High frequency of enterovirus serotype circulation in a densely populated area of India

Abstract

Introduction: In the state of Uttar Pradesh in India, enteroviruses are a significant cause of infection presenting in endemic or epidemic forms. The present study aimed to use molecular methods to identify enterovirus serotypes in clinical specimens to determine their circulation in the community. Methodology; A total of 320 clinical specimens were collected between January 2009 and December 2010 from children younger than 15 year of age in northern India. Reverse-transcription (RT) real time PCR and semi-nested RT PCR targeting the 5′untranslated region and VP1 region was used for the detection and identification of enterovirus serotypes. Results: The enterovirus genome was detected in 79 (24.7%) of 320 clinical specimens by real time PCR. Central nervous system syndrome (CNS) was the most common clinical manifestation (n=32, 62.74%), followed by respiratory tract infection (n=8, 15.69%), acute febrile illness (n=7, 13.73%), and gastrointestinal disease (n=4, 7.84%). A total of 32 different serotypes were identified with the predominance of coxsackievirus B5 and echovirus 6. Phylogenetic analysis of partial VP1 gene sequences from this study showed that many enterovirus serotypes showed good similarity with strains from America and Europe in comparison to neighbouring Asian countries. Conclusions: To our knowledge this is the first study of enterovirus prevalence from northern India based on unbiased molecular methods which leads to the identification of fifteen different enterovirus serotypes. The high frequency of enterovirus B species serotypes circulation may be an important cause of CNS infection in the children of this region.

Genotyping of enteroviruses isolated in Kenya from pediatric patients using partial VP1 region

“…Enteroviruses (EV), family Picornaviridae and genus Enterovirus , are common etiologic agents of diseases affecting millions of people worldwide every year (Jacques et al 2008 ; Oberste et al 2003 ). The disease manifestations range from asymptomatic to a wide variety of acute diseases, including mild respiratory illnesses, hand, foot and mouth disease, aseptic meningitis, encephalitis, myocarditis, and neonatal sepsis-like diseases (Tan et al 2011 ; Khetsuriani et al 2006 ; Kiang et al 2009 ; Harvala et al 2014 ; Chiang et al 2012 ; Linsuwanon et al 2012 ; Kumar et al 2013 ). They are classified into twelve species based on molecular characteristics and biological properties (Kumar et al 2013 ; Nasri et al 2007 ; Hu et al 2011 ; Pallansch and Roos 2007 ).…”

“…The disease manifestations range from asymptomatic to a wide variety of acute diseases, including mild respiratory illnesses, hand, foot and mouth disease, aseptic meningitis, encephalitis, myocarditis, and neonatal sepsis-like diseases (Tan et al 2011 ; Khetsuriani et al 2006 ; Kiang et al 2009 ; Harvala et al 2014 ; Chiang et al 2012 ; Linsuwanon et al 2012 ; Kumar et al 2013 ). They are classified into twelve species based on molecular characteristics and biological properties (Kumar et al 2013 ; Nasri et al 2007 ; Hu et al 2011 ; Pallansch and Roos 2007 ). Seven of these species, namely Enterovirus A, Enterovirus B, Enterovirus C, Enterovirus D, Rhinovirus A, B and C affect humans (Adams et al 2014 , 2015 ).…”

“…However, neutralization assays are labor-intensive and often result in untypeable strains (Chiang et al 2012 ; Nasri et al 2007 ). Presently, typing of EV is often based on reverse transcription-PCR followed by sequencing (Kumar et al 2013 ; Nasri et al 2007 ; Perera et al 2010 ; Tan et al 2011 ; Casas et al 2001 ; Nix et al 2006 ; Kroneman et al 2011 ). Different genomic regions, especially those encoding viral structural proteins are usually targeted (Perera et al 2010 ).…”

Role of Viral Agents in Childhood Central Nervous System Infections

“…22 EVs are responsible for high percentages of all aseptic meningitis cases, ranging from 43 to 83%. 21,[23][24][25] Herpes viruses are the most common encephalitis agents, and herpes encephalitis often leads to severe clinical manifestations. In our study, HSV-1, the second most frequently detected agent after EVs, accounted for about 50% of the positivity.…”

“…In childhood viral infections, these viruses are generally seen as the first two agents. 16,24 However, HSV-1 is of particular importance among the agents because of its severe clinical picture that can progress to fatal conditions and dramatic response to antiviral therapy. This situation increases the importance of rapid and accurate diagnosis of the agent.…”