1887

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Volume 60, Issue 9

An echovirus 18-associated outbreak of aseptic meningitis in Taiwan: epidemiology and diagnostic and genetic aspects Free

Abstract

In 2006, an outbreak of aseptic meningitis was noted in Taiwan. From January to October 2006, a total of 3283 specimens collected from patients with viral infection, including 173 cerebrospinal fluid (CSF) samples, were examined for virus isolation and identification. Overall, 339 enterovirus (EV)-positive cases were identified by virus culture: echovirus 18 (E18) formed the majority (27.4 %, 93 cases), followed by coxsackievirus B2 (13.8 %, 47 cases) and coxsackievirus A2 (10.8 %, 37 cases). The manifestations of the 93 E18 cases were aseptic meningitis (44.1 %), viral exanthema (23.6 %), acute tonsillitis (15.1 %), acute pharyngitis (14.0 %), acute gastritis (11.8 %), herpangina (7.5 %) and bronchopneumonia (5.3 %). Of 107 E18 isolates identified, 100, 62.5 and 19 % were obtained following culture in RD, MRC-5 and A549 cells, respectively. E18 was identified most frequently from throat swabs (67.2 %) and less frequently from stool samples (15.9 %) and CSF (16.8 %). The detection rate of E18 was 78.2 % from CSF, 50 % from stool samples and 22.9 % from throat swabs. Phylogenetic relationships among the E18 strains were examined. Analysis of the partial VP1 gene showed 3.7–23.8 % variation in sequence compared with sequences from GenBank and, notably, the amino acid change V152S was detected in a protruding loop within the VP1 protein. These results indicate that a genetic variant of E18 was circulating and caused an outbreak of aseptic meningitis in Taiwan in 2006.

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© 2011 SGM
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2011-09-01
2024-04-19
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References

  1. Andersson P., Edman K., Lindberg A. M. 2002; Molecular analysis of the echovirus 18 prototype: evidence of interserotypic recombination with echovirus 9. Virus Res 85:71–83 [View Article][PubMed]
     [Google Scholar]
  2. Bendig J., Earl P. 2005; The Lim Benyesh-Melnick antiserum pools for serotyping human enterovirus cell culture isolates – still useful, but may fail to identify current strains of echovirus 18. J Virol Methods 127:96–99 [View Article][PubMed]
     [Google Scholar]
  3. Borrego B., Carra E., García-Ranea J. A., Brocchi E. 2002; Characterization of neutralization sites on the circulating variant of swine vesicular disease virus (SVDV): a new site is shared by SVDV and the related coxsackie B5 virus. J Gen Virol 83:35–44[PubMed]
     [Google Scholar]
  4. Butler B. A. 1998; Sequence analysis using gcg . Methods Biochem Anal 39:74–97 [View Article][PubMed]
     [Google Scholar]
  5. Cabrerizo M., Echevarria J. E., González I., de Miguel T., Trallero G. 2008; Molecular epidemiological study of HEV-B enteroviruses involved in the increase in meningitis cases occurred in Spain during 2006. J Med Virol 80:1018–1024 [View Article][PubMed]
     [Google Scholar]
  6. CDC 2002; Enterovirus surveillance – United States, 2000–2001. MMWR Morb Mortal Wkly Rep 51:1047–1049[PubMed]
     [Google Scholar]
  7. Chambon M., Archimbaud C., Bailly J. L., Henquell C., Regagnon C., Charbonné F., Peigue-Lafeuille H. 2001; Circulation of enteroviruses and persistence of meningitis cases in the winter of 1999–2000. J Med Virol 65:340–347 [View Article][PubMed]
     [Google Scholar]
  8. dos Santos G. P., Skraba I., Oliveira D., Lima A. A., de Melo M. M., Kmetzsch C. I., da Costa E. V., da Silva E. E. 2006; Enterovirus meningitis in Brazil, 1998–2003. J Med Virol 78:98–104 [View Article][PubMed]
     [Google Scholar]
  9. Hogle J. M., Chow M., Filman D. J. 1985; Three-dimensional structure of poliovirus at 2.9 Å resolution. Science 229:1358–1365 [View Article][PubMed]
     [Google Scholar]
  10. Kapsenberg J. G., Ras A., Korte J. 1979; Improvement of enterovirus neutralization by treatment with sodium deoxycholate or chloroform. Intervirology 12:329–334 [View Article][PubMed]
     [Google Scholar]
  11. Khetsuriani N., Lamonte-Fowlkes A., Oberst S., Pallansch M. A. 2006; Enterovirus surveillance – United States, 1970–2005. MMWR Surveill Summ 55:1–20[PubMed]
     [Google Scholar]
  12. Künkel U., Schreier E. 2000; Genetic variability within the VP1 coding region of echovirus type 30 isolates. Arch Virol 145:1455–1464 [View Article][PubMed]
     [Google Scholar]
  13. Mateu M. G. 1995; Antibody recognition of picornaviruses and escape from neutralization: a structural view. Virus Res 38:1–24 [View Article][PubMed]
     [Google Scholar]
  14. McLaughlin J. B., Gessner B. D., Lynn T. V., Funk E. A., Middaugh J. P. 2004; Association of regulatory issues with an echovirus 18 meningitis outbreak at a children’s summer camp in Alaska. Pediatr Infect Dis J 23:875–877 [View Article][PubMed]
     [Google Scholar]
  15. Minor P. D., Ferguson M., Evans D. M., Almond J. W., Icenogle J. P. 1986; Antigenic structure of polioviruses of serotypes 1, 2 and 3. J Gen Virol 67:1283–1291 [View Article][PubMed]
     [Google Scholar]
  16. Mirand A., Archimbaud C., Henquell C., Michel Y., Chambon M., Peigue-Lafeuille H., Bailly J. L. 2006; Prospective identification of HEV-B enteroviruses during the 2005 outbreak. J Med Virol 78:1624–1634 [View Article][PubMed]
     [Google Scholar]
  17. Mistchenko A. S., Viegas M., Latta M. P., Barrero P. R. 2006; Molecular and epidemiologic analysis of enterovirus B neurological infection in Argentine children. J Clin Virol 37:293–299 [View Article][PubMed]
     [Google Scholar]
  18. Modlin J. F. 1996; Update on enterovirus infections in infants and children. Adv Pediatr Infect Dis 12:155–180[PubMed]
     [Google Scholar]
  19. Muir P., Kämmerer U., Korn K., Mulders M. N., Pöyry T., Weissbrich B., Kandolf R., Cleator G. M., van Loon A. M. for The European Union Concerted Action on Virus Meningitis and Encephalitis 1998; Molecular typing of enteroviruses: current status and future requirements. Clin Microbiol Rev 11:202–227[PubMed]
     [Google Scholar]
  20. Nijhar S. K., Mackay D. K., Brocchi E., Ferris N. P., Kitching R. P., Knowles N. J. 1999; Identification of neutralizing epitopes on a European strain of swine vesicular disease virus. J Gen Virol 80:277–282[PubMed]
     [Google Scholar]
  21. Oberste M. S., Maher K., Pallansch M. A. 1998; Molecular phylogeny of all human enterovirus serotypes based on comparison of sequences at the 5′ end of the region encoding VP2. Virus Res 58:35–43 [View Article][PubMed]
     [Google Scholar]
  22. Oberste M. S., Maher K., Kilpatrick D. R., Flemister M. R., Brown B. A., Pallansch M. A. 1999a; Typing of human enteroviruses by partial sequencing of VP1. J Clin Microbiol 37:1288–1293[PubMed]
     [Google Scholar]
  23. Oberste M. S., Maher K., Kennett M. L., Campbell J. J., Carpenter M. S., Schnurr D., Pallansch M. A. 1999b; Molecular epidemiology and genetic diversity of echovirus type 30 (E30): genotypes correlate with temporal dynamics of E30 isolation. J Clin Microbiol 37:3928–3933[PubMed]
     [Google Scholar]
  24. Oberste M. S., Maher K., Flemister M. R., Marchetti G., Kilpatrick D. R., Pallansch M. A. 2000; Comparison of classic and molecular approaches for the identification of untypeable enteroviruses. J Clin Microbiol 38:1170–1174[PubMed]
     [Google Scholar]
  25. Page R. D. 2002; Visualizing phylogenetic trees using TreeView. Curr Protoc Bioinformatics Chapter 6:6.2[PubMed]
     [Google Scholar]
  26. Posada D. 2003; Using modeltest and paup* to select a model of nucleotide substitution. Curr Protoc Bioinformatics Chapter 6:6.5[PubMed]
     [Google Scholar]
  27. Pöyry T., Kinnunen L., Hyypiä T., Brown B., Horsnell C., Hovi T., Stanway G. 1996; Genetic and phylogenetic clustering of enteroviruses. J Gen Virol 77:1699–1717 [View Article][PubMed]
     [Google Scholar]
  28. Richter J., Koptides D., Tryfonos C., Christodoulou C. 2006; Molecular typing of enteroviruses associated with viral meningitis in Cyprus, 2000–2002. J Med Microbiol 55:1035–1041 [View Article][PubMed]
     [Google Scholar]
  29. Thoelen I., Lemey P., Van Der Donck I., Beuselinck K., Lindberg A. M., Van Ranst M. 2003; Molecular typing and epidemiology of enteroviruses identified from an outbreak of aseptic meningitis in Belgium during the summer of 2000. J Med Virol 70:420–429 [View Article][PubMed]
     [Google Scholar]
  30. Wang J.-R., Tsai H.-P., Huang S.-W., Kuo P.-H., Kiang D., Liu C.-C. 2002; Laboratory diagnosis and genetic analysis of an echovirus 30-associated outbreak of aseptic meningitis in Taiwan in 2001. J Clin Microbiol 40:4439–4444 [View Article][PubMed]
     [Google Scholar]
  31. Wang S.-M., Ho T.-S., Shen C.-F., Wang J.-R., Liu C.-C. 2011; Echovirus 18 meningitis in southern Taiwan. Pediatr Infect Dis J 30:259–260 [CrossRef]
     [Google Scholar]
  32. Witsø E., Palacios G., Cinek O., Stene L. C., Grinde B., Janowitz D., Lipkin W. I., Rønningen K. S. 2006; High prevalence of human enterovirus A infections in natural circulation of human enteroviruses. J Clin Microbiol 44:4095–4100 [View Article][PubMed]
     [Google Scholar]
  33. Xia X., Xie Z. 2001; dambe: software package for data analysis in molecular biology and evolution. J Hered 92:371–373 [View Article][PubMed]
     [Google Scholar]
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An echovirus 18-associated outbreak of aseptic meningitis in Taiwan: epidemiology and diagnostic and genetic aspects
J. Med. Microbiol. 60, 1360 (2011); https://doi.org/10.1099/jmm.0.027698-0
/content/journal/jmm/10.1099/jmm.0.027698-0
/content/journal/jmm/10.1099/jmm.0.027698-0
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