Molecular Epidemiological Study of Enteroviruses Associated with Encephalitis in Children from India

Kumar, Arvind; Shukla, Deepti; Kumar, Rashmi; Idris, M Z; Misra, U. K.; Dhole, Tapan N.

doi:10.1128/jcm.01483-12

Cited by 50 publications

(43 citation statements)

References 23 publications

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“…The epidemiology of CVB1 fits with these predictions. CVB1 has been one of the most frequent enteroviruses isolated in recent years in the U.S. (22,23) as well as in Korea (24), India (25), Tunisia (26), Western Germany (27), and Finland (28). It can cause severe systemic infections in young infants (29,30) and infects human pancreatic islets in vitro, being one of the most cytolytic enterovirus serotype in this model (7).…”

Section: Discussionmentioning

confidence: 99%

Coxsackievirus B1 Is Associated With Induction of β-Cell Autoimmunity That Portends Type 1 Diabetes

Laitinen¹,

Honkanen

Pakkanen³

et al. 2014

Diabetes

221

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The rapidly increasing incidence of type 1 diabetes implies that environmental factors are involved in the pathogenesis. Enteroviruses are among the suspected environmental triggers of the disease, and the interest in exploring the possibilities to develop vaccines against these viruses has increased. Our objective was to identify enterovirus serotypes that could be involved in the initiation of the disease process by screening neutralizing antibodies against 41 different enterovirus types in a unique longitudinal sample series from a large prospective birth-cohort study. The study participants comprised 183 case children testing persistently positive for at least two diabetes-predictive autoantibodies and 366 autoantibody-negative matched control children. Coxsackievirus B1 was associated with an increased risk of β-cell autoimmunity. This risk was strongest when infection occurred a few months before autoantibodies appeared and was attenuated by the presence of maternal antibodies against the virus. Two other coxsackieviruses, B3 and B6, were associated with a reduced risk, with an interaction pattern, suggesting immunological cross-protection against coxsackievirus B1. These results support previous observations suggesting that the group B coxsackieviruses are associated with the risk of type 1 diabetes. The clustering of the risk and protective viruses to this narrow phylogenetic lineage supports the biological plausibility of this phenomenon.

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Section: Discussionmentioning

confidence: 99%

Coxsackievirus B1 Is Associated With Induction of β-Cell Autoimmunity That Portends Type 1 Diabetes

Laitinen¹,

Honkanen

Pakkanen³

et al. 2014

Diabetes

221

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“…Though these cases were originally presumed to be due to Japanese encephalitis virus, they turned out to be negative for JEV. A few investigations revealed enterovirus association with these encephalitis cases (Joshi et al, 2012;Joshi et al, 2013;Sapkal et al, 2009;Kumar et al, 2011;Kumar et al, 2012;Lewthwaite et al, 2010), but there is no consensus on the serotype/s associated with the disease. Similarly, a few epidemiological studies on aseptic meningitis and acute hemorrhagic conjunctivitis cases from different regions of the country have been reported (Gopalakrishna 2007; Kumar et al, 2013;Madhavan et al, 2000;Maitreyi et al, 1999;Satpathy et al, 1996;Shukla et al, 2010), but a detailed analysis needs to be carried out.…”

Section: Emerging Eneterovirus Infections and The Need For Active Rementioning

confidence: 99%

“…Majority of the infantile diarrhoeal deaths occur in rural and tribal areas due to limited access to healthcare facilities in contrast to urban settings. We have not examined CSF samples in any of the subjects, because such procedures are required only for infections of brain and central nervous system causing aseptic meningitis , acute encephalitis Kumar et al, 2012), brainstem disease (Xing et al, 2014) etc. No serious neurological complications or HFMD have been observed in the diarrhoeal children, but about 20% of the subjects had either common cold, non-febrile illness or respiratory illness, suggesting that, EV infections are also associated with other symptoms along with diarrhoea.…”

mentioning

confidence: 99%

“…A major proportion of these cases appear to be of non-Japanese Encephalitis Virus etiology, and enteroviruses have been implicated (Kakkar et al, 2013;Kumar et al, 2011;Kumar et al, 2012;Fowlkes et al, 2008;Sapkal et al, 2009;Joshi et al, 2012;Joshi et al, 2013;Reingold et al, 2013) and there is a need for systematic detailed study of the disease (Kakkar et al, 2013). Though epidemics of hemorrhagic conjunctivitis and handfoot-and mouth disease associated with enterovirus infections are being reported in the news (Times of India 2013) frequently from different parts of the country, very few have been investigated (Deshpande et al, 2003;Gopalakrishna et al, 2007;Gopalakrishna et al, 2012;Maitreyi et al, 1999;Madhavan et al, 2000).…”

mentioning

confidence: 99%

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Non-Polio Enteroviruses, the Neglected and Emerging Human Pathogens:Are we Waiting for the Sizzling Enterovirus Volcano to Erupt?

Rao¹

2015

Proceedings of the Indian National Science Academy

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Enteroviruses consist of a large group of pathogenic viruses, poliovirus being the notorious member. For the last several decades, all the attention and resources were directed towards control and eradication of poliomyelitis in India. There is very little research on non-polio enteroviruses (NPEVs), the cousins of poliovirus, which are associated with a wide range of diseases, especially in infants and young children. We have established an active research group on NPEVs during the last six years and showed that about 35% of non-polio acute flaccid paralysis (NP-AFP) children were positive for NPEV infections, and detected 66 serotypes in NP-AFP children, EV71 being more frequently detected followed by Echovirus 13 and CVB5. Long-term comparative epidemiological studies on NPEVs and rotavirus in acute diarrhoea revealed for the first time, that, NPEV association is as significant as that of rotavirus. A surprising observation was the contrasting seasonal prevalence between enterovus-and rotavirus-associated diarrhoea, the former predominating in non-winter months and the latter occurring primarily in the winter season. NPEVs were associated with epidemics-like outbreaks during which they were detected in up to 50% children with acute diarrhoea. In recent years, enterovirus has been identified to be associated with acute encephalitis cases in Uttar Pradesh. HFMD outbreaks have been reported in recent years, including a major outbreak in Bangalore in 2013. Since, no studies exist in India on the biology of EVs, including HFMD, we have recently initiated work on this emerging disease. Our studies uncover an urgent need for detailed studies on these "so far" neglected and emerging viruses for effective child health management in the country.

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“…They are single-stranded RNA viruses belonging to the Picornaviridae family. There are more than 100 serotypes, including poliovirus, A and B coxsackievirus, and echovirus 3,5,8,9,10,11 .…”

Section: Introductionmentioning

confidence: 99%

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Alves

Wajnsztejn

Alves

et al. 2015

J. Hum. Growth Dev.

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Abstract:Introduction: Meningitis is the leading infectious syndrome that affects the central nervous system, and most cases are caused by viral infections, mainly enterovirus. The clinical diagnosis for meningitis etiology still presents major challenges. The analysis of polymerase chain reaction (PCR), white blood cells, red blood cells, glucose, protein, and lactate in the cerebrospinal fluid (CSF) provides the first clues to the diagnosis. However, the reference values of some parameters can suffer changes. Objective: Analyze the laboratory parameters of CSF in patients with enterovirus meningitis, and then, theirrelationship by age group. Methods: A descriptive study was conducted based on data from a CSF reference service, located in São Paulo, Brazil, on 202 individuals who had enterovirus meningitis. Data was analysed by the Shapiro-Wilk and Kruskal-Wallis tests (CI = 95%, p < 0.05) and represented by the median and percentile 25 and 75, respectively. Results: The cytological and biochemical parameters of the CSF shows us that proteins had median concentrations of 33.0mg/ dL, glucose of 57.0mg/dl, lactate of 19.0mg/dL and the leukocyte of 119.0 cells/mm 3 , with a predominance of lymphocytes (42%). It was found that age can cause cytological and biochemical changes in the parameters of CSF. Children younger than 2 years had a range percentage of neutrophils and monocytes different then children aged < 2 and < 6 years, and aged < 6 and < 10 years. The protein concentration range in CSF as well as glucose track can also change according to age. Conclusion:The parameters of the CSF in patients with enteroviral meningitis showed similar median concentrations to those found in the literature. Age may lead to changes in cytological and biochemical parameters of CSF. CSF protein and glucose concentrations also change according to age.

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Molecular Epidemiological Study of Enteroviruses Associated with Encephalitis in Children from India

Cited by 50 publications

References 23 publications

Coxsackievirus B1 Is Associated With Induction of β-Cell Autoimmunity That Portends Type 1 Diabetes

Coxsackievirus B1 Is Associated With Induction of β-Cell Autoimmunity That Portends Type 1 Diabetes

Non-Polio Enteroviruses, the Neglected and Emerging Human Pathogens:Are we Waiting for the Sizzling Enterovirus Volcano to Erupt?

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

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