Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Abstract

The epidemiology of enteroviral infection in South Korea during 1999–2011 chronicles nationwide outbreaks and changing detection and subtyping methods used over the 13-year period. Of 14,657 patients whose samples were tested, 4,762 (32.5%) samples were positive for human enterovirus (human EV); as diagnostic methods improved, the rate of positive results increased. A seasonal trend of outbreaks was documented. Genotypes enterovirus 71, echovirus 30, coxsackievirus B5, enterovirus 6, and coxsackievirus B2 were the most common genotypes identified. Accurate test results correlated clinical syndromes to enterovirus genotypes: aseptic meningitis to echovirus 30, enterovirus 6, and coxsackievirus B5; hand, foot and mouth disease to coxsackievirus A16; and hand, foot and mouth disease with neurologic complications to enterovirus 71. There are currently no treatments specific to human EV infections; surveillance of enterovirus infections such as this study provides may assist with evaluating the need to research and develop treatments for infections caused by virulent human EV genotypes.

Epidemiology and virologic investigation of human enterovirus 71 infection in the Republic of Korea from 2007 to 2012: a nationwide cross-sectional study

“…To determine the EV genotype, conventional reverse transcription polymerase chain reaction (RT-PCR) was carried out for detection of VP1 using primers designed in a previously study [ 21 ]. In the ROK, cell culture and RT-PCR were used for identification of EV strains from 1993 to 2004; after 2005, detection of VP1 by RT-PCR was used to genotype EV as a routine detection method, and real-time RT-PCR detection of EV71 was used as the standard detection method since 2008, providing more rapid analysis [ 22 ]. The partial VP1 sequences of EV71 have been deposited in GenBank with the accession numbers EU729114, EU729123, AY125972, HM443644, HM44366, HM443645-HM443662, KC162863-KC162883 and KT182938-KT182945.…”

Phylodynamic reconstruction of the spatiotemporal transmission and demographic history of coxsackievirus B2

“…In Taiwan, episodes of unusually high CV-B2 activity were detected in 1999, 2002, 2003 and 2006, and infections are still reported almost annually to the Taiwan Centers for Disease Control (Additional file 1 ). CV-B2 has an endemic circulation pattern worldwide where it comprises 1.5 %–6.0 % of the annual reported EV rates (Additional file 2 ) [ 1 , 3 – 7 ]. The peak activity of CV-B2 (>10 %) is rare, but it is commonly identified as one of the top 15 most frequently detected EV serotypes globally [ 3 , 4 ].…”

“…CV-B2 has an endemic circulation pattern worldwide where it comprises 1.5 %–6.0 % of the annual reported EV rates (Additional file 2 ) [ 1 , 3 – 7 ]. The peak activity of CV-B2 (>10 %) is rare, but it is commonly identified as one of the top 15 most frequently detected EV serotypes globally [ 3 , 4 ]. CV-B2 shares many common properties and clinical features with other CV-Bs but they have different outbreak tempos, and overwhelming infection may develop in infants (<1 year) [ 8 ].…”

Enteroviruses Associated with Aseptic Meningitis in Poland, 2011–2014

“…E30 is the most commonly associated with aseptic meningitis. Increases in echovirus 30 activity are characterized by global spread and large-scale aseptic meningitis outbreaks (Martinez et al, 2012;Hyeon et al, 2013;Xiao et al, 2014;Nougairede et al, 2014).…”