An outbreak of aseptic meningitis due to echovirus 30 associated with attending school and swimming in pools

Faustini, Annunziata; Fano, Valeria; Muscillo, Michele; Zaniratti, S.; Rosa, Giuseppina La; Tribuzi, Laura; Perucci, Carlo A.

doi:10.1016/j.ijid.2005.06.008

Cited by 37 publications

(26 citation statements)

References 25 publications

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“…11,12 Direct or indirect contact was the main mode of propagation among subjects included in this study. Similarly to other enteroviruses, E30 can be transmitted via the digestive tract through contaminated food, articles in daily use, and contamination water.…”

Section: Discussionmentioning

confidence: 97%

Laboratory diagnosis and genetic analysis of a family clustering outbreak of aseptic meningitis due to echovirus 30

Zheng

Ye²,

Yan

et al. 2016

Pathogens and Global Health

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Echovirus 30 (E30) is a major pathogen associated with aseptic meningitis. In the summer of 2014, a family clustering aseptic meningitis outbreak occurred in urban-rural fringe of Ningbo city in Zhejiang Province in China. To identify the etiologic agent, specimens were tested by cell culture and reverse transcriptase-polymerase chain reaction. Pathogenic examination confirmed that the outbreak is caused by E30. The first case is a 6-year-old child, who studied in kindergarten in local, suffered from headache and fever. Same symptoms appeared in his parents, aunts, and other six relatives continuously. Meanwhile, vomiting occurred in majority of the patients and diarrhea in parts of them. White blood cells in cerebrospinal fluid (CSF) exceeded normal range in all patients. Protein levels in CSF were above normal range in half of the patients. Glucose levels in CSF were within normal range in all patients. We isolated six strains E30 in the stool specimens of patients, and carried out sequencing analysis to VP1 region. Sequencing results showed that 100% sequence identity was seen in both nucleotide and amino acid levels. Phylogenetic analysis discovered that isolate in this study was grouped into sublineage D2 together with sequences isolated from other areas of China in the 2000s and 2010s. Our study is the first family clustering outbreak of aseptic meningitis caused by E30 in Zhejiang Province in China. It is essential to establish an enterovirus molecular surveillance system in China to prevent mass outbreaks in Zhejiang.

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Section: Discussionmentioning

confidence: 97%

Laboratory diagnosis and genetic analysis of a family clustering outbreak of aseptic meningitis due to echovirus 30

Zheng

Ye²,

Yan

et al. 2016

Pathogens and Global Health

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“…The attack rate was, therefore, quite low. We found only a few reports of E30 meningitis outbreaks in limited communities, but one was of co-infection with other enteroviruses (22) and others were of a lower attack rate (23)(24)(25)(26)(27) (Table 1).…”

Section: Some Serotypes Have Strong Association With Meningitis Thmentioning

confidence: 99%

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

et al. 2009

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“…Most frequently, the infection is asymptomatic or subclinical; however, severe and life-threatening forms are not rare (18). E30 has recently been a common cause of meningitis in many countries (4,5,7,9,12,14,19) and was a subject of several epidemiological studies (2,15,21); therefore, many sequences for the VP1 genome region are available in GenBank for comparison. Previously, however, most studies of E30 epidemiology were conducted by using only the VP1 genome region.…”

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Analysis of Echovirus 30 Isolates from Russia and New Independent States Revealing Frequent Recombination and Reemergence of Ancient Lineages

et al. 2008

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We studied two genome regions, VP1 and 3D, of 48 echovirus 30 (E30) isolates from Russia and the new independent states. In VP1, most isolates were similar to European strains reported earlier, and frequent change of circulating subgroups was noticed. We also observed, in [2003][2004][2005][2006], the reemergence of a group of E30 strains with a VP1 region very distant from most modern E30 strains and remotely similar to E30 isolates from the 1960s and the 1970s. A study of the 3D genome region detected multiple recombination events among the studied strains. Recombination presumably occurred every few years, and therefore, the study of a single VP1 genome region cannot accurately describe the phylogenetic history of the virus or predict pathogenetic properties of an isolate. In general, a comparison of the VP1 and 3D genome region phylogenies revealed, in some instances, virtually independent circulation of enterovirus genome fragments on a scale of years.Echovirus 30 (E30) is a member of the human enterovirus B (HEV-B) species, which also includes 28 serotypes of echoviruses, 6 coxsackie B viruses, coxsackie A9 virus and several new enterovirus serotypes. Enteroviruses cause a wide spectrum of clinical manifestations. Most frequently, the infection is asymptomatic or subclinical; however, severe and life-threatening forms are not rare (18). E30 has recently been a common cause of meningitis in many countries (4,5,7,9,12,14,19) and was a subject of several epidemiological studies (2, 15, 21); therefore, many sequences for the VP1 genome region are available in GenBank for comparison. Previously, however, most studies of E30 epidemiology were conducted by using only the VP1 genome region. A number of recent publications revealed that intertypic recombination is a very frequent event in circulating enteroviruses, thus allowing virtually independent evolution of different genome regions (8,10,16). In this work, we studied the epidemiology of E30 in Russia and the new independent states (NIS) in 1998-2006 by using two genome regions, VP1 and 3D, to estimate the role of recombination in the short-term epidemiology of enteroviruses. MATERIALS AND METHODSWe used 48 strains of E30 isolated in the course of the WHO polio surveillance program and enterovirus surveillance (Table 1). Virus isolation and identification were carried out according to a standard WHO protocol (24) by using RD and Hep-2 cell cultures. Strain serotypes were identified by neutralization test with antisera produced by RIVM (Bilthoven, The Netherlands). Virus RNA was isolated from cell culture supernatant by guanidine thiocyanate lysis and adsorption to silica (3). Reverse transcription was carried out using Moloney murine leukemia virus reverse transcriptase (Promega) and random hexanucleotide primers. PCR was performed with previously published oligonucleotides for VP1 (15) and 3D (11). All nucleotide positions are given according to the prototype E30 strain Bastianni (GenBank accession no. AF311938). After amplification, bands were excised from a...

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An outbreak of aseptic meningitis due to echovirus 30 associated with attending school and swimming in pools

Abstract: The epidemic occurred by person-to-person transmission in a number of classrooms and at swimming pool X.

Cited by 37 publications

References 25 publications

Laboratory diagnosis and genetic analysis of a family clustering outbreak of aseptic meningitis due to echovirus 30

Laboratory diagnosis and genetic analysis of a family clustering outbreak of aseptic meningitis due to echovirus 30

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

Analysis of Echovirus 30 Isolates from Russia and New Independent States Revealing Frequent Recombination and Reemergence of Ancient Lineages

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