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Anderson CA, Barrera MD, Boghdeh NA, Smith M, Alem F, Narayanan A. Brilacidin as a Broad-Spectrum Inhibitor of Enveloped, Acutely Infectious Viruses. Microorganisms 2023; 12:54. [PMID: 38257881 PMCID: PMC10819233 DOI: 10.3390/microorganisms12010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Alphaviruses, belonging to the Togaviridae family, and bunyaviruses, belonging to the Paramyxoviridae family, are globally distributed and lack FDA-approved vaccines and therapeutics. The alphaviruses Venezuelan equine encephalitis virus (VEEV) and eastern equine encephalitis virus (EEEV) are known to cause severe encephalitis, whereas Sindbis virus (SINV) causes arthralgia potentially persisting for years after initial infection. The bunyavirus Rift Valley Fever virus (RVFV) can lead to blindness, liver failure, and hemorrhagic fever. Brilacidin, a small molecule that was designed de novo based on naturally occurring host defensins, was investigated for its antiviral activity against these viruses in human small airway epithelial cells (HSAECs) and African green monkey kidney cells (Veros). This testing was further expanded into a non-enveloped Echovirus, a Picornavirus, to further demonstrate brilacidin's effect on early steps of the viral infectious cycle that leads to inhibition of viral load. Brilacidin demonstrated antiviral activity against alphaviruses VEEV TC-83, VEEV TrD, SINV, EEEV, and bunyavirus RVFV. The inhibitory potential of brilacidin against the viruses tested in this study was dependent on the dosing strategy which necessitated compound addition pre- and post-infection, with addition only at the post-infection stage not eliciting a robust inhibitory response. The inhibitory activity of brilacidin was only modest in the context of the non-enveloped Picornavirus Echovirus, suggesting brilacidin may be less potent against non-enveloped viruses.
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Affiliation(s)
| | | | | | | | | | - Aarthi Narayanan
- Center for Infectious Disease Research, School of Systems Biology, George Mason University, Manassas, VA 20110, USA; (C.A.A.); (M.D.B.); (N.A.B.); (M.S.); (F.A.)
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Roh D, Jeon W, Lee J. Enterovirus Meningitis without Pleocytosis: a Retrospective Observational Study in Adults. Jpn J Infect Dis 2023; 76:329-334. [PMID: 37394460 DOI: 10.7883/yoken.jjid.2023.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Reverse-transcription polymerase chain reaction (RT-PCR)-confirmed enterovirus (EV) meningitis without pleocytosis has only been previously reported in children. In this study, we examined the frequency of EV meningitis without pleocytosis in adults and compared its clinical features. We retrospectively analyzed the data of adult patients with EV meningitis confirmed using cerebrospinal fluid (CSF) RT-PCR. Among the 17 patients included in this study, 58.8% showed no pleocytosis. The median age and clinical symptoms did not differ between the pleocytosis and non-pleocytosis groups. There were no statistically significant differences in seasonal variation or time from the onset of meningitis symptoms to lumbar puncture. The peripheral white blood cell (WBC) count in patients with pleocytosis was significantly higher than that in patients without pleocytosis. The median CSF pressure showed a higher trend in the non-pleocytosis group. Patients with CSF pressures higher than normal were more common in the non-pleocytosis group. The median CSF protein values were higher than the normal values in both groups. We confirmed the high frequency of EV meningitis without pleocytosis in adults. Accurate diagnosis using RT-PCR is necessary when meningitis symptoms are prominent during an EV epidemic, and CSF protein levels and pressure are high, even if the CSF WBC count is normal.
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Affiliation(s)
- Dongkeun Roh
- Department of Emergency Medicine, Ajou University School of Medicine, Republic of Korea
| | - Woochan Jeon
- Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Republic of Korea
| | - Jisook Lee
- Department of Emergency Medicine, Ajou University School of Medicine, Republic of Korea
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Mamana J, Humber GM, Espinal ER, Seo S, Vollmuth N, Sin J, Kim BJ. Coxsackievirus B3 infects and disrupts human induced-pluripotent stem cell derived brain-like endothelial cells. Front Cell Infect Microbiol 2023; 13:1171275. [PMID: 37139492 PMCID: PMC10149843 DOI: 10.3389/fcimb.2023.1171275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Coxsackievirus B3 (CVB3) is a significant human pathogen that is commonly found worldwide. CVB3 among other enteroviruses, are the leading causes of aseptic meningo-encephalitis which can be fatal especially in young children. How the virus gains access to the brain is poorly-understood, and the host-virus interactions that occur at the blood-brain barrier (BBB) is even less-characterized. The BBB is a highly specialized biological barrier consisting primarily of brain endothelial cells which possess unique barrier properties and facilitate the passage of nutrients into the brain while restricting access to toxins and pathogens including viruses. To determine the effects of CVB3 infection on the BBB, we utilized a model of human induced-pluripotent stem cell-derived brain-like endothelial cells (iBECs) to ascertain if CVB3 infection may alter barrier cell function and overall survival. In this study, we determined that these iBECs indeed are susceptible to CVB3 infection and release high titers of extracellular virus. We also determined that infected iBECs maintain high transendothelial electrical resistance (TEER) during early infection despite possessing high viral load. TEER progressively declines at later stages of infection. Interestingly, despite the high viral burden and TEER disruptions at later timepoints, infected iBEC monolayers remain intact, indicating a low degree of late-stage virally-mediated cell death, which may contribute to prolonged viral shedding. We had previously reported that CVB3 infections rely on the activation of transient receptor vanilloid potential 1 (TRPV1) and found that inhibiting TRPV1 activity with SB-366791 significantly limited CVB3 infection of HeLa cervical cancer cells. Similarly in this study, we observed that treating iBECs with SB-366791 significantly reduced CVB3 infection, which suggests that not only can this drug potentially limit viral entry into the brain, but also demonstrates that this infection model could be a valuable platform for testing antiviral treatments of neurotropic viruses. In all, our findings elucidate the unique effects of CVB3 infection on the BBB and shed light on potential mechanisms by which the virus can initiate infections in the brain.
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Affiliation(s)
- Julia Mamana
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Gabrielle M. Humber
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Eric R. Espinal
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Soojung Seo
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Nadine Vollmuth
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Jon Sin
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, United States
- *Correspondence: Jon Sin, ; Brandon J. Kim,
| | - Brandon J. Kim
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, United States
- Department of Microbiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- Center for Convergent Biosciences and Medicine, University of Alabama, Tuscaloosa, AL, United States
- Alabama Life Research Institute, University of Alabama, Tuscaloosa, AL, United States
- *Correspondence: Jon Sin, ; Brandon J. Kim,
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Zhou D, Qin L, Duyvesteyn HME, Zhao Y, Lin TY, Fry EE, Ren J, Huang KYA, Stuart DI. Switching of Receptor Binding Poses between Closely Related Enteroviruses. Viruses 2022; 14:2625. [PMID: 36560629 PMCID: PMC9781616 DOI: 10.3390/v14122625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
Echoviruses, for which there are currently no approved vaccines or drugs, are responsible for a range of human diseases, for example echovirus 11 (E11) is a major cause of serious neonatal morbidity and mortality. Decay-accelerating factor (DAF, also known as CD55) is an attachment receptor for E11. Here, we report the structure of the complex of E11 and the full-length ectodomain of DAF (short consensus repeats, SCRs, 1-4) at 3.1 Å determined by cryo-electron microscopy (cryo-EM). SCRs 3 and 4 of DAF interact with E11 at the southern rim of the canyon via the VP2 EF and VP3 BC loops. We also observe an unexpected interaction between the N-linked glycan (residue 95 of DAF) and the VP2 BC loop of E11. DAF is a receptor for at least 20 enteroviruses and we classify its binding patterns from reported DAF/virus complexes into two distinct positions and orientations, named as E6 and E11 poses. Whilst 60 DAF molecules can attach to the virion in the E6 pose, no more than 30 can attach to E11 due to steric restrictions. Analysis of the distinct modes of interaction and structure and sequence-based phylogenies suggests that the two modes evolved independently, with the E6 mode likely found earlier.
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Affiliation(s)
- Daming Zhou
- Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Wellcome Centre for Human Genetics, Headington, Oxford OX3 7BN, UK
- Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford OX3 7FZ, UK
| | - Ling Qin
- Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Wellcome Centre for Human Genetics, Headington, Oxford OX3 7BN, UK
| | - Helen M. E. Duyvesteyn
- Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Wellcome Centre for Human Genetics, Headington, Oxford OX3 7BN, UK
| | - Yuguang Zhao
- Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Wellcome Centre for Human Genetics, Headington, Oxford OX3 7BN, UK
| | - Tzou-Yien Lin
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Elizabeth E. Fry
- Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Wellcome Centre for Human Genetics, Headington, Oxford OX3 7BN, UK
| | - Jingshan Ren
- Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Wellcome Centre for Human Genetics, Headington, Oxford OX3 7BN, UK
| | - Kuan-Ying A. Huang
- Graduate Institute of Immunology and Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - David I. Stuart
- Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Wellcome Centre for Human Genetics, Headington, Oxford OX3 7BN, UK
- Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford OX3 7FZ, UK
- Diamond Light Source Ltd., Harwell Science & Innovation Campus, Didcot OX11 0DE, UK
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Muacevic A, Adler JR, Furuya S, Kondo Y, Naito T. Aseptic Meningitis With an Isolated Positive Ocular Globe Compression Sign Diagnosed by Repeat Lumbar Puncture. Cureus 2022; 14:e32036. [PMID: 36600832 PMCID: PMC9801136 DOI: 10.7759/cureus.32036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
Aseptic meningitis is diagnosed using clinical and laboratory findings of meningeal inflammation in the absence of bacteria in cerebrospinal fluid smear and culture. It is commonly caused by a viral infection, and most cases are improved without specific treatment. We present a case of aseptic meningitis in a 33-year-old Japanese man that was diagnosed only after a repeat lumbar puncture. The patient had a positive ocular globe compression sign with no other positive meningeal signs. This case highlights the importance of repeated lumbar puncture in patients with suspected aseptic meningitis if the initial lumbar puncture results are negative, and there is a clinical value in assessing the ocular globe compression sign, particularly when other clinical signs of meningitis are absent.
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Abstract
Meningitis remains an important cause of mortality and morbidity. Clinicians should be alert to this diagnosis and have a low threshold for investigation and treatment of meningitis. This article provides an update of current evidence and existing guidelines for the management of suspected acute meningitis in adults in the UK.
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Affiliation(s)
- Emma Carter
- ALeeds Teaching Hospitals NHS Trust, Leeds, UK,Address for correspondence: Dr Emma Carter, Accelerator Research Clinic, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
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Bodilsen J, Mens H, Midgley S, Brandt CT, Petersen PT, Larsen L, Hansen BR, Lüttichau HR, Helweg-Larsen J, Wiese L, Østergaard C, Storgaard M, Nielsen H. Enterovirus Meningitis in Adults: A Prospective Nationwide Population-Based Cohort Study. Neurology 2021; 97:e454-e463. [PMID: 34088872 DOI: 10.1212/wnl.0000000000012294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/19/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the hypothesis that enterovirus meningitis (EM) is a frequent and self-limiting condition, the epidemiology of EM in adults was examined. METHODS Using a prospective, nationwide, population-based database, all adults with EM confirmed by PCR of the CSF from 2015 to 2019 were included. Unfavorable outcome was defined as Glasgow Outcome Scale scores of 1-4 at discharge. Modified Poisson regression was used to compute adjusted relative risks (RRs). RESULTS A total of 419 cases of EM in 418 adults (46% female, median age 31 years [interquartile range (IQR) 27-35]) yielded an incidence of 1.80/100,000/year. Admission diagnoses included CNS infection 247/397 (62%), other neurologic conditions 89/397 (22%), and cerebrovascular diseases 33/397 (8%). Genotype was available for 271 cases, of which echovirus 30 accounted for 155 (57%). Patients presented with headache 412/415 (99%), history of fever 303/372 (81%), photophobia 292/379 (77%), and neck stiffness 159/407 (39%). Fever (≥38.0°C) was observed in 192/399 (48%) at admission. The median CSF leukocyte count was 130 106/L (range 0-2,100) with polymorphonuclear predominance (>50%) in 110/396 (28%). Cranial imaging preceded lumbar puncture in 127/417 (30%) and was associated with non-CNS infection admission diagnoses and delayed lumbar puncture (median 4.8 hours [IQR 3.4-7.9] vs 1.5 [IQR 0.8-2.8], p < 0.001). Unfavorable outcome occurred in 99/419 (24%) at discharge; more often in female patients (RR 2.30 [1.58-3.33]) and less frequent in echovirus 30 (RR 0.67 [0.46-1.00]) in adjusted analyses. Outcome remained unfavorable in 22/379 (6%) after 6 months. CONCLUSIONS EM is common among young, healthy adults. Although the long-term prognosis remains reassuring, a substantial proportion have moderate disability at discharge, especially female patients.
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Affiliation(s)
- Jacob Bodilsen
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark.
| | - Helene Mens
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Sofie Midgley
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Christian Thomas Brandt
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Pelle Trier Petersen
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Lykke Larsen
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Birgitte Rønde Hansen
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Hans Rudolf Lüttichau
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Jannik Helweg-Larsen
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Lothar Wiese
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Christian Østergaard
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Merete Storgaard
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
| | - Henrik Nielsen
- From the Department of Infectious Diseases (J.B.), Aalborg University Hospital; Department of Pulmonary and Infectious Diseases (H.M., C.T.B., P.T.P.), Nordsjællands Hospital, Hillerød; Department of Infectious Diseases (H.M., J.H.-L.), Rigshospitalet; Virology Surveillance and Research Section (S.M.), Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen; Department of Infectious Diseases (L.L.), Odense University Hospital; Department of Infectious Diseases (B.R.H.), Hvidovre University Hospital; Department of Clinical Microbiology (C.Ø.), Copenhagen University Hospital, Amager and Hvidovre; Department of Infectious Diseases (H.R.L.), Copenhagen University Hospital, Herlev and Gentofte,; Department of Medicine (L.W.), Zealand University Hospital, Roskilde; Department of Infectious Diseases (M.S.), Aarhus University Hospital; and Departments of Infectious Diseases (H.N.) and Clinical Medicine (H.N.), Aalborg University, Denmark
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Maruo Y, Nakanishi M, Suzuki Y, Kaneshi Y, Terashita Y, Narugami M, Takahashi M, Kato S, Suzuki R, Goto A, Miyoshi M, Nagano H, Sugisawa T, Okano M. Outbreak of aseptic meningitis caused by echovirus 30 in Kushiro, Japan in 2017. J Clin Virol 2019; 116:34-38. [PMID: 31082730 DOI: 10.1016/j.jcv.2019.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/23/2019] [Accepted: 05/05/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Echovirus 30 (E30) is one of the most common causative agents for aseptic meningitis. OBJECTIVES In the autumn of 2017, there was an outbreak caused by E30 in Kushiro, Hokkaido, Japan. The aim of this study was to characterize this outbreak. STUDY DESIGN Fifty-nine patients were admitted to the Department of Pediatrics, Kushiro Red Cross Hospital (KRCH) with clinical diagnosis of aseptic meningitis. Among those, 36 patients were finally diagnosed as E30-associated aseptic meningitis by the detection of viral RNA using reverse transcription-polymerase chain reaction (RT-PCR) and/or the evidence of more than four-fold rise in neutralizing antibody (NA) titers in the convalescent phase relative to those in the acute phase. We investigated these 36 confirmed cases. RESULTS The median age was 6 years (range: 6 months-14 years). The positive signs and symptoms were as follows: fever (100%), headache (94%), vomiting (92%), jolt accentuation (77%), neck stiffness (74%), Kernig sign (29%), and abdominal pain (28%). The median cerebrospinal fluid (CSF) white cell count, neutrophil count, and lymphocyte count were 222/μL (range: 3-1434/μL), 144/μL (range: 1-1269/μL), and 85/μL (range: 2-354/μL), respectively. Although the detected viral genes demonstrated same cluster, they were different from E30 strains observed in Japan between 2010 and 2014. CONCLUSION We mainly showed clinical and virological features of the E30-associated aseptic meningitis outbreak that occurred in Kushiro. To prevent further spread of E30 infection, continuous surveillance of enterovirus (EV) circulation and standard precautions are considered essential.
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Affiliation(s)
- Yuji Maruo
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.
| | - Masanori Nakanishi
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Yasuto Suzuki
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Yosuke Kaneshi
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Yukayo Terashita
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Masashi Narugami
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Michi Takahashi
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Sho Kato
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Ryota Suzuki
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Akiko Goto
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
| | - Masahiro Miyoshi
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
| | - Hideki Nagano
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
| | - Takahisa Sugisawa
- Kushiro Center of Public Health, 4-22, Shiroyama 2, Kushiro 085-0826, Japan
| | - Motohiko Okano
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
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9
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Wright WF, Pinto CN, Palisoc K, Baghli S. Viral (aseptic) meningitis: A review. J Neurol Sci 2019; 398:176-183. [PMID: 30731305 DOI: 10.1016/j.jns.2019.01.050] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 11/17/2022]
Abstract
Viral meningitis is an inflammation of the meninges associated with acute onset of meningeal symptoms and fever, pleocytosis of the cerebrospinal fluid, and no growth on routine bacterial culture. It is sometimes associated with viral encephalitis and meningoencephalitis. Viruses reach the central nervous system (CNS) hematogenously or in a retrograde manner from nerve endings. The viral etiology varies according to age and country. Molecular diagnostics technology has helped improve the rate of pathogen detection reducing unnecessary antibiotic use and length of hospitalization. Most of the viral infections detailed in this article have no specific treatment other than supportive care. Many of the viruses discussed are preventable by vaccination and proper skin protection against transmitting vectors.
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Affiliation(s)
- William F Wright
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center, Pinnacle, United States.
| | - Casey N Pinto
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center, Pinnacle, United States; Department of Public Health Sciences, The Pennsylvania State University, United States.
| | - Kathryn Palisoc
- Division of Hospital Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pinnacle, United States
| | - Salim Baghli
- Division of Hospital Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pinnacle, United States
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10
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Ahlbrecht J, Hillebrand LK, Schwenkenbecher P, Ganzenmueller T, Heim A, Wurster U, Stangel M, Sühs KW, Skripuletz T. Cerebrospinal fluid features in adults with enteroviral nervous system infection. Int J Infect Dis 2018; 68:94-101. [DOI: 10.1016/j.ijid.2018.01.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/16/2018] [Accepted: 01/19/2018] [Indexed: 12/16/2022] Open
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11
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Zhu R, Cheng T, Yin Z, Liu D, Xu L, Li Y, Wang W, Liu J, Que Y, Ye X, Tang Q, Zhao Q, Ge S, He S, Xia N. Serological survey of neutralizing antibodies to eight major enteroviruses among healthy population. Emerg Microbes Infect 2018; 7:2. [PMID: 29323107 PMCID: PMC5837151 DOI: 10.1038/s41426-017-0003-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/03/2017] [Accepted: 11/06/2017] [Indexed: 12/13/2022]
Abstract
Human enteroviruses (EVs) are the most common causative agents infecting human, causing many harmful diseases, such as hand, foot, and mouth disease (HFMD), herpangina (HA), myocarditis, encephalitis, and aseptic meningitis. EV-related diseases pose a serious worldwide threat to public health. To gain comprehensive insight into the seroepidemiology of major prevalent EVs in humans, we firstly performed a serological survey for neutralizing antibodies (nAbs) against Enterovirus A71 (EV-A71), Coxsackie virus A16 (CV-A16), Coxsackie virus A6 (CV-A6), Coxsackie virus A10 (CV-A10), Coxsackie virus B3 (CV-B3), Coxsackie virus B5 (CV-B5), Echovirus 25 (ECHO25), and Echovirus 30 (ECHO30) among the healthy population in Xiamen City in 2016, using micro-neutralization assay. A total of 515 subjects aged 5 months to 83 years were recruited by stratified random sampling. Most major human EVs are widely circulated in Xiamen City and usually infect infants and children. The overall seroprevalence of these eight EVs were ranged from 14.4% to 42.7%, and most of them increased with age and subsequently reached a plateau. The co-existence of nAbs against various EVs are common among people ≥ 7 years of age, due to the alternate infections or co-infections with different serotypes of EVs, while most children were negative for nAb against EVs, especially those < 1 year of age. This is the first report detailing the seroepidemiology of eight prevalent EVs in the same population, which provides scientific data supporting further studies on the improvement of EV-related disease prevention and control.
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Affiliation(s)
- Rui Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Tong Cheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Zhichao Yin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Dongxiao Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Longfa Xu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Yongchao Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Wei Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Jian Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Yuqiong Que
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Xiangzhong Ye
- Beijing Wantai Biological Pharmacy Enterprise, Beijing, 102206, China
| | - Qiyi Tang
- Department of Microbiology, Howard University College of Medicine, Washington, DC, 20059, USA
| | - Qinjian Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Shengxiang Ge
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Shuizhen He
- Xiamen Center for Disease Control and Prevention, Xiamen, 361012, China.
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Sciences, School of Public Health, Xiamen University, Xiamen, 361102, China.
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12
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Abstract
PURPOSE OF REVIEW The purpose of this review is to give an overview of viral meningitis and then focus in on some of the areas of uncertainty in diagnostics, treatment and outcome. RECENT FINDINGS Bacterial meningitis has been declining in incidence over recent years. Over a similar time period molecular diagnostics have increasingly been used. Because of both of these developments viral meningitis is becoming relatively more important. However, there are still many unanswered questions. Despite improvements in diagnostics many laboratories do not use molecular methods and even when they are used many cases still remain without a proven viral aetiology identified. There are also no established treatments for viral meningitis and the one potential treatment, aciclovir, which is effective in vitro for herpes simplex virus, has never been subjected to a clinical trial. SUMMARY Viruses are in increasingly important cause of meningitis in the era of declining bacterial disease. The exact viral aetiology varies according to age and country. Molecular diagnostics can not only improve the rate of pathogen detection but also reduce unnecessary antibiotics use and length of hospitalization. Further research is required into treatments for viral meningitis and the impact in terms of longer term sequelae.
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13
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Hospital admissions for viral meningitis in children in England over five decades: a population-based observational study. THE LANCET. INFECTIOUS DISEASES 2016; 16:1279-1287. [DOI: 10.1016/s1473-3099(16)30201-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/19/2016] [Accepted: 06/13/2016] [Indexed: 11/18/2022]
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14
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Kadambari S, Bukasa A, Okike IO, Pebody R, Brown D, Gallimore C, Xerry J, Sharland M, Ladhani SN. Enterovirus infections in England and Wales, 2000-2011: the impact of increased molecular diagnostics. Clin Microbiol Infect 2014; 20:1289-96. [PMID: 25039903 DOI: 10.1111/1469-0691.12753] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 06/24/2014] [Accepted: 06/29/2014] [Indexed: 11/28/2022]
Abstract
There have recently been significant changes in diagnostic practices for detecting enterovirus (EV) infections across England and Wales. Reports of laboratory-confirmed EV infections submitted by National Health Service (NHS) hospital laboratories to Public Health England (PHE) over a 12-year period (2000-2011) were analysed. Additionally, the PHE Virus Reference Department (VRD) electronic database containing molecular typing data from 2004 onwards was interrogated. Of the 13,901 reports, there was a decline from a peak of 2254 in 2001 to 589 in 2006, and then an increase year-on-year to 1634 in 2011. This increase coincided with increasing PCR-based laboratory diagnosis, which accounted for 36% of reported cases in 2000 and 92% in 2011. The estimated annual incidence in 2011 was 3.9/100,000 overall and 238/100,000 in those aged <3 months, who accounted for almost one-quarter of reported cases (n = 2993, 23%). During 2004-2011, 2770 strains were submitted for molecular typing to the VRD, who found no evidence for a predominance of any particular strain. Thus, the recent increase in reported cases closely reflects the increase in PCR testing by NHS hospitals, but is associated with a lower proportion of samples being submitted for molecular typing. The high EV rate in young infants merits further investigation to inform evidence-based management guidance.
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Affiliation(s)
- S Kadambari
- Paediatric Infectious Diseases Research Group, St George's University of London, London, UK
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15
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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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16
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Complete genome sequence analysis of human echovirus 30 isolated during a large outbreak in Guangdong Province of China, in 2012. Arch Virol 2013; 159:379-83. [PMID: 23990054 PMCID: PMC3906529 DOI: 10.1007/s00705-013-1818-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 07/03/2013] [Indexed: 11/14/2022]
Abstract
In May and June 2012, an outbreak of aseptic meningitis caused by Echovirus 30 (E30) occurred on a large scale in Luoding, Guangdong Province, China. Our team successfully isolated one subtype, strain 2012EM161, and its complete genome was sequenced. The phylogenetic tree of viral protein (VP) 1 gene sequences showed that the viral isolate was similar to the E30 strain prevalent in Fujian (2011), with identity of 98.05–99.32 % and 98.63–99.32 % for nucleotides and amino acids respectively. Whole genome-based phylogenetic analysis indicated that 2012EM161 contained the most proximate consensus to DQ246620 (Zhejiang, 2003) and FDJS03 (AY948442, Jiangsu, 2005), with nucleotide homogeneity of 87.09 % and 86.98 % respectively. The RDP4.16 and Simplot analysis showed that the newly discovered 2012EM161 was probably a recombinant, which was closely related to the strain of E30 (DQ246620) in the first half of the genome and the strain of E6 (JX976771) in genomic P3 region. The whole genome sequence of 2012EM161 will allow further study of the origin, evolution, and the molecular epidemiology of E30 strains.
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17
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Yang XH, Yan YS, Weng YW, He AH, Zhang HR, Chen W, Zhou Y. Molecular epidemiology of Echovirus 30 in Fujian, China between 2001 and 2011. J Med Virol 2013; 85:696-702. [PMID: 23359298 DOI: 10.1002/jmv.23503] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2012] [Indexed: 11/12/2022]
Abstract
Echovirus 30 (E-30) was responsible for an outbreak of aseptic meningitis between April 1 and June 2, 2011 in Fujian Province, China. A molecular epidemiology study of 115 E-30 strains was performed to characterize the genetic features of the etiologic agent of the 2011 aseptic meningitis outbreak. The phylogenetic trees of the complete VP1 gene (876 bp) from 74 of 115 isolates and 50 reference sequences were analyzed. Three lineages (E-30_h, i, and j) were detected that had co-circulated in Fujian in the last decade, of which E-30_j was new. The other 72 Fujian strains and 16 representative strains from other provinces of China all belong to E-30_h and E-30_i. Two distinct E-30 clusters including virus isolates obtained during adult surveillance were associated with the 2011 outbreak and differed from Fujian isolates prior to 2011, suggesting that the viruses may vary and adult infections play an important role in viral transmission. Thus, the multiple lineages of E-30 in Fujian and variant viruses enhanced transmissibility, which may be related to the epidemic activity of E-30.
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Affiliation(s)
- Xiu-hui Yang
- Department of Pathogenic Biology, School of Basic Medical Science, Fujian Medical University, Fuzhou, Fujian, China
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18
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Molecular identification of enteroviruses associated with aseptic meningitis in children from India. Arch Virol 2012; 158:211-5. [PMID: 22975986 DOI: 10.1007/s00705-012-1476-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 07/29/2012] [Indexed: 10/27/2022]
Abstract
We identified and characterized enteroviruses associated with aseptic meningitis in children between April 2009 and March 2010. Enterovirus RNA was detected in 51 (45.5 %) of 112 CSF samples. Molecular typing by RT-PCR and sequencing of a partial VP1 region revealed the predominance of echovirus (ECV) 32 (n = 20), followed by ECV 11 (n = 10), ECV 13 and ECV 14 (n = 5 each), coxsackievirus (CV) B3 and CV B6 (n = 3 each), CV A2, CV A10 and ECV 30 (n = 1 each). Phylogenetic analysis of ECV 32 showed 0 to 4 % sequence divergence among strains of the present study and 20-23 % from the prototype Puerto Rico strain at the nucleotide level. This is the first report of ECV 32 associated with an aseptic meningitis epidemic and identification of seven different enterovirus serotypes (CV A2, CV A10, CV B3, CV B6, ECV 13, ECV 14 and ECV 32) in meningitis cases from India.
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19
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Mace SE. Central nervous system infections as a cause of an altered mental status? What is the pathogen growing in your central nervous system? Emerg Med Clin North Am 2010; 28:535-70. [PMID: 20709243 DOI: 10.1016/j.emc.2010.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There are several central nervous system (CNS) infections (meningitis, encephalitis, and brain abscess), any of which may present with an altered level of consciousness. Because CNS infections can have a devastating outcome, it is important to recognize the presence of a CNS infection and begin treatment as soon as possible because early appropriate therapy may, in some cases, limit morbidity and mortality.
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Affiliation(s)
- Sharon E Mace
- Department of Emergency Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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20
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Echovirus-30-bedingte Meningitiden. Monatsschr Kinderheilkd 2010. [DOI: 10.1007/s00112-009-2134-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Hayashi T, Shirayoshi T, Nagano T, Yaoita H, Kogure S, Nariai H, Natsumeda T, Taniuchi M, Sandoh M, Sato Y. An outbreak of aseptic meningitis due to echovirus 30 in a high school baseball club--possible role of severe exercise for a high attack rate. Intern Med 2009; 48:1767-71. [PMID: 19797835 DOI: 10.2169/internalmedicine.48.2298] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In September 2008, an outbreak of aseptic meningitis caused by echovirus 30 occurred in Ota City, Gunma. Among the 26 people hospitalized, 17 were members of a high school baseball club. The attack rate within the club was as high as 40%. The other 9 patients were either their families or close relatives of the baseball club members, indicating the outbreak was confined to a limited community. Although numerous outbreaks of echoviral meningitis have been reported worldwide, those with such a high attack rate within a limited community are rare. Severe physical exercise in a hot temperature could be associated with this high attack rate.
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Affiliation(s)
- Takeshi Hayashi
- Department of Neurology, Fuji Heavy Industries Health Insurance Corporation, Ota General Hospital, Ota.
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Sulik A, Wojtkowska M, Oldak E. Elevated Levels of MMP-9 and TIMP-1 in the Cerebrospinal Fluid of Children with Echovirus Type 30 and Mumps Meningitis. Scand J Immunol 2008; 68:323-7. [DOI: 10.1111/j.1365-3083.2008.02137.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fitch MT, Abrahamian FM, Moran GJ, Talan DA. Emergency department management of meningitis and encephalitis. Infect Dis Clin North Am 2008; 22:33-52, v-vi. [PMID: 18295682 DOI: 10.1016/j.idc.2007.10.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bacterial meningitis and viral encephalitis are infectious disease emergencies that can cause significant patient morbidity and mortality. Clinicians use epidemiologic, historical, and physical examination findings to identify patients at risk for these infections, and central nervous system (CNS) imaging and lumbar puncture (LP) may be needed to further evaluate for these diagnoses. The diagnosis of bacterial meningitis can be challenging, as patients often lack some of the characteristic findings of this disease with presentations that overlap with more common disorders seen in the emergency department. This article addresses considerations in clinical evaluation, need for CNS imaging before LP, interpretation of cerebrospinal fluid results, standards for and effects of timely antibiotic administration, and recommendations for specific antimicrobial therapy and corticosteroids.
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Affiliation(s)
- Michael T Fitch
- Department of Emergency Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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