M.A.P. S.p.A. "Impianto di depurazione Acqua dei Corsari", Palermo, Italy
| | | | | | - Maria Triassi
- Università degli Studi di Napoli "Federico II", Naples, Italy
| | | | - Lucia Fiore
- CRIVIB, National Centre for Immunobiologicals Research and Evaluation, Viral Vaccines Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Manor Y, Shulman LM, Kaliner E, Hindiyeh M, Ram D, Sofer D, Moran-Gilad J, Lev B, Grotto I, Gamzu R, Mendelson E. Intensified environmental surveillance supporting the response to wild poliovirus type 1 silent circulation in Israel, 2013. ACTA ACUST UNITED AC 2014; 19:20708. [PMID: 24576473 DOI: 10.2807/1560-7917.es2014.19.7.20708] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An emergency response was triggered by recovery of wild poliovirus type 1 (WPV1) of the South Asia (SOAS) lineage from sewage in southern Israel in April 2013 during routine environmental surveillance. Public health risk assessment necessitated intensification of environmental surveillance in order to facilitate countrywide monitoring of WPV1-SOAS circulation. This involved increasing sampling frequency and broadening the geographical area, for better coverage of the population at risk, as well as modifying sewage testing algorithms to accommodate a newly developed WPV1-SOAS-specific quantitative real-time RT-PCR assay for screening of RNA extracted directly from sewage concentrates, in addition to standard virus isolation. Intensified surveillance in 74 sites across Israel between 1 February and 31 August 2013 documented a sustained high viral load of WPV1-SOAS in sewage samples from six Bedouin settlements and two cities with Jewish and Arab populations in the South district. Lower viral loads and intermittent detection were documented in sampling sites representing 14 mixed communities in three of the five health districts in central and northern Israel. Environmental surveillance plays a fundamental role in routine monitoring of WPV circulation in polio-free countries. The rapid assay specific for the circulating strain facilitated implementation of intensified surveillance and informed the public health response and decision-making.
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Affiliation(s)
- Y Manor
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Tel Hashomer, Israel
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