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Mamidi P, Panda S, Ray A, Mohanty M, Mandal MC, Santra D, Moharana B, Nayak B, Chattopadhyay S, Mishra B. Molecular characterization of coxsackievirus A24 variants isolated from an outbreak of acute hemorrhagic conjunctivitis. Indian J Med Microbiol 2024; 49:100601. [PMID: 38705277 DOI: 10.1016/j.ijmmb.2024.100601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/27/2024] [Accepted: 04/27/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Acute Hemorrhagic conjunctivitis (AHC) is associated with CVA24v. Recently there was a severe outbreak of conjunctivitis in months of July and August 2023 in India. This study emphasizes the identification of the distinct mutations in the CVA24v strains, which were isolated during the AHC outbreak and could have potentially played a role in the high transmission of AHC in India during the 2023 outbreak. METHODS A total of 71 conjunctivitis patients aged 1-75 years comprising 47 males and 24 females who attended Ophthalmology department of a tertiary care hospital of easternIndia were studied.RNA was extracted from all conjunctival swab samples and converted into cDNA. Subsequently, the viral 5' UTR was amplified and the PCR positive samples were subjected to sequencing. The newly isolated viral 5' UTR sequences were aligned with other worldwide sequences using the Clustal W tool to conduct mutational analysis. A phylogenetic tree was built using the MEGA software for viral genotype identification. RESULTS All of the current outbreak strains belonged to genotype IV of CVA24v. The present outbreak strains formed a distinct clade in the phylogenetic tree and were different from previously reported Indian strains. Two persistent mutations, specifically in domain IV (T213C) and domain V (C475T), were exclusively detected within the internal ribosome entry site (IRES) of the 5' UTR of the current strains causing the outbreak. These two alterations have previously been shown to impact the virulence of another enterovirus (CV B3), but they have not been described in CVA24v until now. CONCLUSION Finding of the present study highlights the possibility and the significance of the aforementioned two mutations in enhancing the transmissibility of the newer CVA24v strains. Hence, these two distinct mutations should be investigated further for developing antiviral therapies to combat future AHC outbreaks associated with CVA24v.
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Affiliation(s)
- Prabhudutta Mamidi
- All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Sailendra Panda
- All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Amrita Ray
- Institute of Life Sciences, Bhubaneswar, 751023, Odisha, India.
| | - Monalisa Mohanty
- All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | | | - Debasish Santra
- All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Bruttendu Moharana
- All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Bhagabat Nayak
- All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
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Chen P, Lin XJ, Ji F, Li Y, Wang ST, Liu Y, Tao ZX, Xu AQ. Evolutionary phylogeography reveals novel genotypes of coxsackievirus A24 variant and updates the spatiotemporal dynamics in the population with acute hemorrhagic conjunctivitis. Int J Infect Dis 2022; 124:227-239. [DOI: 10.1016/j.ijid.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/19/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022] Open
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Othman I, Slama I, Mastouri M, Bailly JL, Aouni M. First detection and characterization of EV-A71 and a new genogroup of CVA-24 causing neurological disease in Tunisia. Future Virol 2022. [DOI: 10.2217/fvl-2021-0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Molecular characterization of enterovirus A71 (EV-A71) and coxsackievirus A24 (CVA-24) strains isolated during neurological diseases surveillance activities in Tunisian patients. Materials & methods: Specimens were obtained from two Tunisian children and analyzed for enterovirus with quantitative reverse transcription PCR (RT-qPCR). We sequenced the whole genome of strains detected. Results: The EV-A71 sequence reported was assigned to subgenogroup C2 with a high nucleotide sequence identity to other EV-A71 C2 detected in other countries, which suggests virus migration. Interestingly, in the VP1 coding region, the Tunisian CV-A24 strain displayed high sequence divergence from other CV-A24, which confirms that it represents a new genogroup. Conclusion: This is the first report of EV-A71 in Tunisia and the first report of a CV-A24 strain causing aseptic meningitis.
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Affiliation(s)
- Ines Othman
- Faculty of Pharmacy, LR99-ES27, Monastir, Tunisia
| | - Ichrak Slama
- Faculty of Pharmacy, LR99-ES27, Monastir, Tunisia
| | - Maha Mastouri
- Faculty of Pharmacy, LR99-ES27, Monastir, Tunisia
- Fattouma Bourguiba University Hospital, Laboratory of Microbiology, Monastir, Tunisia
| | - Jean-Luc Bailly
- Université Clermont Auvergne, Faculty of Pharmacy, LMGE CNRS 6023, Clermont-Ferrand, 63001, France
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Li J, Huang F, Zhang Y, Ji T, Zhu S, Wang D, Han Z, Xiao J, Si F, Xu W, Yan D. Molecular analysis of Coxsackievirus A24 variant isolates from three outbreaks of acute hemorrhagic conjunctivitis in 1988, 1994 and 2007 in Beijing, China. Virol Sin 2022; 37:168-176. [PMID: 35277374 PMCID: PMC9170931 DOI: 10.1016/j.virs.2022.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 01/14/2022] [Indexed: 11/30/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v) is a major pathogen that causes continued outbreaks and pandemics of acute hemorrhagic conjunctivitis (AHC). In China, the first confirmed outbreak of CVA24v-related AHC occurred in Beijing in 1988, followed by another two significant outbreaks respectively in 1994 and 2007, which coincides with the three-stage dynamic distribution of AHC in the world after 1970s. To illustrate the genetic characteristics of CVA24v in different periods, a total of 23 strains were isolated from those three outbreaks and the whole genome of those isolations were sequenced and analyzed. Compared with the prototype strain, the 23 strains shared four nucleotide deletions in the 5′ UTR except the 0744 strain isolated in 2007. And at the 98th site, one nucleotide insertion was found in all the strains collected from 2007. From 1994 to 2007, amino acid polarity in the VP1 region at the 25th and the 32nd site were changed. Both the 3C and VP1 phylogenetic tree indicated that isolates from 1988 and 1994 belonged to Genotype III (GIII), and 2007 strains to Genotype IV (GIV). According to the Bayesian analysis based on complete genome sequence, the most recent common ancestors for the isolates in 1988, 1994 and 2007 were respectively estimated around October 1987, February 1993 and December 2004. The evolutionary rate of the CVA24v was estimated to be 7.45 × 10−3 substitutions/site/year. Our study indicated that the early epidemic of CVA24v in Chinese mainland was the GIII. Point mutations and amino acid changes in different genotypes of CVA24v may generate intensity differences of the AHC outbreak. CVA24v has been evolving constantly with a relatively rapid rate. The early epidemic of CVA24v in Chinese mainland is the Genotype III. Mutations may generate intensity differences of the AHC outbreak. CVA24v has been evolving constantly with a relatively rapid rate.
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Fonseca MC, Pupo-Meriño M, García-González LA, Resik S, Hung LH, Muné M, Rodríguez H, Morier L, Norder H, Sarmiento L. Molecular evolution of coxsackievirus A24v in Cuba over 23-years, 1986-2009. Sci Rep 2020; 10:13761. [PMID: 32792520 PMCID: PMC7427094 DOI: 10.1038/s41598-020-70436-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/21/2020] [Indexed: 12/29/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v) is a major causative agent of acute hemorrhagic conjunctivitis outbreaks worldwide, yet the evolutionary and transmission dynamics of the virus remain unclear. To address this, we analyzed and compared the 3C and partial VP1 gene regions of CVA24v isolates obtained from five outbreaks in Cuba between 1986 and 2009 and strains isolated worldwide. Here we show that Cuban strains were homologous to those isolated in Africa, the Americas and Asia during the same time period. Two genotypes of CVA24v (GIII and GIV) were repeatedly introduced into Cuba and they arose about two years before the epidemic was detected. The two genotypes co-evolved with a population size that is stable over time. However, nucleotide substitution rates peaked during pandemics with 4.39 × 10-3 and 5.80 × 10-3 substitutions per site per year for the 3C and VP1 region, respectively. The phylogeographic analysis identified 25 and 19 viral transmission routes based on 3C and VP1 regions, respectively. Pandemic viruses usually originated in Asia, and both China and Brazil were the major hub for the global dispersal of the virus. Together, these data provide novel insight into the epidemiological dynamics of this virus and possibly other pandemic viruses.
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Affiliation(s)
- Magilé C Fonseca
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba.
| | - Mario Pupo-Meriño
- Departamento de Bioinformática, Centro de Matemática Computacional, Universidad de las Ciencias Informáticas (UCI), Havana, Cuba
| | - Luis A García-González
- Departamento de Ciencias de la Computación, Centro de Investigación Científica y de Educación Superior de Ensenada, Ensenada, Baja California, México
| | - Sonia Resik
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Lai Heng Hung
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Mayra Muné
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Hermis Rodríguez
- Cell Culture Laboratory, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Havana, Cuba
| | - Luis Morier
- Department of Microbiology and Virology, Biology Faculty, Havana University, Havana, Cuba
| | - Heléne Norder
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Luis Sarmiento
- Immunovirology Unit, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
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Complete genome sequence of a coxsackievirus type A24 variant causing an outbreak of acute haemorrhagic conjunctivitis in southeastern Mexico in 2017. Arch Virol 2020; 165:1015-1018. [DOI: 10.1007/s00705-020-04552-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/19/2020] [Indexed: 10/25/2022]
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Lal A, Akhtar J, Isaac S, Mishra AK, Khan MS, Noreldin M, Abraham GM. Unusual cause of chest pain, Bornholm disease, a forgotten entity; case report and review of literature. Respir Med Case Rep 2018; 25:270-273. [PMID: 30364740 PMCID: PMC6197799 DOI: 10.1016/j.rmcr.2018.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/08/2018] [Indexed: 11/28/2022] Open
Abstract
Chest pain is a common symptom culminating in hospital admissions and specialist referrals. Although cardiac work up is pursued in most of the cases, cardiac etiology is found to be the culprit in minority of the cases. Acute chest pain is a clinical syndrome that may be caused by almost any condition affecting the thorax, abdomen, or internal organs. On occasions this extensive and expensive diagnostic work up can be avoided with awareness of commoner and non-lethal reasons. We report a case of a woman with Bornholm disease secondary to Coxsackievirus B5 (CB5) infection and supplementary review of literature till date.
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Affiliation(s)
- Amos Lal
- Department of Internal Medicine, 123 Summer Street, Saint Vincent Hospital, Worcester, MA, 01608, USA
| | - Jamal Akhtar
- Department of Internal Medicine, 123 Summer Street, Saint Vincent Hospital, Worcester, MA, 01608, USA
| | - Sangeetha Isaac
- Department of Intensive Care Unit, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore
| | - Ajay Kumar Mishra
- Department of Internal Medicine, 123 Summer Street, Saint Vincent Hospital, Worcester, MA, 01608, USA
| | | | - Mohsen Noreldin
- Department of Internal Medicine, 123 Summer Street, Saint Vincent Hospital, Worcester, MA, 01608, USA
| | - George M Abraham
- Department of Internal Medicine, 123 Summer Street, Saint Vincent Hospital, Worcester, MA, 01608, USA
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8
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Zhang L, Zhao N, Huang X, Jin X, Geng X, Chan TC, Liu S. Molecular epidemiology of acute hemorrhagic conjunctivitis caused by coxsackie A type 24 variant in China, 2004-2014. Sci Rep 2017; 7:45202. [PMID: 28332617 PMCID: PMC5362916 DOI: 10.1038/srep45202] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/21/2017] [Indexed: 11/09/2022] Open
Abstract
To understand control interventions, the molecular epidemiology of acute hemorrhagic conjunctivitis (AHC) was investigated from 2004 to 2014.A total of 613,485 AHC cases (annualized cases 55,771) with two deaths were included. Our findings showed that AHC was reported in all provinces, predominantly in Southern and Eastern China. The incidence rates were highest in 2007 (5.65/100,000) and 2010 (21.78/100,000) respectively. A clear seasonal pattern was identified with a peak from August to October. AHC cases occurred in all age groups; however, five to 14 years was the predominant group [23.06%, 133, 510/578,909]. The median age was 24 years (one month~97 years). The median duration from onset to diagnosis was 1.5 days, and there was no difference between the <15, 15~60 and >60-year-old patients [p = 0.0653]. The phylogenetic analysis of 100 nonstructural proteins (3C) and 84 structural proteins (VP1) revealed that AHC outbreaks were caused by Coxsackievirus A24 variant. Genotypes G4-c5a, G4-c5b, and G4-c3 co-circulated with both temporal and geographical overlaps. In conclusion, despite the overall steady decline in the number of AHC cases since the peak in 2010, it still remains a serious public health problem in Southern and Eastern China that targets on the school aged children under 15 years old.
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Affiliation(s)
- Li Zhang
- Eye Center of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Na Zhao
- National Research Center for Wildlife Borne Diseases, Key Lab of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Xiaodan Huang
- Eye Center of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xiuming Jin
- Eye Center of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xingyi Geng
- Emergency Offices, Jinan Centre for Disease Control and Prevention, Jinan, Shandong Province, China
| | - Ta-Chien Chan
- Center for Geographic Information Science, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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Yen YC, Chu PH, Lu PL, Lin YC, Shi YY, Chou LC, Wang CF, Lin YY, Su HJ, Lin CC, Zeng JY, Tyan YC, Ke GM, Chu PY. Phylodynamic Characterization of an Ocular-Tropism Coxsackievirus A24 Variant. PLoS One 2016; 11:e0160672. [PMID: 27529556 PMCID: PMC4987047 DOI: 10.1371/journal.pone.0160672] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/13/2016] [Indexed: 01/22/2023] Open
Abstract
Recent phylodynamic studies have focused on using tree topology patterns to elucidate interactions among the epidemiological, evolutionary, and demographic characteristics of infectious agents. However, because studies of viral phylodynamics tend to focus on epidemic outbreaks, tree topology signatures of tissue-tropism pathogens might not be clearly identified. Therefore, this study used a novel Bayesian evolutionary approach to analyze the A24 variant of coxsackievirus (CV-A24v), an ocular-tropism agent of acute hemorrhagic conjunctivitis. Analyses of the 915-nucleotide VP1 and 690-nt 3Dpol regions of 21 strains isolated in Taiwan and worldwide during 1985-2010 revealed a clear chronological trend in both the VP1 and 3Dpol phylogenetic trees: the emergence of a single dominant cluster in each outbreak. The VP1 sequences included three genotypes: GI (prototype), GIII (isolated 1985-1999), and GIV (isolated after 2000); no VP1 sequences from GII strains have been deposited in GenBank. Another five genotypes identified in the 3Dpol region had support values >0.9. Geographic and demographic transitions among CV-A24v clusters were clearly identified by Bayes algorithm. The transmission route was mapped from India to China and then to Taiwan, and each prevalent viral population declined before new clusters emerged. Notably, the VP1 and 3Dpol genes had high nucleotide sequence similarities (94.1% and 95.2%, respectively). The lack of co-circulating lineages and narrow tissue tropism affected the CV-A24v gene pool.
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Affiliation(s)
- Yung-Chang Yen
- Department of Ophthalmology, Chi Mei Medical Center, Liou-Ying, Tainan, Taiwan
- Department of Nursing, Min Hwei College of Health Care Management, Tainan, Taiwan
| | - Pei-Huan Chu
- Division of Cardiology, Department of Medicine, Wei Gong Memorial Hospital, Miaoli, Taiwan
| | - Po-Liang Lu
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yung-Cheng Lin
- Institute of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan
| | - Yong-Ying Shi
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Chiu Chou
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chu-Feng Wang
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Ying Lin
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Ju Su
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chien-Ching Lin
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jing-Yun Zeng
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Chang Tyan
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Guan-Ming Ke
- Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Neipu, Pingtung, Taiwan
| | - Pei-Yu Chu
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Epidemic outbreak of acute haemorrhagic conjunctivitis caused by coxsackievirus A24 in Thailand, 2014. Epidemiol Infect 2015; 143:3087-93. [PMID: 25824006 DOI: 10.1017/s0950268815000643] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Acute haemorrhagic conjunctivitis outbreaks are often attributed to viral infection. In 2014, an unprecedented nationwide outbreak of infectious conjunctivitis occurred in Thailand, which affected >300 000 individuals over 3 months. To identify and characterize the virus responsible for the epidemic, eye swab specimens from 119 patients were randomly collected from five different provinces. Conserved regions in the enteroviral 5'-UTR and adenovirus hexon gene were analysed. Enterovirus was identified in 71·43% (85/119) of the samples, while no adenovirus was detected. From enterovirus-positive samples, the coxsackievirus A24 variant (70·59%, 84/119) and echovirus (0·84%, 1/119) were identified. Additional sequencing of full-length VP1 and 3C genes and subsequent phylogenetic analysis revealed that these clinical isolates form a new lineage cluster related to genotype IV-C5. In summary, the coxsackievirus A24 variant was identified as an aetiological agent for the recent acute haemorrhagic conjunctivitis outbreak in Thailand.
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Nidaira M, Kuba Y, Saitoh M, Taira K, Maeshiro N, Mahoe Y, Kyan H, Takara T, Okano S, Kudaka J, Yoshida H, Oishi K, Kimura H. Molecular evolution of VP3, VP1, 3C(pro) and 3D(pol) coding regions in coxsackievirus group A type 24 variant isolates from acute hemorrhagic conjunctivitis in 2011 in Okinawa, Japan. Microbiol Immunol 2014; 58:227-38. [PMID: 24517637 DOI: 10.1111/1348-0421.12141] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/03/2014] [Accepted: 02/06/2014] [Indexed: 11/28/2022]
Abstract
A large acute hemorrhagic conjunctivitis (AHC) outbreak occurred in 2011 in Okinawa Prefecture in Japan. Ten strains of coxsackievirus group A type 24 variant (CA24v) were isolated from patients with AHC and full sequence analysis of the VP3, VP1, 3C(pro) and 3D(pol) coding regions performed. To assess time-scale evolution, phylogenetic analysis was performed using the Bayesian Markov chain Monte Carlo method. In addition, similarity plots were constructed and pairwise distance (p-distance) and positive pressure analyses performed. A phylogenetic tree based on the VP1 coding region showed that the present strains belong to genotype 4 (G4). In addition, the present strains could have divided in about 2010 from the same lineages detected in other countries such as China, India and Australia. The mean rates of molecular evolution of four coding regions were estimated at about 6.15 to 7.86 × 10(-3) substitutions/site/year. Similarity plot analyses suggested that nucleotide similarities between the present strains and a prototype strain (EH24/70 strain) were 0.77-0.94. The p-distance of the present strains was relatively short (<0.01). Only one positive selected site (L25H) was identified in the VP1 protein. These findings suggest that the present CA24v strains causing AHC are genetically related to other AHC strains with rapid evolution and emerged in around 2010.
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Affiliation(s)
- Minoru Nidaira
- Okinawa Prefectural Institute of Health and Environment, 2085 Ozato, Nanjo-Shi, Okinawa, 901-1202
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Smura T, Blomqvist S, Vuorinen T, Ivanova O, Samoilovich E, Al-Hello H, Savolainen-Kopra C, Hovi T, Roivainen M. Recombination in the evolution of enterovirus C species sub-group that contains types CVA-21, CVA-24, EV-C95, EV-C96 and EV-C99. PLoS One 2014; 9:e94579. [PMID: 24722726 PMCID: PMC3983234 DOI: 10.1371/journal.pone.0094579] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/17/2014] [Indexed: 01/16/2023] Open
Abstract
Genetic recombination is considered to be a very frequent phenomenon among enteroviruses (Family Picornaviridae, Genus Enterovirus). However, the recombination patterns may differ between enterovirus species and between types within species. Enterovirus C (EV-C) species contains 21 types. In the capsid coding P1 region, the types of EV-C species cluster further into three sub-groups (designated here as A–C). In this study, the recombination pattern of EV-C species sub-group B that contains types CVA-21, CVA-24, EV-C95, EV-C96 and EV-C99 was determined using partial 5′UTR and VP1 sequences of enterovirus strains isolated during poliovirus surveillance and previously published complete genome sequences. Several inter-typic recombination events were detected. Furthermore, the analyses suggested that inter-typic recombination events have occurred mainly within the distinct sub-groups of EV-C species. Only sporadic recombination events between EV-C species sub-group B and other EV-C sub-groups were detected. In addition, strict recombination barriers were inferred for CVA-21 genotype C and CVA-24 variant strains. These results suggest that the frequency of inter-typic recombinations, even within species, may depend on the phylogenetic position of the given viruses.
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Affiliation(s)
- Teemu Smura
- National Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Virology, Haartman Institute, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Soile Blomqvist
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tytti Vuorinen
- Department of Virology, University of Turku, Turku, Finland
| | - Olga Ivanova
- M.P. Chumakov Institute of Poliomyelitis and Viral Encephalitides, Russian Academy of Medical Sciences, Moscow, Russia
| | - Elena Samoilovich
- Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Republic of Belarus
| | - Haider Al-Hello
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - Tapani Hovi
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Merja Roivainen
- National Institute for Health and Welfare (THL), Helsinki, Finland
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The evolution of Vp1 gene in enterovirus C species sub-group that contains types CVA-21, CVA-24, EV-C95, EV-C96 and EV-C99. PLoS One 2014; 9:e93737. [PMID: 24695547 PMCID: PMC3973639 DOI: 10.1371/journal.pone.0093737] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/07/2014] [Indexed: 12/17/2022] Open
Abstract
Genus Enterovirus (Family Picornaviridae,) consists of twelve species divided into genetically diverse types by their capsid protein VP1 coding sequences. Each enterovirus type can further be divided into intra-typic sub-clusters (genotypes). The aim of this study was to elucidate what leads to the emergence of novel enterovirus clades (types and genotypes). An evolutionary analysis was conducted for a sub-group of Enterovirus C species that contains types Coxsackievirus A21 (CVA-21), CVA-24, Enterovirus C95 (EV-C95), EV-C96 and EV-C99. VP1 gene datasets were collected and analysed to infer the phylogeny, rate of evolution, nucleotide and amino acid substitution patterns and signs of selection. In VP1 coding gene, high intra-typic sequence diversities and robust grouping into distinct genotypes within each type were detected. Within each type the majority of nucleotide substitutions were synonymous and the non-synonymous substitutions tended to cluster in distinct highly polymorphic sites. Signs of positive selection were detected in some of these highly polymorphic sites, while strong negative selection was indicated in most of the codons. Despite robust clustering to intra-typic genotypes, only few genotype-specific ‘signature’ amino acids were detected. In contrast, when different enterovirus types were compared, there was a clear tendency towards fixation of type-specific ‘signature’ amino acids. The results suggest that permanent fixation of type-specific amino acids is a hallmark associated with evolution of different enterovirus types, whereas neutral evolution and/or (frequency-dependent) positive selection in few highly polymorphic amino acid sites are the dominant forms of evolution when strains within an enterovirus type are compared.
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Wu B, Qi X, Xu K, Ji H, Zhu Y, Tang F, Zhou M. Genetic characteristics of the coxsackievirus A24 variant causing outbreaks of acute hemorrhagic conjunctivitis in Jiangsu, China, 2010. PLoS One 2014; 9:e86883. [PMID: 24475191 PMCID: PMC3901726 DOI: 10.1371/journal.pone.0086883] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/19/2013] [Indexed: 11/19/2022] Open
Abstract
During September 2010, an outbreak of acute hemorrhagic conjunctivitis reemerged in Jiangsu, three years after the nationwide epidemic in China in 2007. In total, 2409 cases were reported, 2118 of which were reported in September; 79.8% of those affected were students or teachers, with a median age of 16 years. To identify and demonstrate the genetic characteristics of the etiological agent, 52 conjunctival swabs were randomly collected from four different cities. After detection and isolation, 43 patients were positive for coxsackievirus A24 variant according to PCR and 20 according to culture isolation. Neither adenovirus nor EV70 was detected. A phylogenetic study of the complete 3Cpro and VP1 regions showed that the Jiangsu isolates clustered into a new lineage, GIV-C5, with two uniform amino-acid mutations that distinguished them from all previous strains. Another new cluster, GIV-C4, formed by Indian isolates from 2007 and Brazilian isolates from 2009, was also identified in this study. Interestingly, our isolates shared greatest homology with the GIV-C4 strains, not with the isolates that were responsible for the nationwide acute hemorrhagic conjunctivitis epidemic in China in 2007. Although all our isolates were closely related, they could be differentiated into two subclusters within GIV-C5. In conclusion, our study suggests that a new cluster of coxsackievirus A24 variant that had already evolved into diverse strains was associated with the acute hemorrhagic conjunctivitis outbreaks in Jiangsu in September 2010. These viruses might have originated from the virus isolated in India in 2007, rather than from the epidemic strains isolated in China in 2007.
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Affiliation(s)
- Bin Wu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xian Qi
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ke Xu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Hong Ji
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yefei Zhu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu, China
- * E-mail:
| | - Fenyang Tang
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Minghao Zhou
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Li J, Yang Y, Lin C, Li W, Yang Y, Zhang Y, Jia L, Li X, Chen L, Wang Q. Etiology of Acute Conjunctivitis Due to Coxsackievirus A24 Variant, Human Adenovirus, Herpes Simplex Virus, and Chlamydia in Beijing, China. Jpn J Infect Dis 2014; 67:349-55. [DOI: 10.7883/yoken.67.349] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Ayoub EA, Shafik CF, Gaynor AM, Mohareb EW, Amin MA, Yassin AS, El-Refaey S, Genedy M, Kandeel A. A molecular investigative approach to an outbreak of acute hemorrhagic conjunctivitis in Egypt, October 2010. Virol J 2013; 10:96. [PMID: 23531270 PMCID: PMC3614871 DOI: 10.1186/1743-422x-10-96] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 03/12/2013] [Indexed: 11/25/2022] Open
Abstract
Background During October 2010, Egypt reported an outbreak of acute hemorrhagic conjunctivitis (AHC). A total of 1831 cases were reported from three governorates; 1703 cases in El Daqahliya, 92 cases in Port Said, and 36 in Damietta. The purpose of this study was to identify and characterize the causative agent associated with this outbreak. Methods The U.S. Naval Medical Research Unit No.3 (NAMRU-3) was contacted by the Egyptian Ministry of Health and Population to perform diagnostic laboratory testing on eighteen conjunctival swabs from patients with conjunctivitis from El Daqahliya Governorate. Conjunctival swabs were tested by molecular methods for human adenovirus (HAdV) and enteroviruses (EV). Virus isolation was performed; the isolated virus was further characterized by molecular typing and phylogenetic analysis. Results The majority of the samples (17/18) were positive for enterovirus and all were negative for HAdV. Molecular typing and sequencing of the isolated virus revealed the presence of coxsackievirus A24 variant. Phylogenetic analysis based on the VP1 and 3C regions demonstrated that the Egyptian viruses belonged to Genotype IV and are closely related to coxsackievirus A24 variant, reported in a similar outbreak in China in August 2010. Conclusions This study strongly suggests that coxsackievirus A24 variant was associated with the acute hemorrhagic conjunctivitis outbreak reported in Egypt in October 2010. There is a possibility that the same strain of CV-A24v was implicated in the AHC outbreaks in both China and Egypt in 2010.
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Affiliation(s)
- Ehab A Ayoub
- US Naval Medical Research Unit No,3, Cairo, 11517, Egypt.
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17
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Shukla D, Kumar A, Srivastava S, Dhole TN. Molecular identification and phylogenetic study of coxsackievirus A24 variant isolated from an outbreak of acute hemorrhagic conjunctivitis in India in 2010. Arch Virol 2013; 158:679-84. [PMID: 23124888 DOI: 10.1007/s00705-012-1520-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 09/17/2012] [Indexed: 11/28/2022]
Abstract
An outbreak of acute hemorrhagic conjunctivitis (AHC) occured in India between August and October 2010. Molecular typing by RT-PCR and sequencing of a partial VP1 region identified coxsackievirus A24 variant (CV A24v) as the serotype involved in this outbreak. Phylogenetic analysis based on the VP1 and 3C genes revealed that CV A24v strains associated with the 2010 AHC outbreak in India were genetically similar to strains from Central and South America that caused outbreaks of AHC in Cuba between 2008 and 2009 and Brazil in 2009. The result shows that the Indian strain of CV A24v may be responsible for the recent AHC outbreak in Marseille, France, in 2012.
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Affiliation(s)
- Deepti Shukla
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014 Uttar Pradesh, India
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18
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De W, Huanying Z, Hui L, Corina M, Xue G, Leng L, Hanri Z, Ling F, Yanling M, Huiqiong Z, Huan Z, Jing K, Caiyun L, Yoshida H, Changwen K. Phylogenetic and molecular characterization of coxsackievirus A24 variant isolates from a 2010 acute hemorrhagic conjunctivitis outbreak in Guangdong, China. Virol J 2012; 9:41. [PMID: 22336176 PMCID: PMC3305440 DOI: 10.1186/1743-422x-9-41] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 02/15/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Acute hemorrhagic conjunctivitis is a common disease in China. As a notifiable disease, cases are registered by ophthalmologists on the AHC surveillance system. An AHC outbreak caused by CA24v was observed in Guangdong Province in 2007 by the National Disease Supervision Information Management System. Three years later, a larger outbreak occurred in Guangdong during the August-October period (2010). To characterize the outbreak and compare the genetic diversity of CA24v, which was determined to be the cause of the outbreak, the epidemiology and the molecular characterization of CA24v were analyzed in this study. RESULTS A total of 69,635 cases were reported in the outbreak. 73.5% of index cases originated from students, children in kindergarten and factory workers, with the ≦ 9 age group at the highest risk. The male to female ratio was 1.84:1 among 0-19 years. 56 conjunctival swabs were collected to identify the causative agent from five cities with the AHC outbreak. 30 virus strains were isolated, and two of the genomes had the highest identity values (95.8%) with CA24v genomes. Four CA24v genotypes were identified by phylogenetic analysis for the VP1 and 3C regions. CA24v which caused the outbreak belonged to genotype IV. Furthermore, full nucleotide sequences for four representative isolates in 2010 and 2007 were determined and compared. 20 aa mutations, two nt insertions and one nt deletion were observed in the open reading frame, with 5'- and 3'- UTR respectively between them. CONCLUSIONS CA24v was determined to be the pathogen causing the outbreak and belongs to genotype IV. VP1 is more informative than 3C(Pro) for describing molecular epidemiology and we hypothesize that accumulative mutations may have promoted the outbreak.
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Affiliation(s)
- Wu De
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zheng Huanying
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Li Hui
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | | | - Guo Xue
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Liu Leng
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zeng Hanri
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Fang Ling
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Mo Yanling
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zhou Huiqiong
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Zhang Huan
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Kou Jing
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Long Caiyun
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
| | - Hiromu Yoshida
- National Institute of Infectious Diseases Gakuen, Tokyo, 2080011, Japan
| | - Ke Changwen
- Institute of Microbiology, Center for Disease Control and Prevention of Guangdong, No.176, Xingang Road W, Guangzhou, Guangdong, 510300, People's Republic of China
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Fonseca MC, Sarmiento L, Resik S, Pereda N, Rodríguez H, Kourí V, Martínez PA, Piñón A, Limonta D, Más P, Hung LH. Isolation of Coxsackievirus A24 variant from patients with hemorrhagic conjunctivitis in Cuba, 2008-2009. J Clin Virol 2011; 53:77-81. [PMID: 22074932 DOI: 10.1016/j.jcv.2011.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 10/12/2011] [Accepted: 10/14/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND An outbreak of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009. OBJECTIVE To determinate the etiological agent associated with the Cuban outbreaks of acute hemorrhagic conjunctivitis during 2008 and 2009. STUDY DESIGN Conjunctival swabs and/or faecal samples from 382 patients with clinical diagnosis suggestive of acute hemorrhagic conjunctivitis were subject to viral culture in HEp-2 human laryngeal epidermoid carcinoma cells. Positive samples were identified by a specific Coxsackievirus A24 variant PCR and the 3C protease region of 16 isolates was sequenced for phylogenetic analysis. RESULTS Enterovirus cytopathic effect was observed in 138 cases (36%). A higher percent of CA24v was recovered from faecal samples, 19 out of 45 cases (42.2%), than from conjunctival swabs, 127 out of 355 samples (35.8%). All isolates were identified as Coxsackievirus A24 variant. Phylogenetic analysis revealed that 2008 and 2009 Cuban outbreaks were caused by the same virus strains and that isolates were closely related to those from Taiwan (2006-2007), China (2007-2008) and Singapore (2005) with a bootstrap value of 71%. CONCLUSIONS Outbreaks of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009 were caused by Coxsackievirus A24 variant. The faecal-oral route is another mode of transmission of CA24v in the acute hemorrhagic conjunctivitis outbreaks. Phylogenetic analysis of Cuban CA24v strains involved in an acute hemorrhagic conjunctivitis outbreak in 2008 and 2009 confirms a new introduction of the CA24 variant into the Americas from South-east Asia.
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Affiliation(s)
- Magilé C Fonseca
- Department of Virology, Pedro Kourí Tropical Medicine Institute (IPK), Autopista Novia del Mediodía km. 6 1/2, Marianao 13, Havana, Cuba.
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Coxsackievirus A24 variant uses sialic acid-containing O-linked glycoconjugates as cellular receptors on human ocular cells. J Virol 2011; 85:11283-90. [PMID: 21880775 DOI: 10.1128/jvi.05597-11] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Coxsackievirus A24 variant (CVA24v) is a main causative agent of acute hemorrhagic conjunctivitis (AHC), which is a highly contagious eye infection. Previously it has been suggested that CVA24v uses sialic acid-containing glycoconjugates as attachment receptors on corneal cells, but the nature of these receptors is poorly described. Here, we set out to characterize and identify the cellular components serving as receptors for CVA24v. Binding and infection experiments using corneal cells treated with deglycosylating enzymes or metabolic inhibitors of de novo glycosylation suggested that the receptor(s) used by CVA24v are constituted by sialylated O-linked glycans that are linked to one or more cell surface proteins but not to lipids. CVA24v bound better to mouse L929 cells overexpressing human P-selectin glycoprotein ligand-1 (PSGL-1) than to mock-transfected cells, suggesting that PSGL-1 is a candidate receptor for CVA24v. Finally, binding competition experiments using a library of mono- and oligosaccharides mimicking known PSGL-1 glycans suggested that CVA24v binds to Neu5Acα2,3Gal disaccharides (Neu5Ac is N-acetylneuraminic acid). These results provide further insights into the early steps of the CVA24v life cycle.
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Skevaki CL, Galani IE, Pararas MV, Giannopoulou KP, Tsakris A. Treatment of viral conjunctivitis with antiviral drugs. Drugs 2011; 71:331-47. [PMID: 21319870 DOI: 10.2165/11585330-000000000-00000] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Viral conjunctivitis is one of the most common disorders observed in ophthalmic emergency departments, yet no established treatment exists. Lately, antiviral medications have been introduced into clinical practice; however, a systematic review focusing on their use and effectiveness in the treatment of viral conjunctivitis has not been previously reported. We systemically reviewed the literature to identify studies where antiviral drugs were used to treat viral conjunctivitis. Currently, aciclovir, trifluridine and valaciclovir are commonly used as antiviral agents to treat herpesvirus infections. Cidofovir has been used successfully to treat some cases of adenoviral conjunctivitis, although toxicity has also been reported. The use of other medications, such as idoxuridine, has been minimized in clinical practice due to their high toxicity. Interestingly, most of the antiviral drugs developed are used to treat herpesvirus infections, while less progress has been made in the field of adenoviral infections. For other viral causes of conjunctivitis, no effective remedy is currently available, and treatment focuses on the relief of symptoms. Caution should be exercised when coadministering other pharmacological agents, such as corticosteroids, because of emerging adverse effects.
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Affiliation(s)
- Chrysanthi L Skevaki
- Department of Microbiology, School of Medicine, University of Athens, Athens, Greece.
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An ex vivo model of coxsackievirus infection using multilayered human conjunctival epithelial cells. Graefes Arch Clin Exp Ophthalmol 2011; 249:1327-32. [DOI: 10.1007/s00417-011-1655-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 01/18/2011] [Accepted: 02/02/2011] [Indexed: 10/18/2022] Open
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Abstract
Several new enterovirus serotypes and a new human rhinovirus species have been characterized in the Enterovirus genus recently, raising a question about the origin of the new viruses. In this article we attempt to outline the general patterns of enterovirus evolution, ultimately leading to the emergence of new serotypes or species. Different evolutionary and epidemiological patterns can be deduced between different enterovirus species, between entero- and rhino-viruses and between different serotypes within a species. This article presents a hypothesis that the divergent evolution leading to a new serotype is likely to involve adaptation to a new ecological niche either within a single host species or due to interspecies transmission. By contrast, evolution within a serotype appears to occur primarily by genetic drift.
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Affiliation(s)
| | - Carita Savolainen-Kopra
- National Institute for Health and Welfare (THL), Division of Health Protection, Department of Infectious Disease Surveillance & Control, Intestinal Viruses Unit, P.O. Box 30, FI-00271 Helsinki, Finland; National Institute for Health & Welfare (THL), PO Box 30, FI-00271 Helsinki, Finland
| | - Merja Roivainen
- National Institute for Health and Welfare (THL), Division of Health Protection, Department of Infectious Disease Surveillance & Control, Intestinal Viruses Unit, P.O. Box 30, FI-00271 Helsinki, Finland; National Institute for Health & Welfare (THL), PO Box 30, FI-00271 Helsinki, Finland
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