First epidemic of aseptic meningitis due to echovirus type 13 among Spanish children

Trallero, Gloria; Casas, Inmaculada; Avellón, Ana; Pérez, C.; Tenorio, Antonio; Loma, A de la

doi:10.1017/s0950268802008191

Cited by 28 publications

(27 citation statements)

References 20 publications

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“…Similarly, in our study, echovirus 30 was the most frequent enteroviral agent with peaks in 1999, 2002 and 2004. The other frequently identified enteroviral agents were Coxsackie B and echovirus 6 in accordance to the literature [5,8] [29][30][31][32][33]. We detected echovirus 13 in one case in 2001, and in three cases in 2002.…”

Section: Discussionsupporting

confidence: 90%

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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Section: Discussionsupporting

confidence: 90%

Enteroviral meningitis in children in Turkey

Şensoy

Sel

Ozkaya³

et al. 2009

Open Medicine

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“…Echovirus 13 (3,6,7,11,28,41). Echovirus 13 existed in Belgium as a single genotype-most likely the same genotype that is responsible for all recent echovirus 13 outbreaks worldwide ( Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Outbreaks of aseptic meningitis typically peak during the summer and early fall, and various serotypes are often associated with a single outbreak (30). The predominant enterovirus types vary from year to year, with echovirus 30, echovirus 13, and echovirus 18 being the most frequently isolated in Europe and the United States over the past few years (2,3,6,7,11,38,41).Laboratory diagnosis of enterovirus infections is currently based on amplification of highly conserved regions within the enteroviral RNA genome (29). The 5Ј noncoding region (5ЈNCR), which contains the cloverleaf and internal ribosome entry site secondary structures, seems to be the most conserved region among enteroviruses and is therefore targeted widely in enterovirus diagnostic procedures (29,38).…”

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Analysis of the Serotype and Genotype Correlation of VP1 and the 5′ Noncoding Region in an Epidemiological Survey of the Human Enterovirus B Species

et al. 2004

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The sequence identity of the enterovirus VP1 gene has been shown to correlate with the serotype concept. Enterovirus molecular typing methods are therefore often based on sequencing of the VP1 genomic region and monophyletic clustering of VP1 sequences of a homologous serotype. For epidemiological surveillance, 342 enterovirus samples obtained from patients with aseptic meningitis in Belgium from 1999 to 2002 were first diagnosed as being enterovirus positive by amplification of the 5 noncoding region (5NCR) by reverse transcription (RT)-PCR. Subsequently, samples were molecularly typed by RT-nested PCR amplification and sequencing of a portion of the VP1 gene. Phylogenetic analyses were performed to investigate enteroviral evolution and to examine the serotype and genotype correlation of the two genomic regions. Our typing results demonstrated echovirus 30, echovirus 13, echovirus 18, and echovirus 6 to be the most predominant types. Echoviruses 13 and 18 were considered to be emerging human serotypes since 2000 and 2001, respectively, as they had been rarely reported before. Several serotypes existed as multiple genotypes (subtypes) from 1999 to 2002, but genomic differences mainly resided at synonymous sites; these results strongly suggest that the subtypes exhibit similar antigenic properties. Phylogenetic analyses confirmed that VP1 is an adequate region for molecular typing. Serotype-specific clusters are not observed commonly in phylogenetic trees based on the 5NCR, and the phylogenetic signal in the 5NCR was found to be particularly low. However, some substructure in the 5NCR tree made a tentative prediction of the enterovirus type possible and was therefore helpful in PCR strategies for VP1 (e.g., primer choice), provided some background knowledge on the local spectrum of enteroviruses already exists.Within the Picornaviridae family, the Enterovirus genus represents 65 human serotypes which have been classified into five species (A to D and the polioviruses). Members of the human enterovirus B species are the most common cause of aseptic meningitis. They include the six serotypes of group B coxsackieviruses, all echoviruses, coxsackievirus A9, enterovirus 69, and the recently characterized enterovirus 73 (10, 21). Outbreaks of aseptic meningitis typically peak during the summer and early fall, and various serotypes are often associated with a single outbreak (30). The predominant enterovirus types vary from year to year, with echovirus 30, echovirus 13, and echovirus 18 being the most frequently isolated in Europe and the United States over the past few years (2,3,6,7,11,38,41).Laboratory diagnosis of enterovirus infections is currently based on amplification of highly conserved regions within the enteroviral RNA genome (29). The 5Ј noncoding region (5ЈNCR), which contains the cloverleaf and internal ribosome entry site secondary structures, seems to be the most conserved region among enteroviruses and is therefore targeted widely in enterovirus diagnostic procedures (29,38). In addition to traditional ...

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“…Large outbreaks of aseptic meningitis caused by human echovirus 13 (E13) (genus Enterovirus) have been reported in various areas in the world since 2000 (3,4,22,23,30). In addition, a nationwide outbreak of aseptic meningitis caused by E13 occurred in Japan during the summer of 2002 (19) after a small outbreak in a limited area in 2001.…”

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Molecular Epidemiology of Echoviruses 11 and 13, Based on an Environmental Surveillance Conducted in Toyama Prefecture, 2002-2003

Iwai

Yoshida

Matsuura

et al. 2006

Appl Environ Microbiol

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Nineteen echovirus 11 (E11) and 12 E13 isolates were isolated from three rivers in Toyama Prefecture, Japan, during an environmental surveillance conducted from April 2002 to March 2003. The nucleotide sequences of E13 isolates were closely related to those from patients with aseptic meningitis, with less than 1.3% divergence in the VP1 region of the viral capsid gene, and belonged to the same clade responsible for a worldwide outbreak that started in 2000. In contrast, E11 isolates were clustered into three genomic groups and were not closely related to echovirus strains isolated from patients. These results suggest that the combination of both virus isolation from environmental sources and phylogenetic analysis could be complementary assessment approaches to trace prevalent and minor circulating enteroviruses in the human population.

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First epidemic of aseptic meningitis due to echovirus type 13 among Spanish children

Cited by 28 publications

References 20 publications

Enteroviral meningitis in children in Turkey

Enteroviral meningitis in children in Turkey

Analysis of the Serotype and Genotype Correlation of VP1 and the 5′ Noncoding Region in an Epidemiological Survey of the Human Enterovirus B Species

Molecular Epidemiology of Echoviruses 11 and 13, Based on an Environmental Surveillance Conducted in Toyama Prefecture, 2002-2003

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