Recombinant Enterovirus A71 Subgenogroup C1 Strains, Germany, 2015

Böttcher, Sindy; Obermeier, Patrick; Neubauer, Katrin; Diedrich, Sabine

doi:10.3201/eid2210.160357

Cited by 36 publications

(44 citation statements)

References 10 publications

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“…Moreover, whereas EV-A71 subgenogroup C2 viruses had been predominant in France since 2006 [5,9], in 2016, the EV-A71 subgenogroup C1 viruses were predominant. These EV-A71 C1 viruses had not previously been detected in France (data not shown) and were closely related to a new cluster of EV-A71 C1 viruses detected in 2015 in Germany [10,11]. Most of the cases were diagnosed in late July, concurrently with the usual peak of EV circulation in the country, but cases were still identified in September and October.…”

Section: Discussionsupporting

confidence: 63%

Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016

et al. 2016

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We report 59 cases of severe paediatric conditions linked with enterovirus (EV)-A71 and EV-D68 in France between May and October 2016. Fifty-two children had severe neurological symptoms. EV sequence-based typing for 42 cases revealed EV-A71 in 21 (18 subgenotype C1, detected for the first time in France) and EV-D68 in eight. Clinicians should be encouraged to obtain stool and respiratory specimens from patients presenting with severe neurological disorders for EV detection and characterisation.

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Section: Discussionsupporting

confidence: 63%

Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016

et al. 2016

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“…For the first time this subgenogroup was detected in Europe in 2004 . Genotype C1, detected in Poland in 2016, was closely related to a new cluster previously detected in Germany (2015) and in France (2016) . Also the analysis of 3D region revealed that the Polish isolate shares a common ancestor with the recombinant variant from Germany.…”

Section: Discussionmentioning

confidence: 60%

“…Although EV‐A71 asymptomatic circulation and sporadic, often mild, cases have been reported in European countries, epidemics with severe neurological complication have been predominantly found in the Asia‐Pacific region. Unfortunately, outbreaks and sporadic cases with severe manifestation have been noted in Europe more and more often …”

Section: Introductionmentioning

confidence: 99%

Genetic characterization of enterovirus A71 isolates from severe neurological cases in Poland

Wieczorek

Purzyńska²,

Krzysztoszek

et al. 2017

Journal of Medical Virology

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The aim of this study was to report a minor outbreak of enterovirus A71 (EV-A71) infection in Poland and characterize isolates from cases of severe neurological infection detected in 2013 and 2016. Phylogenetic analysis revealed that Polish strains belonged to the C genogroup: C1, C2, and C4. Severe neurological manifestations as encephalitis or acute flaccid paralysis (AFP), were associated with all detected subgenogroups. The C2 subgenogroup was associated with the outbreak in Gdansk, with serious cases of AFP, myelitis, cerebellitis, encephalitis, but also with mild, sporadic cases of aseptic meningitis, in other Polish cities. Data from the study established relationships of EV-A71 from Poland with previously characterized strains and confirmed the importance of high quality enterovirus surveillance with international reach.

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“…All samples were tested at the RKI using RT-nested PCR with the primers targeting the 5'NCR gene, as previously described 18 . All PCR products were sequenced and -based on the resulting EV species -tested with species-specific PCR assays in the VP1 region for typing as recently described [19][20][21] .…”

Section: Case Definitionmentioning

confidence: 99%

Meningitis gone viral: Description of the Echovirus Wave 2013 in Germany

Graf

Hartmann

Lehmann

et al. 2019

Preprint

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BACKGROUND: Aseptic meningitis epidemics may pose various health care challenges. METHODS: We describe the German enterovirus meningitis epidemics in the university hospital centers of Düsseldorf, Cologne and Berlin between January 1st and December 31st, 2013 in order to scrutinize clinical differences from other aseptic meningitis cases.RESULTS: A total of 72 enterovirus (EV-positive) meningitis cases were detected in our multicenter cohort, corresponding to 5.8% of all EV-positive cases which were voluntarily reported within the National Enterovirus surveillance (EVSurv, based on investigation of patients with suspected aseptic meningitis/encephalitis and/or acute flaccid paralysis) by physicians within this period of time. Among these 72 patients, 38 (52.8%) were enterovirus positive and typed as echovirus (18 pediatric and 20 adult cases, median age 18.5 years; echovirus 18 (1), echovirus 2 (1), echovirus 30 (31), echovirus 33 (1), echovirus 9 (4)). At the same time, 45 aseptic meningitis cases in our cohort were excluded to be due to enteroviral infection (EV-negative). Three EV-negative patients were tested positive for varicella zoster virus (VZV) and one EV-negative patient for herpes simplex virus 2. Hospitalization was significantly longer in EV-negative cases. Cerebrospinal fluid analysis did not reveal significant differences between the two groups. After discharge, EV-meningitis resulted in significant burden of sick leave in our pediatric cohort as parents had to care for the children at home. CONCLUSIONS: Voluntary syndromic surveillance, such as provided by the EVSurv in our study may be a valuable tool for epidemiological research. Our analyses suggest that EV-positive meningitis predominantly affects younger patients and may be associated with a rather benign clinical course, compared to EV-negative cases.

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Recombinant Enterovirus A71 Subgenogroup C1 Strains, Germany, 2015

Cited by 36 publications

References 10 publications

Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016

Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016

Genetic characterization of enterovirus A71 isolates from severe neurological cases in Poland

Meningitis gone viral: Description of the Echovirus Wave 2013 in Germany

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