Elucidation of Echovirus 30's Origin and Transmission during the 2012 Aseptic Meningitis Outbreak in Guangdong, China, through Continuing Environmental Surveillance

Abstract

e An aseptic meningitis outbreak occurred in Luoding City of Guangdong, China, in 2012, and echovirus type 30 (ECHO30) was identified as the major causative pathogen. Environmental surveillance indicated that ECHO30 was detected in the sewage of a neighboring city, Guangzhou, from 2010 to 2012 and also in Luoding City sewage samples (6/43, 14%) collected after the outbreak. In order to track the potential origin of the outbreak viral strains, we sequenced the VP1 genes of 29 viral strains from clinical patients and environmental samples. Sequence alignments and phylogenetic analyses based on VP1 gene sequences revealed that virus strains isolated from the sewage of Guangzhou and Luoding cities matched well the clinical strains from the outbreak, with high nucleotide sequence similarity (98.5% to 100%) and similar cluster distribution. Five ECHO30 clinical strains were clustered with the Guangdong environmental strains but diverged from strains from other regions, suggesting that this subcluster of viruses most likely originated from the circulating virus in Guangdong rather than having been more recently imported from other regions. These findings underscore the importance of long-term, continuous environmental surveillance and genetic analysis to monitor circulating enteroviruses.

One-year Survey of human enteroviruses from sewage and the factors affecting virus adsorption to the suspended solids

“…Environmental surveillance has been used successfully in monitoring the circulation of PVs and NPEVs and it is of crucial importance in the final stage of the GPEI. In China, it is currently conducted in 9 provinces as a useful supplementary method for poliovirus surveillance, and all these experiences focus on the liquid fraction of the sewage 6 7 10 11 . So, it is necessary to ascertain the extent to which the enteroviruses were adsorbed to the solids in the sewage under different conditions.…”

Surveillance of poliomyelitis in Northern Italy: Results of acute flaccid paralysis surveillance and environmental surveillance, 2012–2015

“…Overall, echovirus type 11 was the genotype most frequently identified in this study; similarly, echovirus type 11 was detected in 31.5% of wastewater samples in Tehran and echovirus type 11, 3 and 6 represented 2-third of NPEVs detected in ES in Poland. 12 In Guangdong province of China, the role of echovirus type 30 in an outbreak of aseptic meningitis has been assessed through continuing ES 35 ; in Wisconsin (US) an association between NPEVs detected in environmental samples and those affecting the population has been documented. 36 These pieces of evidence emphasize that ES is able to provide comprehensive epidemiological information about EVs circulation and phylogenetic study can be used to assess links of NPEV dynamics and transmission route in a population.…”

Molecular epidemiological study of enteroviruses associated with encephalitis in children from Hangzhou, China

“…Echovirus 30 was the major pathogen causing encephalitis which was confirmed in many provinces of China. [ 16 – 18 ] Patients’ information was obtained to confirm clinical characteristics of EVE in children to prevent inappropriately antibiotic treatments. Like viral encephalitis, fever, headache, and vomiting were also common symptoms in children with EVE.…”