Detection of enterovirus 68 as one of the commonest types of enterovirus found in patients with acute respiratory tract infection in China

Lu, Qing‐Bin; Wo, Ying; Wang, Hongyu; Wei, Minxin; Zhang, Lei; Yang, Hong; Liu, Enmei; Li, Tingyu; Zhao, Zhong; Liu, Wei; Cao, Wu‐Chun

doi:10.1099/jmm.0.068247-0

Cited by 52 publications

(50 citation statements)

References 19 publications

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“…Our phylogenetic analyses are notable in that they suggest a relatively complex molecular evolution of EV-D68 during the 2014 outbreak. Before this outbreak, EV-D68 was rarely reported and was associated with mild respiratory illness, although small outbreaks had been documented since 2005 (15,16,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Previous studies showed that the A, B, and C clades circulated or cocirculated during different time periods in different geographic regions (15,16,18,19,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)59).…”

Section: Discussionmentioning

confidence: 99%

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Tan

Hassan

Schuster

et al. 2016

J Virol

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In August 2014, an outbreak of enterovirus D68 (EV-D68) occurred in North America, causing severe respiratory disease in children. Due to a lack of complete genome sequence data, there is only a limited understanding of the molecular evolution and epidemiology of EV-D68 during this outbreak, and it is uncertain whether the differing clinical manifestations of EV-D68 infection are associated with specific viral lineages. We developed a high-throughput complete genome sequencing pipeline for EV-D68 that produced a total of 59 complete genomes from respiratory samples with a 95% success rate, including 57 genomes from Kansas City, MO, collected during the 2014 outbreak. With these data in hand, we performed phylogenetic analyses of complete genome and VP1 capsid protein sequences. Notably, we observed considerable genetic diversity among EV-D68 isolates in Kansas City, manifest as phylogenetically distinct lineages, indicative of multiple introductions of this virus into the city. In addition, we identified an intersubclade recombination event within EV-D68, the first recombinant in this virus reported to date. Finally, we found no significant association between EV-D68 genetic variation, either lineages or individual mutations, and a variety of demographic and clinical variables, suggesting that host factors likely play a major role in determining disease severity. Overall, our study revealed the complex pattern of viral evolution within a single geographic locality during a single outbreak, which has implications for the design of effective intervention and prevention strategies. IMPORTANCEUntil recently, EV-D68 was considered to be an uncommon human pathogen, associated with mild respiratory illness. However, in 2014 EV-D68 was responsible for more than 1,000 disease cases in North America, including severe respiratory illness in children and acute flaccid myelitis, raising concerns about its potential impact on public health. Despite the emergence of EV-D68, a lack of full-length genome sequences means that little is known about the molecular evolution of this virus within a single geographic locality during a single outbreak. Here, we doubled the number of publicly available complete genome sequences of EV-D68 by performing high-throughput next-generation sequencing, characterized the evolutionary history of this outbreak in detail, identified a recombination event, and investigated whether there was any correlation between the demographic and clinical characteristics of the patients and the viral variant that infected them. Overall, these results will help inform the design of intervention strategies for EV-D68.

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Section: Discussionmentioning

confidence: 99%

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Tan

Hassan

Schuster

et al. 2016

J Virol

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“…Surveillance studies in Japan, China, and the Netherlands revealed that enterovirus D68 was responsible for less than 1% of acute viral respiratory infections and that the incidence of infection peaked between September and November. [3][4][5] In a US enterovirus surveillance report of cases between 1970 and 2005, enterovirus D68 was identified in only 26 of 49 637 cases. 6 A total of 68 cases of enterovirus D68 infection were reported among clusters of infection in Asia, Europe, and the United States between 2008 and 2010.…”

Section: Discussionmentioning

confidence: 99%

Enterovirus D68 Infection in an Adult

Ward

Hughes

Mermel

2016

American Journal of Critical Care

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A 35-year-old woman came to her obstetrical clinic at 33.5 weeks of gestation in August 2014. A productive cough, headache, and increasing dyspnea had developed 4 days earlier. She reported close contact with family members who had signs and symptoms suggestive of an upper respiratory tract infection. She had no nausea, vomiting, diarrhea, subjective fever, or chest or abdominal pain. She had no history of asthma but regularly used cigarettes. She had a known diagnosis of preeclampsia, gestational hypertension, and a protein to creatinine ratio of 0.4.Because she was hypoxic, she was sent to the emergency department. Vital signs included blood pressure 170/108 mm Hg, heart rate 126/min, respirations 36/min, and body temperature 37.1°C. Oxygen saturation was 86% on room air. Physical examination revealed diffusely rhonchorous breath sounds with wheezes throughout the lung fields. Laboratory data included white blood cell count 8900/µL, with 78% polymorphonuclear leukocytes, 4% band cells, 6% lymphocytes, and 10% monocytes. With regard to the known preeclampsia, she had no qualifying evidence of end-organ dysfunction, platelet count was 210 000/µL, serum level of aspartate aminotransferase was 41 IU/L (less than twice the upper limit of the reference value; to convert to microkatals per liter, multiply by 0.0167), and creatinine concentration was 0.65 mg/dL (to convert to micromoles per liter, multiply by 88.4).Because of the concern that she might have pulmonary embolism, a computed tomography angiogram of the chest was obtained, which showed diffuse, patchy alveolar infiltrates in multiple lobes Abstract The first confirmed US case of severe respiratory tract infection caused by enterovirus D68 in an adult occurred in a pregnant woman with no history of asthma in August 2014. Before she came to the hospital, she had a productive cough, headache, and increasing dyspnea. At the hospital, she was hypoxic and required admittance to the intensive care unit and management with noninvasive bilevel positive pressure assistance. Analysis of a nasopharyngeal swab sent to the Centers for Disease Control and Prevention for a viral respiratory panel of tests confirmed enterovirus D68 infection. She eventually had an uneventful vaginal delivery, was discharged without oxygen supplementation, and has resumed normal activities. This case suggests that pregnant women may be a sentinel group infected with this pathogen, similar to what has been described for influenza virus infection.

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“…Following the initial outbreaks, EV-D68 continued its seasonal circulation, and was occasionally detected in respiratory samples from paediatric patients with URTI and severe LRTI in different countries, further supporting its clinical relevance [83][84][85][86]. Further concern was raised after the EV-D68 outbreak in the USA in 2014 [87], when over 1000 patients across the country were diagnosed with acute respiratory illness (ARI) caused by EV-D68.…”

Section: Enterovirus 68mentioning

confidence: 99%

Human picornaviruses associated with neurological diseases and their neutralization by antibodies

Anastasina

Domanska

Palm

et al. 2017

Journal of General Virology

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Picornaviruses are the most commonly encountered infectious agents in mankind. They typically cause mild infections of the gastrointestinal or respiratory tract, but sometimes also invade the central nervous system. There, they can cause severe diseases with long-term sequelae and even be lethal. The most infamous picornavirus is poliovirus, for which significant epidemics of poliomyelitis were reported from the end of the nineteenth century. A successful vaccination campaign has brought poliovirus close to eradication, but neurological diseases caused by other picornaviruses have increasingly been reported since the late 1990s. In this review we focus on enterovirus 71, coxsackievirus A16, enterovirus 68 and human parechovirus 3, which have recently drawn attention because of their links to severe neurological diseases. We discuss the clinical relevance of these viruses and the primary role of humoral immunity in controlling them, and summarize current knowledge on the neutralization of such viruses by antibodies.

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Detection of enterovirus 68 as one of the commonest types of enterovirus found in patients with acute respiratory tract infection in China

Cited by 52 publications

References 19 publications

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Molecular Evolution and Intraclade Recombination of Enterovirus D68 during the 2014 Outbreak in the United States

Enterovirus D68 Infection in an Adult

Human picornaviruses associated with neurological diseases and their neutralization by antibodies

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