Community-wide outbreak of enteroviral illness caused by echovirus 30: a cross-sectional survey and a case-control study

Reintjes, Ralf; Pohle, Martina; Vieth, U. C.; Lyytikäinen, Outi; Timm, H.; Schreier, E.; Petersen, Lyle R.

doi:10.1097/00006454-199902000-00005

Cited by 29 publications

(22 citation statements)

References 10 publications

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“…Children under 15 years old accounted for 80% of the patients. Comparable distribution patterns were found during previously reported outbreaks, which occurred in different geographical areas [Sawyer et al, 1994;Khalfan et al, 1998;Reintjes et al, 1999]. Leonardi et al [1993] reported a different age distribution with peak incidence in younger children, but this is not uncommon in enterovirus infections.…”

Section: Discussionsupporting

confidence: 54%

“…The role of echovirus 30 in the etiology of this disease has been known since the virus was first isolated in 1958 [Plager and Dechler, 1963]. The distribution of recent meningitis outbreaks caused by echovirus 30 strongly suggests that infections are widespread [Leonardi et al, 1993;Drebot et al, 1994;Rice et al, 1995;Lopez-Alcala et al, 1997;Gorgievski-Hrisoho et al, 1998;Khalfan et al, 1998;Reintjes et al, 1999;Uysal et al, 2000].…”

Section: Introductionmentioning

confidence: 99%

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Genetic diversity of echovirus 30 during a meningitis outbreak, demonstrated by direct molecular typing from cerebrospinal fluid

Bailly

Brosson

Archimbaud

et al. 2002

Journal of Medical Virology

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Echovirus 30 is one of the enterovirus serotypes isolated most frequently in meningitis cases. The genetic diversity of echovirus 30 was investigated in patients hospitalised during an outbreak in 2000 in Clermont-Ferrand, France. A nested reverse transcription-PCR (RT-PCR) assay was developed for qualitative analysis of the echovirus 30 VP1 encoding sequence directly from cerebrospinal fluid. The viral sequences obtained for 22 patients were compared with those of virus isolates obtained from nine patients with echovirus 30 meningitis admitted to hospital in 1996-1997 and with echovirus 30 sequences from international databases. In 2000, meningitis cases were caused by two virus variants (C3 and C4) distinct genetically from the other two variants (C1 and C2) identified during the period 1996-1997. A detailed phylogenetic analysis established that the C1, C2, and C3 variants had close relatives among viruses previously identified in other geographical areas. The C4 variant had not been described earlier. The genomic differences observed between the four echovirus 30 variants arose at synonymous sites indicating that the viruses shared similar antigenic sites in the VP1 encoding sequence. Overall, these observations suggest wide circulation of different echovirus 30 variants and periodic importation of new viruses. The apparent displacement observed between virus variants did not result from a selective advantage caused by antigenic variation.

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Genetic diversity of echovirus 30 during a meningitis outbreak, demonstrated by direct molecular typing from cerebrospinal fluid

Bailly

Brosson

Archimbaud

et al. 2002

Journal of Medical Virology

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“…An outbreak of echovirus 30 meningitis has occurred in Switzerland in the summer of 1996 [21]. Reintjes et al [15] reported the echovirus 30 meningitis outbreak in Germany in 1997. In Turkey, we detected an echovirus 30 aseptic meningitis outbreak during the summer of 1999 [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…All samples were collected in the acute phase of the disease. Enteroviral meningitis was defined as isolation of enterovirus from CSF and/or stool samples [4,15].…”

Section: Methodsmentioning

confidence: 99%

Enteroviral meningitis in children in Turkey

Şensoy

Sel

Ozkaya³

et al. 2009

Open Medicine

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AbstractIn the indexed medical literature, there have been a very limited number of studies to investigate the epidemiologic and clinical features of enteroviral meningitis in Turkey. The aim of the present retrospective study is to update the actual situation to recognize the spectrum and magnitude of this important clinical entity. Between June 1999 and December 2004, 612 cases of aseptic meningitis were followed up at our hospital. Enteroviral meningitis was defined by isolation of enteroviruses from cerebrospinal fluid (CSF) and/or stool samples. Mumps virus was detected in 310 cases (50.7%) and enteroviruses were the etiologic agents in 104 (17%) of the patients with aseptic meningitis. Most of the enteroviral meningitis cases (36 cases, 34.6%) were diagnosed in August and 70 (67.3%) of them were male. The mean age was 5.6 ± 3.4 years. The most common initial symptoms were fever (81.7%), vomiting (77.9%) and headache (57.7%). In the physical examination, 46.2% of the cases had neck stiffness and 38.5% had pharyngitis. Echovirus 30 was the most frequently (38 cases, 36.5%) isolated enterovirus with peaks in 1999, 2002 and 2004. The other frequently isolated enteroviruses were Coxsackie virus type B (17 cases, 16.3%), echovirus 6 (11 cases, 10.6%), echovirus 11 (6 cases, 5.8%), and echovirus 13 (4 cases, 3.8 %). Mean hospitalization time was 6.2 ± 2.4 days. All patients recovered without any sequelae. Enteroviruses have an important role in childhood aseptic meningitis cases in Turkey too, and the predominant serotypes vary according to years.

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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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confidence: 99%

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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Community-wide outbreak of enteroviral illness caused by echovirus 30: a cross-sectional survey and a case-control study

Abstract: Echovirus 30 caused substantial morbidity during this community outbreak caused by person-to-person spread. Household contacts, day-care centers and playgrounds were prominent risk factors for transmission.

Cited by 29 publications

References 10 publications

Genetic diversity of echovirus 30 during a meningitis outbreak, demonstrated by direct molecular typing from cerebrospinal fluid

Genetic diversity of echovirus 30 during a meningitis outbreak, demonstrated by direct molecular typing from cerebrospinal fluid

Enteroviral meningitis in children in Turkey

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

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