1
|
He Q, Shu J, Liang Z, Li M, Li S, Liu T, Yang X, Lu Q, Wang L, Wang L. Prevalence of Multiple RNA Virus Infections in Nine Types of Commonly Used Laboratory Animals in China. Zoonoses Public Health 2025; 72:301-312. [PMID: 39777991 DOI: 10.1111/zph.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 11/30/2024] [Accepted: 12/24/2024] [Indexed: 01/11/2025]
Abstract
INTRODUCTION Laboratory animals are widely used in biomedical research. Surveillance of naturally occurring virus in laboratory animals is important to fully understand the results of animal experiment, control laboratory-acquired infections among research personnel and manage viral transmission within laboratory animal populations. This study aimed to investigate the prevalence of multiple RNA viruses in laboratory animals commonly used in China. METHODS We screened viral RNA for five different potentially zoonotic RNA viruses (astrovirus, coronavirus, hepevirus, hepatovirus and picornavirus) that can be transmitted via the faecal-oral route in 759 faecal samples collected from nine commonly used laboratory animals (mice, rats, monkeys, rabbits, pigs, dogs, ferrets, goats and tree shrews) in China. Viral RNA was screened by broad-spectrum reverse transcription polymerase chain reaction (RT-PCR) using primers annealing in genome-conserved regions. The laboratory mice and rats used in this study were specific-pathogen-free. The other laboratory animals were conventional animals. RESULTS At least one selected virus was detected in each of the nine sampled laboratory animal types, except tree shrews. The total positive rates of viral RNA for astroviruses, coronaviruses, hepeviruses and picornaviruses in the selected laboratory animals were 4.3%, 7.6%, 8.0% and 1.1%, respectively. Among these, the positivity rates for hepevirus RNA in laboratory ferrets (41.3%) and rabbits (17.8%), astrovirus RNA in laboratory pigs (75.0%) and coronavirus RNA in laboratory ferrets (45.7%) were relatively high. Viral RNA for hepatovirus was negative in all selected laboratory animals. Co-infection with multiple viruses has also been observed in laboratory dogs, pigs, ferrets and rabbits. CONCLUSIONS Our findings highlight the need for the surveillance of natural viral infections in laboratory animals.
Collapse
Affiliation(s)
- Qiyu He
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Jingyi Shu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Zhaochao Liang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Manyu Li
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Shuangshuang Li
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Tianxu Liu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Xinyue Yang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Qinghui Lu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Ling Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Lin Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| |
Collapse
|
2
|
Sun X, Lu H, Tie Y, Zhao M, Zhang R, Sun Z, Fan G, Li F, Tian F, Hu Y, Zhang M, Shen X, Ma X, Feng Z. A one-step reverse-transcription recombinase aided PCR assay for the rapid and sensitive detection of human enteroviruses. BIOSAFETY AND HEALTH 2023; 5:126-131. [PMID: 40078830 PMCID: PMC11894955 DOI: 10.1016/j.bsheal.2023.03.002] [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: 12/28/2022] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023] Open
Abstract
Human enteroviruses (HEVs) include many different types that cause a wide range of diseases, and an effective method of genus-level identification has therefore significant clinical implications. However, quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), the gold-standard method, still has shortfalls in diagnostic sensitivity and timeliness. Here we established a one-step real-time reverse-transcription recombinase-aided PCR assay (RT-RAP) to detect HEV fragment within an hour. The RT-RAP assay showed a detection limit of 5 copies/μL using recombinant plasmids and was extensively verified using 15 HEV strains. Among 15 types of HEV (species A-C), the sensitivity of RT-RAP was approximately 2-8 folds lower than that of the qRT-PCR in 9 types, and no-cross reaction with other viruses was observed. RT-RAP was further applied to analyze CSF and fecal specimens; the clinical performance demonstrated that the RT-RAP and the commercial qRT-PCR kit provided consistent results. These results indicated that RT-RAP assay may be a promising approach for rapid and sensitive detection of HEV.
Collapse
Affiliation(s)
- Xiuli Sun
- North China University of Science and Technology, Tangshan 063210, China
- Hebei General Hospital, Shijiazhuang 050051, China
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Huanhuan Lu
- National Laboratory for Poliomyelitis, National Institute for Viral Disease Control and Prevention of the Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yanqing Tie
- Hebei General Hospital, Shijiazhuang 050051, China
- Hebei Key Laboratory of Molecular Medicine, Shijiazhuang 050051, China
- Hebei Clinical Research Center for Laboratory Medicine, Shijiazhuang 050051, China
| | - Mengchuan Zhao
- Department of Laboratory Medicine, Children's Hospital of Hebei Province, Shijiazhuang 050031, China
| | - Ruiqing Zhang
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zhenlu Sun
- Yantai Center for Disease Control and Prevention, Yantai 264003, China
| | - Guohao Fan
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Fengyu Li
- Hebei General Hospital, Shijiazhuang 050051, China
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Fengyu Tian
- Hebei General Hospital, Shijiazhuang 050051, China
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yaxin Hu
- North China University of Science and Technology, Tangshan 063210, China
- Hebei General Hospital, Shijiazhuang 050051, China
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Mengyi Zhang
- North China University of Science and Technology, Tangshan 063210, China
- Hebei General Hospital, Shijiazhuang 050051, China
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xinxin Shen
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xuejun Ma
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zhishan Feng
- Hebei General Hospital, Shijiazhuang 050051, China
- Hebei Key Laboratory of Molecular Medicine, Shijiazhuang 050051, China
- Hebei Clinical Research Center for Laboratory Medicine, Shijiazhuang 050051, China
| |
Collapse
|
3
|
Sanjay RE, Josmi J, Sasidharanpillai S, Shahin S, Michael CJ, Sabeena S, Aswathyraj S, Kavitha K, Shilpa C, Prasada SV, Anup J, Arunkumar G. Molecular epidemiology of enteroviruses associated with hand, foot, and mouth disease in South India from 2015 to 2017. Arch Virol 2022; 167:2229-2238. [PMID: 35970888 PMCID: PMC9377658 DOI: 10.1007/s00705-022-05561-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is a common childhood infection caused by human enteroviruses and is clinically characterised by fever with vesicular rash on the hands, feet, and mouth. While enterovirus A71 (EV-A71) and coxsackievirus A16 (CVA16) were the major etiological agents of HFMD in India earlier, the data on recently circulating enteroviruses associated with HFMD are sparse. Here, we describe the molecular epidemiology of enteroviruses associated with HFMD in South India from 2015 to 2017. We used archived enterovirus real-time reverse transcription (RT) PCR-positive vesicle swab and/or throat swab specimens from clinically suspected HFMD cases collected from four secondary-care hospitals in South India between July 2015 and December 2017. PCR amplification and sequencing were done based on the 5'VP1, 3'VP1, VP2, or 5´NCR regions to identify enterovirus types. Genetic diversity among enteroviruses was inferred by phylogenetic analysis. Of the 107 enterovirus RNA real-time RT-PCR-positive HFMD cases, 69 (64%) were typed as CVA6, 16 (15%) were CVA16, and one (1%) was CVA10, whereas in 21 (20%) cases, the virus was not typeable by any of the methods used in the study. The majority of HFMD cases (89, 83%) were in children less than five years old, while 11 (10.3%) were in adults. 5'VP1 yielded the maximum number of enteroviruses genotyped, and phylogenetic analysis showed that the CVA6 strains belonged to subclade D3, while the subclades of CVA16 and CVA10 were B1c and D, respectively. The predominant etiological agent of HFMD in South India during 2015-2017 was CVA6, followed by CVA16 and CVA10.
Collapse
Affiliation(s)
- Ramachandran Erathodi Sanjay
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - Joseph Josmi
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - Sarita Sasidharanpillai
- Department of Dermatology and Venereology, Government Medical College, Kozhikode, Kerala 673008 India
| | - Sheik Shahin
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - C. J. Michael
- Department of ENT, Government General Hospital, Kozhikode, Kerala 673032 India
| | - Sasidharanpillai Sabeena
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
- Allure Residency, Near The British School, Jhamsikhel Lalitpur, Kathmandu, 44600 Nepal
| | - S. Aswathyraj
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
- Institute of Advanced Virology (IAV) (Autonomous Institute under Science and Technology Dept Govt of Kerala), Bio360 Life Sciences Park, Thonnakkal, Trivandrum, Kerala 695317 India
| | - Karunakaran Kavitha
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - Cheerngod Shilpa
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - S. Varamballi Prasada
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - Jayaram Anup
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
| | - Govindakarnavar Arunkumar
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka 576104 India
- Present Address: 2-49, Vaikathu, Marotithota Road, Mooduathrady, Athrady Post, Udupi, Karnataka 576107 India
| |
Collapse
|
4
|
Evolutionary Relationships of Ljungan Virus Variants Circulating in Multi-Host Systems across Europe. Viruses 2021; 13:v13071317. [PMID: 34372523 PMCID: PMC8310206 DOI: 10.3390/v13071317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/12/2022] Open
Abstract
The picornavirus named 'Ljungan virus' (LV, species Parechovirus B) has been detected in a dozen small mammal species from across Europe, but detailed information on its genetic diversity and host specificity is lacking. Here, we analyze the evolutionary relationships of LV variants circulating in free-living mammal populations by comparing the phylogenetics of the VP1 region (encoding the capsid protein and associated with LV serotype) and the 3Dpol region (encoding the RNA polymerase) from 24 LV RNA-positive animals and a fragment of the 5' untranslated region (UTR) sequence (used for defining strains) in sympatric small mammals. We define three new VP1 genotypes: two in bank voles (Myodes glareolus) (genotype 8 from Finland, Sweden, France, and Italy, and genotype 9 from France and Italy) and one in field voles (Microtus arvalis) (genotype 7 from Finland). There are several other indications that LV variants are host-specific, at least in parts of their range. Our results suggest that LV evolution is rapid, ongoing and affected by genetic drift, purifying selection, spillover and host evolutionary history. Although recent studies suggest that LV does not have zoonotic potential, its widespread geographical and host distribution in natural populations of well-characterized small mammals could make it useful as a model for studying RNA virus evolution and transmission.
Collapse
|
5
|
Gopalkrishna V, Ganorkar N. Epidemiological and molecular characteristics of circulating CVA16, CVA6 strains and genotype distribution in hand, foot and mouth disease cases in 2017 to 2018 from Western India. J Med Virol 2021; 93:3572-3580. [PMID: 32833231 DOI: 10.1002/jmv.26454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/16/2020] [Indexed: 12/22/2022]
Abstract
Hand, Foot, and Mouth disease (HFMD) is a mild exanthematous and febrile disease occurs in children aged ≤10 years old. The present study highlights clinical, epidemiological characteristics, distribution of enterovirus (EV) types, and sub genotypes in HFMD cases reported during 2017 to 2018 in Western India. A total of 93 clinical samples collected from 68 HFMD cases were included. The presence of EV-RNA was determined by 5'UTR based nested reverse transcription polymerase chain reaction followed by molecular typing, sub genotyping by VP1/2A junction or VP1, full VP1 gene amplification, and phylogenetic analysis. The study reports 80.64% (75/93) EV positivity and 94.66% (71/75) typing rate, with a predominant circulation of CVA16 and CVA6 strains. Sequence analysis revealed the presence of coxsackievirus (CV)A16 (57.7%), CVA6 (40.8%), and Echo1 (1.4%) strains. EV infections were predominantly observed in children aged 1 to 3 years old (43.9%). Although cases were reported throughout the year, peaked in July (15.8%) and August (24.6%) months and persisted till September (19.3%). All the CVA16 and CVA6 positive strains were genotyped using full VP1 gene amplification. All CVA16 Indian strains (n = 41) were clustered with rarely reported B1c sub genotype and CVA6 strains (n = 29) with E2 sub-lineage. The study highlights the genetic characteristics of circulating CVA16, CVA6, and Echo1 strains in HFMD cases from Western India. The emergence of CVA16 B1c genotype and sub-lineage E2 of CVA6 strains and their constant circulation further demands systemic surveillance studies on HFMD from different parts of India to facilitate the rapid diagnosis of CVA16 and CVA6 strains using the molecular and serological based approach and for intervention strategies.
Collapse
Affiliation(s)
- Varanasi Gopalkrishna
- Enteric Viruses Group, Indian Council of Medical Research (ICMR), National Institute of Virology, Pune, India
| | - Nital Ganorkar
- Enteric Viruses Group, Indian Council of Medical Research (ICMR), National Institute of Virology, Pune, India
| |
Collapse
|
6
|
Chen M, He S, Yan Q, Zhang J, Li C, Su X, Zhang S, Li T, Ge S, Chen M, Zhang J, Xia N. Sporadic hand, foot, and mouth disease cases associated with non-C4 enterovirus 71 strains in Xiamen, China, from 2009 to 2018. Arch Virol 2021; 166:2263-2266. [PMID: 34008106 PMCID: PMC8130986 DOI: 10.1007/s00705-021-05097-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
Enterovirus 71 (EV71) has caused large hand, foot, and mouth disease (HFMD) epidemics among young children, and EV71 infection is the leading cause of severe HFMD cases and deaths. In mainland China, the prevalence and risk factors of non-C4 EV71 strains are still unclear. In this study, we monitored non-C4 strains over a 10-year HFMD epidemiological surveillance period in Xiamen. The 5’UTR and VP1 coding region of EV71 strains were amplified by RT-nested PCR and sequenced. Thirty-two non-C4 EV71 strains were identified during 2009-2018. This study provides important information about the prevalence of EV71 in China that will be applicable for development of vaccines and diagnostic reagents as well as establishment of policies for HFMD prevention and control.
Collapse
Affiliation(s)
- Mengyuan Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| | - Shuizhen He
- Xiamen Haicang Hospital, Haiyu Road, Xiamen, 361026, China
| | - Qiang Yan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| | - Jianmei Zhang
- Xiamen Center for Disease Control and Prevention, Shengguang Road, Jimei District, Xiamen, 361021, China
| | - Caiyu Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| | - Xiaosong Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| | - Shiyin Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China.
| | - Tingdong Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| | - Shengxiang Ge
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| | - Min Chen
- Xiamen Center for Disease Control and Prevention, Shengguang Road, Jimei District, Xiamen, 361021, China.
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
- The Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, South Xiang'an Road, Xiamen, 361102, China
| |
Collapse
|
7
|
Epidemical and etiological study on hand, foot and mouth disease following EV-A71 vaccination in Xiangyang, China. Sci Rep 2020; 10:20909. [PMID: 33262488 PMCID: PMC7708472 DOI: 10.1038/s41598-020-77768-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/12/2020] [Indexed: 12/29/2022] Open
Abstract
Coxsackievirus A6 (CV-A6) and Coxsackievirus A10 (CV-A10) have been emerging as the prevailing serotypes and overtaking Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16) in most areas as main pathogens of hand, foot and mouth disease (HFMD) in China since 2013. To investigate whole etiological spectrum following EV-A71 vaccination of approximate 40,000 infants and young children in Xiangyang, enteroviruses were serotyped in 4415 HFMD cases from October 2016 to December 2017 using Real Time and conventional PCR and cell cultures. Of the typeable 3201 specimen, CV-A6 was the predominant serotype followed by CV-A16, CV-A10, CV-A5, CV-A2 and EV-A71 with proportions of 59.54%, 15.31%, 11.56%, 4.56%, 3.78% and 3.03%, respectively. Other 12 minor serotypes were also detected. The results demonstrated that six major serotypes of enteroviruses were co-circulating, including newly emerged CV-A2 and CV-A5. A dramatic decrease of EV-A71 cases was observed, whereas the total cases remained high. Multivalent vaccines against major serotypes are urgently needed for control of HFMD.
Collapse
|
8
|
Li J, Wang X, Cai J, Ge Y, Wang C, Qiu Y, Xia A, Zeng M. Non-polio enterovirus infections in children with central nervous system disorders in Shanghai, 2016-2018: Serotypes and clinical characteristics. J Clin Virol 2020; 129:104516. [PMID: 32585621 DOI: 10.1016/j.jcv.2020.104516] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/01/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Non-polio enrerovirus causes a wide spectrum of neurologic syndromes. The epidemiological and clinical profiles of non-polio enrerovirus-associated central nervous system infections vary by regions and over year. OBJECTIVES This study aimed to understand the prevalence, serotypes and clinical characteristics of enterovirus-associated aseptic meningitis, encephalitis and meningo-encephalitis in children in Shanghai during 2016-2018. METHODS We collected the clinical data and the cerebrospinal fluid specimens from the pediatric patients with aseptic meningitis, encephalitis and meningo-encephalitis during 2016-2018. The nested RT-PCR and sequencing were performed to identify enterovirus and serotypes. RESULTS A total of 424 patients were included in this study and their non-duplicated cerebrospinal fluid specimens were collected during the acute stage of illness. Based on PCR assay, enterovirus was detected in 272 (64.15 %) patients, of whom, the ratio of male to female subjects was 1.99, and the mean age was 5.71 ± 3.55 years (range: 0.03-16 years). There were 17 serotypes identified. Echovirus 30 (24.63 %), Coxsackievirus A10 (20.96 %), Coxsackievirus A6 (18.01 %) accounted for 63.6 %, followed by Coxsackievirus B5 (7.72 %), Echovirus 6 (5.88 %), and other serotypes (22.8 %). Of the 10 (3.68 %) critically severe patients, all had refractory seizure, 8 required mechanical ventilation, 7 survivors had recurrent attacks of epilepsy and 3 abandoned treatment; Coxsackievirus A10, Echovirus 9, Coxsackievirus A2, Coxsackievirus A6 and Echovirus 6 were identified. CONCLUSIONS Non-polio enterovirus is the major pathogen causing aseptic meningitis, encephalitis and meningo-encephalitis in Chinese children and can cause life-threatening encephalitis and severe sequelae.
Collapse
Affiliation(s)
- Jingjing Li
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Xiangshi Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Jiehao Cai
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Yanling Ge
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Chuning Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Yue Qiu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Aimei Xia
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| |
Collapse
|
9
|
Ceylan AN, Turel O, Gultepe BS, Inan E, Turkmen AV, Doymaz MZ. Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6: A Preliminary Report from Istanbul. Pol J Microbiol 2019; 68:165-171. [PMID: 31257789 DOI: 10.21307/pjm-2019-016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/07/2019] [Accepted: 01/07/2019] [Indexed: 11/11/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is caused by various serotypes of Enterovirus genus. Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) were known to be the only responsible agents for these epidemics; however, this opinion was challenged after the detection that coxsackievirus A6 (CV-A6) was the responsible species for the outbreak in Finland in 2008. HFMD is frequently seen in Turkey, and no detailed study on its clinical and microbiological epidemiology has previously been reported. The present study addresses this question. Twenty-seven patient samples collected between 2015 and 2017 were included in the study. Typing was conducted by RT-PCR and the sequencing applied directly to patient's samples and as well as to the viral cultures with pan-enterovirus and serotype-specific primers. The presence of Enterovirus in 12 of 27 HFMD samples was shown with RT-PCR. The causative agent for three of these 12 samples was CV-A16, one of the most frequent two serotypes around the world, and the remaining nine samples was CV-A6. The findings of the study are relevant since it pertains to the molecular epidemiology of HFMD in Turkey, a gateway country where different serotypes might be circulating and transmitted. The findings also support the notion that CV-A6 cases are rising in number, which has caused more severe clinical features and widespread rashes in recent outbreaks. Hand, foot, and mouth disease (HFMD) is caused by various serotypes of Enterovirus genus. Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) were known to be the only responsible agents for these epidemics; however, this opinion was challenged after the detection that coxsackievirus A6 (CV-A6) was the responsible species for the outbreak in Finland in 2008. HFMD is frequently seen in Turkey, and no detailed study on its clinical and microbiological epidemiology has previously been reported. The present study addresses this question. Twenty-seven patient samples collected between 2015 and 2017 were included in the study. Typing was conducted by RT-PCR and the sequencing applied directly to patient’s samples and as well as to the viral cultures with pan-enterovirus and serotype-specific primers. The presence of Enterovirus in 12 of 27 HFMD samples was shown with RT-PCR. The causative agent for three of these 12 samples was CV-A16, one of the most frequent two serotypes around the world, and the remaining nine samples was CV-A6. The findings of the study are relevant since it pertains to the molecular epidemiology of HFMD in Turkey, a gateway country where different serotypes might be circulating and transmitted. The findings also support the notion that CV-A6 cases are rising in number, which has caused more severe clinical features and widespread rashes in recent outbreaks.
Collapse
Affiliation(s)
- Ayse N Ceylan
- Bezmialem Vakif University, Department of Medical Microbiology , Istanbul , Turkey
| | - Ozden Turel
- Bezmialem Vakif University, Department of Pediatrics , Istanbul , Turkey
| | - Bilge Sumbul Gultepe
- Bezmialem Vakif University, Department of Medical Microbiology , Istanbul , Turkey
| | - Elif Inan
- Bezmialem Vakif University, Department of Pediatrics , Istanbul , Turkey
| | | | - Mehmet Z Doymaz
- Bezmialem Vakif University, Department of Medical Microbiology , Istanbul , Turkey ; Bezmialem Vakif University, Beykoz Institute of Life Sciences and Biotechnology (BILSAB) , Istanbul , Turkey
| |
Collapse
|
10
|
Ceylan AN, Turel O, Gultepe BS, Inan E, Turkmen AV, Doymaz MZ. Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6: A Preliminary Report from Istanbul. Pol J Microbiol 2019. [PMID: 31257789 PMCID: PMC7260638 DOI: 10.33073/pjm-2019-016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is caused by various serotypes of Enterovirus genus. Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) were known to be the only responsible agents for these epidemics; however, this opinion was challenged after the detection that coxsackievirus A6 (CV-A6) was the responsible species for the outbreak in Finland in 2008. HFMD is frequently seen in Turkey, and no detailed study on its clinical and microbiological epidemiology has previously been reported. The present study addresses this question. Twenty-seven patient samples collected between 2015 and 2017 were included in the study. Typing was conducted by RT-PCR and the sequencing applied directly to patient’s samples and as well as to the viral cultures with pan-enterovirus and serotype-specific primers. The presence of Enterovirus in 12 of 27 HFMD samples was shown with RT-PCR. The causative agent for three of these 12 samples was CV-A16, one of the most frequent two serotypes around the world, and the remaining nine samples was CV-A6. The findings of the study are relevant since it pertains to the molecular epidemiology of HFMD in Turkey, a gateway country where different serotypes might be circulating and transmitted. The findings also support the notion that CV-A6 cases are rising in number, which has caused more severe clinical features and widespread rashes in recent outbreaks.
Collapse
Affiliation(s)
- Ayse N Ceylan
- Bezmialem Vakif University, Department of Medical Microbiology , Istanbul , Turkey
| | - Ozden Turel
- Bezmialem Vakif University, Department of Pediatrics , Istanbul , Turkey
| | - Bilge Sumbul Gultepe
- Bezmialem Vakif University, Department of Medical Microbiology , Istanbul , Turkey
| | - Elif Inan
- Bezmialem Vakif University, Department of Pediatrics , Istanbul , Turkey
| | | | - Mehmet Z Doymaz
- Bezmialem Vakif University, Department of Medical Microbiology , Istanbul , Turkey ; Bezmialem Vakif University, Beykoz Institute of Life Sciences and Biotechnology (BILSAB) , Istanbul , Turkey
| |
Collapse
|
11
|
Bian L, Gao F, Mao Q, Sun S, Wu X, Liu S, Yang X, Liang Z. Hand, foot, and mouth disease associated with coxsackievirus A10: more serious than it seems. Expert Rev Anti Infect Ther 2019; 17:233-242. [PMID: 30793637 DOI: 10.1080/14787210.2019.1585242] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Hand, foot, and mouth disease (HFMD) is a common viral childhood illness, that has been a severe public health concern worldwide, particularly in the Asia-Pacific region. According to epidemiological data of HFMD during the past decade, the most prevalent causal viruses were enterovirus (EV)-A71, coxsackievirus (CV)-A16, CV-A6, and CV-A10. The public health burden of CV-A10-related diseases has been underestimated as their incidence was lower than that of EV-A71 and CV-A16 in most HFMD outbreaks. However, cases of CV-A10 infection are more severe, and its genome is more variable, which has alerted the research community worldwide. Areas covered: In this paper, studies on the epidemiology, laboratory diagnosis, clinical manifestations, molecular epidemiology, seroepidemiology, animal models of CV-A10, and vaccines and antiviral strategies against this genotype are reviewed. In addition, the genetic evolution of circulating strains was analyzed. Expert opinion: Multivalent vaccines against EV-A71, CV-A16, CV-A6, and CV-A10 should be a next-step HFMD vaccine strategy.
Collapse
Affiliation(s)
- Lianlian Bian
- a Division of Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , China.,b Division of Hepatitis Virus Vaccines , Wuhan Institute of Biological Products Co., Ltd , Wuhan , China
| | - Fan Gao
- a Division of Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , China
| | - Qunying Mao
- a Division of Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , China
| | - Shiyang Sun
- a Division of Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , China
| | - Xing Wu
- a Division of Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , China
| | - Siyuan Liu
- a Division of Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , China
| | - Xiaoming Yang
- b Division of Hepatitis Virus Vaccines , Wuhan Institute of Biological Products Co., Ltd , Wuhan , China
| | - Zhenglun Liang
- a Division of Hepatitis Virus Vaccines , National Institutes for Food and Drug Control , Beijing , China
| |
Collapse
|
12
|
Wang J, Zhao L, Sun Z, Li G, Niu P, Li D, Wang L, Zhang Y, Feng Z, Ma X. Development of an innovative one-step nested PCR strategy for virus detection using the LNA technique. SCIENCE CHINA-LIFE SCIENCES 2018; 62:428-430. [PMID: 30519878 DOI: 10.1007/s11427-018-9347-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/06/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Ji Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Li Zhao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.,Hebei Medical University, Shijiazhuang, 050017, China
| | - Zhihua Sun
- Beijing Chaoyang Maternal & Child Health Hospital, Beijing, 100021, China
| | - Guixia Li
- Children's Hospital of Hebei Province, Shijiazhuang, 050030, China
| | - Peihua Niu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Dandi Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Lianjun Wang
- Dongcheng Center for Disease Control and Prevention, Beijing, 100009, China
| | - Yi Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Zhishan Feng
- Children's Hospital of Hebei Province, Shijiazhuang, 050030, China.
| | - Xuejun Ma
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| |
Collapse
|
13
|
Atanasova ND, Dey R, Scott C, Li Q, Pang XL, Ashbolt NJ. Persistence of infectious Enterovirus within free-living amoebae - A novel waterborne risk pathway? WATER RESEARCH 2018; 144:204-214. [PMID: 30031365 DOI: 10.1016/j.watres.2018.07.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/04/2018] [Accepted: 07/08/2018] [Indexed: 05/21/2023]
Abstract
Free-living amoebae (FLA) are phagocytic protozoa found in natural and engineered water systems. They can form disinfectant-resistant cysts, which can harbor various human pathogenic bacteria, therefore providing them with a means of environmental persistence and dispersion through water distribution and other engineered water systems. The association of FLA with human viruses has been raised, but the limited data on the persistence of infectious virions within amoebae leaves this aspect unresolved. Enteroviruses can cause a wide range of illness and replicate in human respiratory and gastrointestinal tracts, both of which could be exposed through contact with contaminated waters if virus detection and removal are compromised by virion internalization in free-living protozoa. This is especially problematic for high-risk contaminants, such as coxsackieviruses, representative members of the Enterovirus genus that are likely infectious at low doses and cause a variety of symptoms to a vulnerable portion of the population (particularly infants). To investigate Enterovirus persistence within free-living amoebae we co-cultured an infectious clinical coxsackievirus B5 (CVB5) isolate, with the commonly reported tap water amoeba Vermamoeba vermiformis, after which we tracked virus localization and persistence in co-culture over time through a combination of advanced imaging, molecular and cell culture assays. Our results clearly demonstrate that infectious CVB5 can persist in all life stages of the amoebae without causing any visible injury to them. We also demonstrated that the amoeba generated vesicles containing virions that were expelled into the bulk liquid surroundings, a finding previously described for FLA-bacteria interactions, but not for FLA and human pathogenic viruses. Therefore, our findings suggest that the ability of CVB5 to persist in V. vermiformis could be a novel waterborne risk pathway for the persistence and dispersion of infectious human enteric viruses through water systems.
Collapse
Affiliation(s)
- Nikki D Atanasova
- Dept. Medical Microbiology and Immunology, 6-020 Katz Group Centre, University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Rafik Dey
- Dept. Medical Microbiology and Immunology, 6-020 Katz Group Centre, University of Alberta, Edmonton, AB, T6G 2E1, Canada; School of Public Health, Room 3-57D, South Academic Building, Edmonton, AB, T6G 2G7, Canada University of Alberta, Edmonton, Canada
| | - Candis Scott
- School of Public Health, Room 3-57D, South Academic Building, Edmonton, AB, T6G 2G7, Canada University of Alberta, Edmonton, Canada
| | - Qiaozhi Li
- School of Public Health, Room 3-57D, South Academic Building, Edmonton, AB, T6G 2G7, Canada University of Alberta, Edmonton, Canada
| | - Xiao-Li Pang
- Provincial Laboratory for Public Health, Edmonton, AB, T6G 2J2, Canada
| | - Nicholas J Ashbolt
- Dept. Medical Microbiology and Immunology, 6-020 Katz Group Centre, University of Alberta, Edmonton, AB, T6G 2E1, Canada; School of Public Health, Room 3-57D, South Academic Building, Edmonton, AB, T6G 2G7, Canada University of Alberta, Edmonton, Canada; Provincial Laboratory for Public Health, Edmonton, AB, T6G 2J2, Canada.
| |
Collapse
|
14
|
Isaacs SR, Kim KW, Cheng JX, Bull RA, Stelzer-Braid S, Luciani F, Rawlinson WD, Craig ME. Amplification and next generation sequencing of near full-length human enteroviruses for identification and characterisation from clinical samples. Sci Rep 2018; 8:11889. [PMID: 30089864 PMCID: PMC6082906 DOI: 10.1038/s41598-018-30322-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/19/2018] [Indexed: 12/16/2022] Open
Abstract
More than 100 different enterovirus (EV) genotypes infect humans and contribute to substantial morbidity. However, current methods for characterisation of full-length genomes are based on Sanger sequencing of short genomic regions, which are labour-intensive and do not enable comprehensive characterisation of viral populations. Here, we describe a simple and sensitive protocol for the amplification and sequencing of near full-length genomes of human EV species using next generation sequencing. EV genomes were amplified from 89% of samples tested, with Ct values ranging between 15.7 and 39.3. These samples included 7 EV-A genotypes (CVA2, 5–7, 10, 16 and EV71), 19 EV-B genotypes (CVA9, CVB1-6, ECHO3, 4, 6, 7, 9, 11, 16, 18, 25, 29, 30, and EV69), 3 EV-C genotypes (CVA19 and PV2, 3) and 1 EV-D genotype (EV70). We characterised 70 EVs from 58 clinical stool samples and eight reference strains, with a minimum of 100X depth. We found evidence of co-infection in four clinical specimens, each containing two distinct EV genotypes (CVB3/ECHO7, CVB3/ECHO18 and ECHO9/30). Characterisation of the complete genome provided conclusive genotyping of EVs, which can be applied to investigate the intra-host virus evolution of EVs, and allows further identification and investigation of EV outbreaks.
Collapse
Affiliation(s)
- Sonia R Isaacs
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Ki Wook Kim
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Junipearl X Cheng
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Rowena A Bull
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Systems Medicine, Inflammation and Infection Research Centre, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sacha Stelzer-Braid
- Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Fabio Luciani
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Systems Medicine, Inflammation and Infection Research Centre, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - William D Rawlinson
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Serology and Virology Division (SAViD), NSW Health Pathology East, Department of Microbiology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Maria E Craig
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. .,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia. .,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, NSW, 2145, Australia. .,Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, 2006, Australia.
| |
Collapse
|
15
|
An emerging and expanding clade accounts for the persistent outbreak of Coxsackievirus A6-associated hand, foot, and mouth disease in China since 2013. Virology 2018; 518:328-334. [PMID: 29587191 DOI: 10.1016/j.virol.2018.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/12/2018] [Accepted: 03/15/2018] [Indexed: 11/23/2022]
Abstract
Enterovirus (EV)-A71 and Coxsackievirus (CV)-A16 have historically been the major pathogens of hand, foot, and mouth disease (HMFD) in China; however, CV-A6, which had previously received little attention, became the predominant pathogen in 2013, and has remained one of the common pathogens since then. In this work, we conducted a molecular epidemiology study of CV-A6-associated HFMD in Xiamen from 2009 to 2015. The data showed CV-A6 pandemics had a certain periodicity rather than occurring randomly. Evolution analysis based on near-complete VP1 nucleotide sequences showed subgenotype D5 lineage 4 strains account for the persistent outbreak of CV-A6-associated HFMD in China since 2013. Alignment analysis revealed eight candidate amino acid substitutions in VP1, which may provide useful information for the research of CV-A6 virulence enhancement. This study contributed to elucidating the circulation patterns and genetic characteristics of CV-A6 in China; however, further surveillance and intervention in CV-A6 epidemics is recommended.
Collapse
|
16
|
Li J, Pan H, Wang X, Zhu Q, Ge Y, Cai J, Li Y, Xia A, Hu J, Zeng M. Epidemiological surveillance of hand, foot and mouth disease in Shanghai in 2014-2016, prior to the introduction of the enterovirus 71 vaccine. Emerg Microbes Infect 2018; 7:37. [PMID: 29559626 PMCID: PMC5861114 DOI: 10.1038/s41426-018-0035-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 01/10/2018] [Accepted: 01/14/2018] [Indexed: 11/11/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is mainly epidemic in China and Southeast Asian countries. A novel enterovirus 71 vaccine has been available in China for preventing severe HFMD since 2016. Knowledge of the dynamic epidemiology of HFMD in different regions is necessary for appropriate intervention strategies. This study focused on the citywide surveillance data on the epidemiology and etiology of HFMD in Shanghai during 2014–2016. In these 3 years, the total numbers of reported HFMD cases were 65,018, 39,702, and 57,548, respectively; the numbers of severe cases (case-severity ratios) were 248 (0.38%), 35 (0.09%), and 59 (0.10%), respectively. Children <6 years old accounted for 86.65% to 89.34% of HFMD cases and 91.53 to 97.14% of severe cases. EV-A71 caused all three fatal cases. In severe cases, the detection rate of EV-A71 was 77.82% in 2014, 100% in 2015 and 98.31% in 2016. In uncomplicated inpatient cases, the detection rates of EV-A71, CV-A16, CV-A6, and CV-A10 were, respectively, 43.40, 22.10, 30.73, and 1.89% in 2014; 28.52, 6.46, 53.61, and 7.98% in 2015; and 31.79, 14.15, 44.55, and 4.64% in 2016. In mild community cases, the detection rates of EV-A71, CV-A16, CV-A6, and CV-A10 were, respectively, 25.78, 41.64, 22.93, and 1.78% in 2014; 17.41, 21.23, 50.99, and 3.15% in 2015; and 18.92, 27.84, 45.11, and 1.64% in 2016. Among the cluster outbreaks, the most common pathogen was CV-A16 in 2014 (50.69%) and 2015 (38.10%) and CV-A6 in 2016 (36.30%). These findings show that HFMD outbreaks remained at a high level in Shanghai during 2014–2016. CV-A6 was emerging as the most common pathogen causing HFMD.
Collapse
Affiliation(s)
- Jingjing Li
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Hao Pan
- Department of Infectious Diseases and Control, Shanghai Municipal Center For Disease Control and Prevention, Shanghai, 200336, China
| | - Xiangshi Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Qirong Zhu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yanling Ge
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Jiehao Cai
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yuefang Li
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Aimei Xia
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Jiayu Hu
- Department of Infectious Diseases and Control, Shanghai Municipal Center For Disease Control and Prevention, Shanghai, 200336, China.
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
| |
Collapse
|
17
|
Shen XX, Qiu FZ, Zhao HL, Yang MJ, Hong L, Xu ST, Zhou SF, Li GX, Feng ZS, Ma XJ. A novel and highly sensitive real-time nested RT-PCR assay in a single closed tube for detection of enterovirus. Diagn Microbiol Infect Dis 2018; 90:181-185. [DOI: 10.1016/j.diagmicrobio.2017.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 11/28/2022]
|
18
|
Ganorkar NN, Patil PR, Tikute SS, Gopalkrishna V. Genetic characterization of enterovirus strains identified in Hand, Foot and Mouth Disease (HFMD): Emergence of B1c, C1 subgenotypes, E2 sublineage of CVA16, EV71 and CVA6 strains in India. INFECTION GENETICS AND EVOLUTION 2017; 54:192-199. [PMID: 28577914 DOI: 10.1016/j.meegid.2017.05.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/22/2017] [Accepted: 05/28/2017] [Indexed: 10/19/2022]
Abstract
Hand, Foot and Mouth disease (HFMD) is a common childhood disease and caused due to Enterovirus-A (EV-A), EV-B and EV-C species worldwide. Cases of HFMD were reported from, Ahmedabad (Gujarat, 2012) and Pune (Maharashtra, 2013-2014) in India. The present study highlights the identification of EV strains (CVA16, CVA6, CVA4 and Echo12), characterization of subgenotypes of CVA16, CVA6 strains during 2012-14 and CVA16, CVA6, EV71 strains reported from the earlier study (2009-10) in HFMD cases from India. A total 158 clinical specimens collected from 64 HFMD cases (2012-2014) were included in the study. EV detection was carried out by 5'NCR based RT-PCR, molecular typing and subgenotyping was by VP1/2A junction or VP1, full VP1 gene amplification respectively followed by phylogenetic analysis. The present study reports 63.92% (101/158) EV positivity by RT-PCR. Ninety four of the 101 (93.06%) EV positive strains were amplified by VP1/2A junction or VP1 regions. Sequence analysis revealed the presence of CVA16 (61.7%), CVA6 (34.04%), CVA4 and Echo12 (4.3%). A total of 114 EV positive strains were genotyped using full and partial VP1 region. All CVA16 Indian strains (n=70) clustered with rarely reported B1c subgenotype, CVA6 (n=43) and EV71 (n=1) strains clustered with sub-lineage E2 and C1 subgenotypes respectively. In summary, the study reports genetic characterization of CVA16, CVA6, CVA4 and Echo12 strains in HFMD cases from India. Circulation of B1c subgenotype of CVA16, E2 sub-lineage of CVA6 and C1 subgenotype of EV 71 strains in HFMD cases were reported for the first time from India. This study helps to understand the genotype distribution, genetic diversity of EV strains associated with HFMD from Eastern, Western and Southern regions in India.
Collapse
Affiliation(s)
- Nital N Ganorkar
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411 001, India
| | - Pooja R Patil
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411 001, India
| | - Sanjay S Tikute
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411 001, India
| | - Varanasi Gopalkrishna
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411 001, India.
| |
Collapse
|
19
|
Chen M, He S, Yan Q, Xu X, Wu W, Ge S, Zhang S, Chen M, Xia N. Severe hand, foot and mouth disease associated with Coxsackievirus A10 infections in Xiamen, China in 2015. J Clin Virol 2017; 93:20-24. [PMID: 28577423 DOI: 10.1016/j.jcv.2017.05.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/06/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Coxsackievirus A10 (CV-A10) is one of the etiological agents associated with hand, foot and mouth disease (HFMD) and usually causes mild cases. During 2009-2014, no severe cases caused by CV-A10 was reported in Xiamen, China, however, an increase in cases was seen in 2015. OBJECTIVES We aimed to perform a retrospective molecular epidemiological analysis of HFMD associated with CV-A10 infections in Xiamen. STUDY DESIGN CV-A10 VP1 (n=41) capsid and full-length or near full-length genomes (n=14) were sequenced. Phylogenetic trees were constructed based on these sequences and other reference sequences and nucleotide and amino acid changes were characterized. RESULTS From 2009-2014, no laboratory-confirmed CV-A10 infections associated with severe cases were identified, however, in 2015, 39% (7/18) of severe HFMD cases were CV-A10 infections. Sequence analysis of severe and non-severe CV-A10 HFMD cases determined that severe cases predominantly clustered with an emerging clade E lineage A strain which contained 4 nucleotide changes in 5' UTR and 5 amino acid substitutions in structural and non-structural proteins. CONCLUSIONS The results indicate CV-A10 infection may be emerging as a new and major cause of severe HFMD and CV-A10 surveillance should be increased and considered in HFMD prevention and control strategies.
Collapse
Affiliation(s)
- Mengyuan Chen
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; School of Public Health, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China.
| | - Shuizhen He
- Xiamen Center for Disease Control and Prevention, Shengguang Rd., Jimei District, Xiamen, China.
| | - Qiang Yan
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China.
| | - Xuerong Xu
- Xiamen Center for Disease Control and Prevention, Shengguang Rd., Jimei District, Xiamen, China.
| | - Wenhui Wu
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; School of Public Health, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China.
| | - Shengxiang Ge
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; School of Public Health, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China.
| | - Shiyin Zhang
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; School of Public Health, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China.
| | - Min Chen
- Xiamen Center for Disease Control and Prevention, Shengguang Rd., Jimei District, Xiamen, China.
| | - Ningshao Xia
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; School of Public Health, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China.
| |
Collapse
|
20
|
Epidemics and aetiology of hand, foot and mouth disease in Xiamen, China, from 2008 to 2015. Epidemiol Infect 2017; 145:1865-1874. [PMID: 28367766 DOI: 10.1017/s0950268817000309] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Over the past 8 years, human enteroviruses (HEVs) have caused 27 227 cases of hand, foot and mouth disease (HFMD) in Xiamen, including 99 severe cases and six deaths. We aimed to explore the molecular epidemiology of HFMD in Xiamen to inform the development of diagnostic assays, vaccines and other interventions. From January 2009 to September 2015, 5866 samples from sentinel hospitals were tested using nested reverse transcription PCR that targeted the HEV 5' untranslated region and viral protein 1 region. Of these samples, 4290 were tested positive for HEV and the amplicons were sequenced and genotyped. Twenty-two genotypes were identified. Enterovirus 71 (EV71) and coxsackieviruses A16, A6 and A10 (CA16, CA6 and CA10) were the most common genotypes, and there were no changes in the predominant lineages of these genotypes. EV71 became the most predominant genotype every 2 years. From 2013, CA6 replaced CA16 as one of the two most common genotypes. The results demonstrate the vast diversity of HFMD pathogens, and that minor genotypes are able to replace major genotypes. We recommend carrying-out long-term monitoring of the full spectrum of HFMD pathogens, which could facilitate epidemic prediction and the development of diagnostic assays and vaccines.
Collapse
|
21
|
Yang L, Liu Y, Li S, Zhao H, Lin Q, Yu H, Huang X, Zheng Q, Cheng T, Xia N. A novel inactivated enterovirus 71 vaccine can elicit cross-protective immunity against coxsackievirus A16 in mice. Vaccine 2016; 34:5938-5945. [PMID: 27771182 DOI: 10.1016/j.vaccine.2016.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 10/01/2016] [Accepted: 10/05/2016] [Indexed: 12/22/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is a highly contagious disease that mainly affects infants and children. Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are the major pathogens of HFMD. Two EV71 vaccines were recently licensed in China and the administration of the EV71 vaccines is believed to significantly reduce the number of HFMD-related severe or fatal cases. However, a monovalent EV71 vaccine cannot cross-protect against CA16 infection, this may result in that it cannot effectively control the overall HFMD epidemic. In this study, a chimeric EV71, whose VP1/210-225 epitope was replaced by that of CA16, was constructed using a reverse genetics technique to produce a candidate EV71/CA16 bivalent vaccine strain. The chimeric EV71 was infectious and showed similar growth characteristics as its parental strain. The replacement of the VP1/210-225 epitope did not significantly affect the antigenicity and immunogenicity of EV71. More importantly, the chimeric EV71 could induce protective immunity against both EV71 and CA16, and protect neonatal mice against either EV71 or CA16 lethal infections, the chimeric EV71 constructed in this study was shown to be a feasible and promising candidate bivalent vaccine against both EV71 and CA16. The construction of a chimeric enterovirus also provides an alternative platform for broad-spectrum HFMD vaccines development.
Collapse
Affiliation(s)
- Lisheng Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| | - Yajing Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| | - Shuxuan Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| | - Huan Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| | - Qiaona Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| | - Hai Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| | - Xiumin Huang
- Department of Obstetrics and Gynecology, Affiliated Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Qingbing Zheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| | - Tong Cheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China.
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China
| |
Collapse
|
22
|
Zhou HT, Guo YH, Chen MJ, Pan YX, Xue L, Wang B, Tao SH, Yu N. Changes in enterovirus serotype constituent ratios altered the clinical features of infected children in Guangdong Province, China, from 2010 to 2013. BMC Infect Dis 2016; 16:399. [PMID: 27506778 PMCID: PMC4977723 DOI: 10.1186/s12879-016-1690-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 06/21/2016] [Indexed: 11/17/2022] Open
Abstract
Background Enterovirus (EV)-related hand, foot, and mouth disease/herpangina (HFMD/HA) has been prevalent in Guangdong Province, China, since 2010. Methods Clinical data for EV-related HFMD/HA inpatients admitted to the Department of Paediatrics of Zhujiang Hospital from 2010 to 2013 were retrospectively reviewed. The corresponding EV serotypes were also determined by reverse transcription-polymerase chain reaction or BLAST analysis of the sequenced partial lengths of the viral protein1/5′-untranslated region. Results A total of 867 eligible inpatients admitted during 2010–2013 were included in the study. Of these, the serotype of the responsible EV was successfully identified in 824 cases. The incidence of enterovirus 71 (EV71) infection amongst pediatric HFMD/HA inpatients decreased dramatically from 55.5 % in 2010 to 8.1 % in 2013, with a similar decrease recorded for coxsackievirus A16 (CVA16). However, the incidence of non-EV71/CVA16 infection increased from 30.0 % in 2010 to 83.8 % in 2013. We noted that the types of infection caused by different EV serotypes varied: EV71 was responsible for 100 % of the paralysis cases (26/26), 84.6 % of the deaths (11/13), and 84.1 % of cases with severe central nervous system involvement (SCNSI) (74/88); echovirus contributed to 16.4 % of the deaths (2/13) and 4.4 % of the SCNSI cases; and coxsackievirus accounted for only 2.2 % of the SCNSI cases (2/90). The clinical features of HFMD/HA cases varied greatly during the time period examined, with drastic changes in the hospitalization rates (45.1, 63.7, 36.4, and 19.1 % for 2010, 2011, 2012, and 21013, respectively), mortality rates (2.3, 0.9, 2.5, and 0.0 %, respectively), paralysis (5.1, 1.2, 5.4, and 0.0 %, respectively), SCNSI (16.8, 7.1, 12.7, and 2.2 %, respectively), and acute respiratory infection (21.1, 22.0, 45.9, and 59.0 %, respectively). Conclusions The incidences of infection caused by different EV serotypes, along with the clinical features of HFMD/HA cases, changed drastically in Guangdong Province, China, from 2010 to 2013, with the biggest changes observed in 2013. The changed constituent ratios of the different EV serotypes might therefore be responsible for the differences in the observed clinical features of HFMD/HA during this period. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1690-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hong-Tao Zhou
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong ye da dao zhong, Guangzhou, 510282, People's Republic of China. .,Department of Clinical Laboratory, Hainan Provincial People's Hospital, No. 19 Xiuhua road, Haikou, 570311, People's Republic of China.
| | - Yong-Hui Guo
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong ye da dao zhong, Guangzhou, 510282, People's Republic of China
| | - Man-Jun Chen
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong ye da dao zhong, Guangzhou, 510282, People's Republic of China
| | - Yu-Xian Pan
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong ye da dao zhong, Guangzhou, 510282, People's Republic of China
| | - Lin Xue
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong ye da dao zhong, Guangzhou, 510282, People's Republic of China
| | - Bin Wang
- Department of Paediatrics, Zhujiang Hospital, Southern Medical University, Guangdong, 510282, People's Republic of China
| | - Shao-Hua Tao
- Department of Paediatrics, Zhujiang Hospital, Southern Medical University, Guangdong, 510282, People's Republic of China
| | - Nan Yu
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong ye da dao zhong, Guangzhou, 510282, People's Republic of China.
| |
Collapse
|
23
|
Niu P, Qi S, Yu B, Zhang C, Wang J, Li Q, Ma X. Development of a highly sensitive real-time nested RT-PCR assay in a single closed tube for detection of enterovirus 71 in hand, foot, and mouth disease. Arch Virol 2016; 161:3003-10. [PMID: 27475103 PMCID: PMC7086773 DOI: 10.1007/s00705-016-2985-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/11/2016] [Indexed: 12/29/2022]
Abstract
Enterovirus 71 (EV71) is one of the major causative agents of outbreaks of hand, foot, and mouth disease (HFMD). A commercial TaqMan probe-based real-time PCR assay has been widely used for the differential detection of EV71 despite its relatively high cost and failure to detect samples with a low viral load (Ct value > 35). In this study, a highly sensitive real-time nested RT-PCR (RTN RT-PCR) assay in a single closed tube for detection of EV71 in HFMD was developed. The sensitivity and specificity of this assay were evaluated using a reference EV71 stock and a panel of controls consisting of coxsackievirus A16 (CVA16) and common respiratory viruses, respectively. The clinical performance of this assay was evaluated and compared with those of a commercial TaqMan probe-based real-time PCR (qRT-PCR) assay and a traditional two-step nested RT-PCR assay. The limit of detection for the RTN RT-PCR assay was 0.01 TCID50/ml, with a Ct value of 38.3, which was the same as that of the traditional two-step nested RT-PCR assay and approximately tenfold lower than that of the qRT-PCR assay. When testing the reference strain EV71, this assay showed favorable detection reproducibility and no obvious cross-reactivity. The testing results of 100 clinical throat swabs from HFMD-suspected patients revealed that 41 samples were positive for EV71 by both RTN RT-PCR and traditional two-step nested RT-PCR assays, whereas only 29 were EV71 positive by qRT-PCR assay.
Collapse
Affiliation(s)
- Peihua Niu
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shunxiang Qi
- Institute for Viral Disease Control and Prevention, Center for Disease Control and Prevention of Hebei, Shijiazhuang, Hebei, People's Republic of China
| | - Benzhang Yu
- Department of Laboratory Medicine, Shengli Oil Field Central Hospital, Jinan Road, Dongying, Shandong, People's Republic of China
| | - Chen Zhang
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Ji Wang
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Qi Li
- Institute for Viral Disease Control and Prevention, Center for Disease Control and Prevention of Hebei, Shijiazhuang, Hebei, People's Republic of China.
| | - Xuejun Ma
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
| |
Collapse
|
24
|
Gao F, Bian LL, Mao QY, Chen P, Yao X, Li JX, Zhu FC, Liang ZL. An epidemic of coxsackievirus B3 infection in infants and children in Jiangsu Province, China: a prospective cohort study. Arch Virol 2016; 161:1945-7. [PMID: 27020571 DOI: 10.1007/s00705-016-2842-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/20/2016] [Indexed: 12/29/2022]
Abstract
To investigate the epidemiological data on coxsackievirus B3 (CVB3) infection and its incidence in infants and children, a prospective cohort study was carried out from 2012 to 2014 in Jiangsu Province, China. According to the results of seropositive rates and NTAb titers of CVB3, an epidemic of CVB3 infection was found, and a dynamic change in CVB3 neutralizing antibody was also observed. One case was recorded with CVB3-associated hand, foot and mouth disease (HFMD), and the isolates belonged to the CVB3 D2 subtype. Our data help us to better understand the epidemic characteristics of CVB3 infection in infants and children.
Collapse
Affiliation(s)
- Fan Gao
- National Institutes for Food and Drug Control, No. 2, Tiantan Xili, Beijing, 100050, People's Republic of China
| | - Lian-Lian Bian
- National Institutes for Food and Drug Control, No. 2, Tiantan Xili, Beijing, 100050, People's Republic of China
| | - Qun-Ying Mao
- National Institutes for Food and Drug Control, No. 2, Tiantan Xili, Beijing, 100050, People's Republic of China
| | - Pan Chen
- National Institutes for Food and Drug Control, No. 2, Tiantan Xili, Beijing, 100050, People's Republic of China
| | - Xin Yao
- National Institutes for Food and Drug Control, No. 2, Tiantan Xili, Beijing, 100050, People's Republic of China
| | - Jing-Xin Li
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Feng-Cai Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Zheng-Lun Liang
- National Institutes for Food and Drug Control, No. 2, Tiantan Xili, Beijing, 100050, People's Republic of China.
| |
Collapse
|
25
|
Zhou HT, Yi HS, Guo YH, Pan YX, Tao SH, Wang B, Chen MJ, Yang M, Yu N. Enterovirus-related diarrhoea in Guangdong, China: clinical features and implications in hand, foot and mouth disease and herpangina. BMC Infect Dis 2016; 16:128. [PMID: 26983856 PMCID: PMC4794821 DOI: 10.1186/s12879-016-1463-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 03/10/2016] [Indexed: 11/15/2022] Open
Abstract
Background A series of complications caused by enteroviruses, including meningitis, encephalitis, acute flaccid paralysis, acute cardiopulmonary failure, respiratory infection, and myocardial injury have been reported in hand, foot and mouth disease/herpangina (HFMD/HA). However, the complication of diarrhoea caused by enteroviruses has been neglected, and a summary of its clinical features and impact on HFMD/HA is unavailable. Methods We included inpatients with HFMD/HA admitted to the Paediatric Department of Zhujiang Hospital during 2009–2012. We summarised and compared clinical data for cases with and without diarrhoea, and determined enterovirus serotypes by reverse transcriptase polymerase chain reaction and genotyping based on a partial-length fragment of viral protein 1 or the 5’-untranslated region. Results There were 804 inpatients with HFMD/HA and 28 (3.5 %) presented with diarrhoea. Gastrointestinal symptoms were mild in most cases of diarrhoea (82.1 %), with high prevalence of no dehydration (82.1 %), short duration of diarrhoea (78.6 %) and watery stools (75.0 %). The prevalence of multi-organ dysfunction syndrome (10.7 vs 0.40 %) (p = 0.001), hepatic injury (14.3 vs 3.4 %) (p = 0.019), myocardial injury (21.4 vs 6.1 %) (p = 0.002) and convulsion (21.4 vs 7.2 %) (p = 0.016) was significantly higher in the diarrhoea than no diarrhoea group. There was no significant difference between the two groups regarding prevalence of death, altered consciousness, paralysis, central nervous system involvement, or acute respiratory infection. Conclusions Most patients with diarrhoea caused by enteroviruses circulating in Guangdong Province in 2009–2012 had mild or moderate gastrointestinal symptoms. Although enterovirus-related diarrhoea caused additional multi-organ dysfunction syndrome, hepatic injury and myocardial injury in children with HFMD/HA, timely intervention efficiently reduced disease severity and improved outcome.
Collapse
Affiliation(s)
- Hong-Tao Zhou
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong Ye Da Dao Zhong, Guangzhou, 510282, China. .,Department of Clinical Laboratory, Hainan Provincial People's Hospital, No. 19 Xiuhua Road,, Haikou, 570311, China.
| | - Hai-Su Yi
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong Ye Da Dao Zhong, Guangzhou, 510282, China
| | - Yong-Hui Guo
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong Ye Da Dao Zhong, Guangzhou, 510282, China
| | - Yu-Xian Pan
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong Ye Da Dao Zhong, Guangzhou, 510282, China
| | - Shao-Hua Tao
- Department of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangdong, 510282, China
| | - Bin Wang
- Department of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangdong, 510282, China
| | - Man-Jun Chen
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong Ye Da Dao Zhong, Guangzhou, 510282, China
| | - Mei Yang
- Department of Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangdong, 510282, China
| | - Nan Yu
- Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong Ye Da Dao Zhong, Guangzhou, 510282, China.
| |
Collapse
|
26
|
Zhang J, Weng Z, Du H, Xu F, He S, He D, Cheng T, Zhang J, Ge S, Xia N. Development and evaluation of rapid point-of-care tests for detection of Enterovirus 71 and Coxsackievirus A16 specific immunoglublin M antibodies. J Virol Methods 2016; 231:44-7. [PMID: 26912234 DOI: 10.1016/j.jviromet.2016.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/15/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
Abstract
Two colloidal gold immunochromatographic assays (CGIAs) for detection of EV71- and CA16- immunoglobulin M (IgM) were developed and evaluated. A total of 1465 sera collected from children with hand, foot, and mouth disease (HFMD), non-HFMD patients and healthy children. The sensitivity of IgM CGIA tests for EV71 and CA16 were 97.6% (330/338) and 91.6% (296/323) respectively, compared to those who were viral RNA positive by PCR. Their performances were comparable to those of commercial ELISA kits, with agreement of 98.1% for EV71-IgM and 97.3% for CA16-IgM. In addition, for EV71- and CA16-IgM CGIAs, the results of whole blood samples were 99.6% (248/249) and 100% (191/191) concordant to those with serum samples, respectively. As rapid point-of-care (POC) tests, the two CGIAs were suitable to be used in community clinic units, especially in resource-poor areas and will facilitate the control of HFMD.
Collapse
Affiliation(s)
- Jing Zhang
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, China
| | - Zuxing Weng
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Hailian Du
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, China
| | - Feihai Xu
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shuizhen He
- Xiamen Center for Disease Control and Prevention, Xiamen, China
| | - Delei He
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Tong Cheng
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, China
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shengxiang Ge
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
| | - Ningshao Xia
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, China
| |
Collapse
|
27
|
Molecular Diagnostics: Huge Impact on the Improvement of Public Health in China. Mol Microbiol 2016. [DOI: 10.1128/9781555819071.ch21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
28
|
Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:802046. [PMID: 26693489 PMCID: PMC4674665 DOI: 10.1155/2015/802046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/29/2015] [Accepted: 09/07/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hand-foot-and-mouth disease (HFMD) is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD. METHODS 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected. RESULTS The atypical HFMD accounted for 7.2% of total HFMD in the same period (64/887) and there were two peaks in its prevalence in nonepidemic seasons. Ten children (15.6%) had manifestations of neurologic involvement, of whom 4 (6.3%) were diagnosed with severe HFMD and 1 with critically severe HFMD, but all recovered smoothly. Onychomadesis and desquamation were found in 14 patients (21.9%) and 15 patients (23.4%), respectively. The most common pathogen was coxsackievirus A6 (CV-A6) which accounted for 67.2%, followed by nontypable enterovirus (26.6%), enterovirus 71 (EV-A71) (4.7%), and coxsackievirus A16 (A16) (1.5%). CONCLUSIONS Atypical HFMD has seasonal prevalence. The manifestations of neurologic involvement in atypical HFMD are mild and usually have a good prognosis. CV-A6 is a major pathogen causing atypical HFMD, but not a major pathogen in Chongqing, China.
Collapse
|
29
|
Guan H, Wang J, Wang C, Yang M, Liu L, Yang G, Ma X. Etiology of Multiple Non-EV71 and Non-CVA16 Enteroviruses Associated with Hand, Foot and Mouth Disease in Jinan, China, 2009-June 2013. PLoS One 2015; 10:e0142733. [PMID: 26562154 PMCID: PMC4642993 DOI: 10.1371/journal.pone.0142733] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 10/26/2015] [Indexed: 11/18/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is an infectious disease caused by human enterovirus 71 (EV71), coxsackievirus A16 (CVA16) and other enteroviruses. It is of interest that other enteroviruses associated with HFMD in Jinan have been rarely reported. The aim of the present study is to detect and characterize the circulating serotypes of non-EV71 and non-CVA16 enteroviruses associated with HFMD in Jinan city, Shandong province, China. A total of 400 specimens were collected from clinically diagnosed HFMD cases in Jinan from January 2009 to June 2013. All specimens were infected with non-EV71 and non-CVA16 enteroviruses previously confirmed by RT-PCR or real-time PCR according to the protocols at that time. The GeXP-based multiplex RT-PCR assay (GeXP assay) was performed to investigate the pathogen spectrum of 15 enteroviruses (coxsackieviruses A4, A5, A6, A9, A10, A16; coxsackieviruses B1, B3, B5; Echoviruses 6, 7, 11, 13, 19 and EV71) infections associated with HMFD. For GeXP assay negative samples, reverse transcription nested PCR (nested RT-PCR) based on the 5’ -untranslated region (5’- UTR) sequence and phylogenetic analysis were conducted to further explore the etiology of multiple enteroviruses. The results showed that a total of twenty serotypes of enteroviruses (including EV71 and CVA16) were identified by GeXP assay and nested RT-PCR. The most circulating twelve serotypes of enteroviruses with HFMD in Jinan from 2009 to June 2013 were EV71, CVA16, CVA10, CVA6, CVA12, CVA2, Echo3, CVA4, CVA9, CVB1, CVB3 and Echo6. CVA10 and CVA6 were the most prevalent pathogens other than EV71 and CVA16 in Jinan and their most prevalent seasons were spring and summer, and a slight increase was observed in autumn and early winter. It should be noted that mixed-infections were identified by GeXP assay and the phylogenetic tree clearly discriminated the multiple pathogens associated with HFMD. Our results thus demonstrate that there was a clear lack of a reliable testing method for EV71 and CVA16 and multiple non-EV71 and non-CVA16 enteroviruses associated with HFMD were present in Jinan. The GeXP assay combined with nested RT-PCR based on 5’-UTR region could meet the need for the national surveillance of multiple enteroviruses or the investigation of epidemic outbreaks triggered by enteroviruses in the future.
Collapse
Affiliation(s)
- Hengyun Guan
- Viral Disease Inspection Laboratory, Jinan Municipal Center for Disease Control and Prevention, Jinan, China
| | - Ji Wang
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chunrong Wang
- Viral Disease Inspection Laboratory, Jinan Municipal Center for Disease Control and Prevention, Jinan, China
| | - Mengjie Yang
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lanzheng Liu
- Viral Disease Inspection Laboratory, Jinan Municipal Center for Disease Control and Prevention, Jinan, China
- * E-mail: (LZL); (XJM)
| | - Guoliang Yang
- Viral Disease Inspection Laboratory, Jinan Municipal Center for Disease Control and Prevention, Jinan, China
| | - Xuejun Ma
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (LZL); (XJM)
| |
Collapse
|
30
|
Lai FF, Yan Q, Ge SX, Tang X, Chen RJ, Xu HM. Epidemiologic and etiologic characteristics of hand, foot, and mouth disease in Chongqing, China between 2010 and 2013. J Med Virol 2015; 88:408-16. [PMID: 26255857 DOI: 10.1002/jmv.24349] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2015] [Indexed: 12/11/2022]
Abstract
Hand, foot, and mouth disease (HFMD) has become very common in children, with widespread occurrence across China. The aim of this study was to investigate the epidemiologic and etiologic characteristics of HFMD, including etiologic variations in Chongqing, China. An epidemiologic investigation was based on 3,472 patients who presented with HFMD manifestations and were admitted at the Children's Hospital of Chongqing Medical University between 2010 and 2013. Fecal specimens from 830 patients were analyzed by nested RT-PCR to identify the enterovirus pathogens, and the molecular characterization of HFMD was illustrated by phylogenetic tree analysis. The results of this study indicate that the peak of the HFMD epidemic in Chongqing between 2010 and 2013 occurred between April and July each year. The median age of onset was 2.24 years old, and children under the age of five accounted for 96.4% of all the HFMD cases; the male-to-female ratio was 1.89:1. Enterovirus 71 accounted for a major proportion of the isolated strains every year, including the majority (74%) of severe cases. However, the proportion of Coxsackie A (CV-A) 6 infections increased from 2.11% in 2010 to 16.36% in 2013, while the proportion of CV-A16 infections decreased from 31.23% in 2010 to 4.67% in 2013. Molecular epidemiologic study showed that all enterovirus 71 strains belonged to subgenotype C4a, whereas all CV-A16 strains belonged to genotype B1, including subgenotype B1a and subgenotype B1b.
Collapse
Affiliation(s)
- Fang-Fang Lai
- Department of Infectious Diseases, Children's Hosptital of Chongqing Medical University, Yuzhong District, Chongqing, China.,Key Laboratory of Developmental Diseases in Childhood, Chongqing Medical University, Ministry of Education, Yuzhong District, Chongqing, China.,Key Laboratory of Pediatrics, Committee of Science and Technology in Chongqing, Yuzhong District, Chongqing, China
| | - Qiang Yan
- National Institute of Diagnostics and Vaccine Development in Infectious Disease, Xiamen University, Xiamen, China
| | - Sheng-Xiang Ge
- National Institute of Diagnostics and Vaccine Development in Infectious Disease, Xiamen University, Xiamen, China
| | - Xiang Tang
- Department of Infectious Diseases, Children's Hosptital of Chongqing Medical University, Yuzhong District, Chongqing, China.,Key Laboratory of Developmental Diseases in Childhood, Chongqing Medical University, Ministry of Education, Yuzhong District, Chongqing, China.,Key Laboratory of Pediatrics, Committee of Science and Technology in Chongqing, Yuzhong District, Chongqing, China
| | - Ru-Juan Chen
- Department of Infectious Diseases, Children's Hosptital of Chongqing Medical University, Yuzhong District, Chongqing, China.,Key Laboratory of Developmental Diseases in Childhood, Chongqing Medical University, Ministry of Education, Yuzhong District, Chongqing, China.,Key Laboratory of Pediatrics, Committee of Science and Technology in Chongqing, Yuzhong District, Chongqing, China
| | - Hong-Mei Xu
- Department of Infectious Diseases, Children's Hosptital of Chongqing Medical University, Yuzhong District, Chongqing, China.,Key Laboratory of Developmental Diseases in Childhood, Chongqing Medical University, Ministry of Education, Yuzhong District, Chongqing, China.,Key Laboratory of Pediatrics, Committee of Science and Technology in Chongqing, Yuzhong District, Chongqing, China
| |
Collapse
|
31
|
Mayaphi S, van Zyl W, Sono T, Loots D, Taylor M. Hand-foot-and-mouth disease caused by coxsackievirus A6 in a patient infected with HIV. S Afr J Infect Dis 2015. [DOI: 10.1080/23120053.2015.1054218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
32
|
Yao X, Bian LL, Lu WW, Li JX, Mao QY, Wang YP, Gao F, Wu X, Ye Q, Xu M, Li XL, Zhu FC, Liang ZL. Enterovirus spectrum from the active surveillance of hand foot and mouth disease patients under the clinical trial of inactivated Enterovirus A71 vaccine in Jiangsu, China, 2012-2013. J Med Virol 2015; 87:2009-17. [DOI: 10.1002/jmv.24275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Xin Yao
- National Institute for Food and Drug Control; Beijing China
| | - Lian-Lian Bian
- National Institute for Food and Drug Control; Beijing China
| | | | - Jing-Xin Li
- Jiangsu Provincial Center for Disease Control and Prevention; Nanjing China
| | - Qun-Ying Mao
- National Institute for Food and Drug Control; Beijing China
| | - Yi-Ping Wang
- National Institute for Food and Drug Control; Beijing China
| | - Fan Gao
- National Institute for Food and Drug Control; Beijing China
| | - Xing Wu
- National Institute for Food and Drug Control; Beijing China
| | - Qiang Ye
- National Institute for Food and Drug Control; Beijing China
| | - Miao Xu
- National Institute for Food and Drug Control; Beijing China
| | | | - Feng-Cai Zhu
- Jiangsu Provincial Center for Disease Control and Prevention; Nanjing China
| | | |
Collapse
|
33
|
Yang Q, Ding J, Cao J, Huang Q, Hong C, Yang B. Epidemiological and etiological characteristics of hand, foot, and mouth disease in Wuhan, China from 2012 to 2013: outbreaks of coxsackieviruses A10. J Med Virol 2015; 87:954-60. [PMID: 25754274 DOI: 10.1002/jmv.24151] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2015] [Indexed: 11/06/2022]
Abstract
Hand-foot-mouth disease (HFMD) is a common infectious disease which often occurs in young children. It is caused by enteroviruses, most commonly enterovirus71 (EV71) and Coxsackievirus A16 (CVA16). The present study focuses on the molecular epidemiology of the pathogen of HFMD in the Wuhan region of China during the period 2012 to 2013. A total of 463 viruses were isolated from throat swab of 3,208 HFMD patients and analyzed by quantitative RT-PCR with all sets of specific primers for EV71, CVA16, and pan-enterovirus. Of the 463 viruses, 111 (21.2%) were EV71, 52 (9.6%) were CVA16, and 300 (69.2%) were pan-enterovirus. In pan-enterovirus isolations 190 (52.8%) were CVA10, 50 (13.9%) were CVA4, 30 were CB2, 17 were CB3, 13 were CB5 identified by VP4 gene sequencing. Eleven EV71 isolates were complete genome sequenced and phylogenetic analysis revealed that the EV71 strains that circulated in Wuhan belonged to the C4 subgenotype. Among the 190 CVA10 isolations, 187 CVA10 strains have the same nucleotide sequence, the other three CVA10 strains belongs to another type of nucleotide sequence. Phylogenetic analysis based on 19 CVA10 isolations suggested that they belonged to the clade of Chinese strains, but form different clusters isolated from Japan, Europe. This study showed that EVA71 and CVA16 were detected as the predominant viruses (>60%) in 2012 and the total reported HFMD cases attained a peak in June and July. In contrast, CVA10 was also detected during April 2012 and replaced EVA71 and CVA16 as the major HFMD-associated pathogen from May 2013.
Collapse
Affiliation(s)
- Qin Yang
- Department of Medical Laboratory, Wuhan General Hospital of Guangzhou Command, Wuhan, China
| | | | | | | | | | | |
Collapse
|
34
|
Phylogenetic analysis of the major causative agents of hand, foot and mouth disease in Suzhou City, Jiangsu province, China, in 2012-2013. Emerg Microbes Infect 2015; 4:e12. [PMID: 26038764 PMCID: PMC4345287 DOI: 10.1038/emi.2015.12] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 12/11/2014] [Accepted: 01/15/2015] [Indexed: 11/29/2022]
Abstract
Hand, foot and mouth disease (HFMD) is a serious public health problem that has emerged over the past several decades. Pathogen detection by the Chinese national HFMD surveillance system has focused mainly on enterovirus 71 (EV71) and coxsackievirus A16 (CA16). Therefore, epidemiological information regarding the other causative enteroviruses is limited. To identify the pandemic enterovirus in Suzhou, Jiangsu province, China, clinical samples from patients with HFMD were collected from 2012 to 2013 and analyzed. The results revealed that CA16 was the most dominant HFMD pathogen in 2012, whereas CA6 and CA10 were the dominant pathogens in 2013. Phylogenetic analysis revealed that the C4a sub-genogroup of EV71 and the B1a and B1b sub-genogroups of CA16 continued to evolve and circulate in Suzhou. The CA6 strains were assigned to six genotypes (A–F) and the CA10 strains were assigned to seven genotypes (A–G), with clear geographical and temporal distributions. All of the CA6 strains in Suzhou belonged to genogroup F, and there were several lineages circulating in Suzhou. All of the CA10 strains in Suzhou belonged to genogroup G, and they had the same genetic origin. Co-infections of EV71/CA16 and CA6/CA10 were found in the samples, and bootscan analysis of 5′-untranslated regions (UTRs) revealed that some CA16 strains in Suzhou had genetic recombination with EV71. This property might allow CA16 to alter its evolvability and circulating ability. This study underscores the need for surveillance of CA6 and CA10 in the Yangtze River Delta and East China.
Collapse
|
35
|
Echovirus 7 associated with hand, foot, and mouth disease in mainland China has undergone a recombination event. Arch Virol 2015; 160:1291-5. [PMID: 25680567 PMCID: PMC4412592 DOI: 10.1007/s00705-015-2350-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 01/24/2015] [Indexed: 02/06/2023]
Abstract
To investigate the evolution of echovirus 7 (Echo7) strains and the relationship between Echo7 strains and the prototype strain Wallace, phylogenetic analysis of Echo7 strains prevailing in mainland China was performed. The Echo7 strain, DH22G/JS/2012 was isolated from a 32-month-old boy who was clinically diagnosed with HFMD. The complete genome sequence of this isolate was determined after the virus was propagated in cell culture. Phylogenetic analysis showed that the subgroups B1 and C1 prevailed in mainland China from 1998 to 2012 and that the subgroup B2 began to circulate in mainland China in 2009. The result of Simplot analysis showed that the Echo7 strain DH22G/JS/2012 is a recombinant coxsackievirus B4 (CVB4) that circulated in mainland China in 2010.
Collapse
|
36
|
Zhang S, Wang J, Yan Q, He S, Zhou W, Ge S, Xia N. A one-step, triplex, real-time RT-PCR assay for the simultaneous detection of enterovirus 71, coxsackie A16 and pan-enterovirus in a single tube. PLoS One 2014; 9:e102724. [PMID: 25029500 PMCID: PMC4100918 DOI: 10.1371/journal.pone.0102724] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 05/16/2014] [Indexed: 01/22/2023] Open
Abstract
The recent, ongoing epidemic of hand, foot, and mouth disease (HFMD), which is caused by enterovirus infection, has affected millions of children and resulted in thousands of deaths in China. Enterovirus 71 (EV71) and coxsackie A16 (CA16) are the two major distinct pathogens for HFMD. However, EV71 is more commonly associated with neurologic complications and even fatalities. Therefore, simultaneously detecting and differentiating EV71 and CA16 specifically from other enteroviruses for diagnosing HFMD is important. Here, we developed a one-step, triplex, real-time RT-PCR assay for the simultaneous detection of EV71, CA16, and pan-enterovirus (EVs) in a single tube with an internal amplification control. The detection results for the serially diluted viruses indicate that the lower limit of detection for this assay is 0.001–0.04 TCID50/ml, 0.02 TCID50/ml, and 0.001 TCID50/ml for EVs, EV71, and CA16, respectively. After evaluating known HFMD virus stocks of 17 strains of 16 different serotypes, this assay showed a favorable detection spectrum and no obvious cross-reactivity. The results for 141 clinical throat swabs from HFMD-suspected patients demonstrated sensitivities of 98.4%, 98.7%, and 100% for EVs, EV71, and CA16, respectively, and 100% specificity for each virus. The application of this one-step, triplex, real-time RT-PCR assay in clinical units will contribute to HFMD surveillance and help to identify causative pathogen in patients with suspected HFMD.
Collapse
Affiliation(s)
- Shiyin Zhang
- National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Life Science, Xiamen University, Xiamen, Fujian, China
| | - Jin Wang
- Xiamen Innovax Biotech Co., LTD, Xiamen, Fujian, China
| | - Qiang Yan
- Xiamen Innovax Biotech Co., LTD, Xiamen, Fujian, China
| | - Shuizhen He
- Xiamen Center for Disease Control and Prevention, Fujian, China
| | - Wenbin Zhou
- Xiamen Innovax Biotech Co., LTD, Xiamen, Fujian, China
| | - Shengxiang Ge
- National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Life Science, Xiamen University, Xiamen, Fujian, China
- School of Public Health, Xiamen University, Xiamen, China
- * E-mail:
| | - Ningshao Xia
- National Institute of Diagnostics and Vaccine Development in Infectious Disease, School of Life Science, Xiamen University, Xiamen, Fujian, China
- School of Public Health, Xiamen University, Xiamen, China
| |
Collapse
|
37
|
A Convenient Nucleic Acid Test on the Basis of the Capillary Convective PCR for the On-Site Detection of Enterovirus 71. J Mol Diagn 2014; 16:452-8. [DOI: 10.1016/j.jmoldx.2014.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 03/25/2014] [Accepted: 04/04/2014] [Indexed: 01/15/2023] Open
|
38
|
Yang L, He D, Tang M, Li Z, Liu C, Xu L, Chen Y, Du H, Zhao Q, Zhang J, Cheng T, Xia N. Development of an enzyme-linked immunosorbent spot assay to measure serum-neutralizing antibodies against coxsackievirus B3. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 21:312-20. [PMID: 24391137 PMCID: PMC3957675 DOI: 10.1128/cvi.00359-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 12/23/2013] [Indexed: 11/20/2022]
Abstract
Coxsackievirus B3 (CVB3) is the most common pathogen that induces acute and chronic viral myocarditis in children. The cytopathic effect (CPE)-based neutralization test (Nt-CPE) and the plaque reduction neutralization test (PRNT) are the most common methods for measuring neutralizing antibody titers against CVB3 in blood serum samples. However, these two methods are inefficient for CVB3 vaccine clinical trials, which require the testing of a large number of serum specimens. In this study, we developed an efficient neutralization test based on the enzyme-linked immunospot (Nt-ELISPOT) assay for measuring CVB3-neutralizing antibodies. This modified ELISPOT assay was based on the use of a monoclonal antibody against the viral capsid protein VP1 to detect the cells that are infected with CVB3, which, after immunoperoxidase staining, are counted as spots using an automated ELISPOT analyzer. Using the modified ELISPOT assay, we characterized the infection kinetics of CVB3 and divided the infection process of CVB3 on a cluster of cells into four phases. The stability of the Nt-ELISPOT was then evaluated. We found that over a wide range of infectious doses (10(2) to 10(6.5)× 50% tissue culture infectious dose [TCID(50)] per well), the neutralizing titers of the sera were steady as long as they were tested during the log phase or the first half of the stationary phase of growth of the spots. We successfully shortened the testing period from 7 days to approximately 20 h. We also found that there was a good correlation (R(2) = 0.9462) between the Nt-ELISPOT and the Nt-CPE assays. Overall, the Nt-ELISPOT assay is a reliable and efficient method for measuring neutralizing antibodies in serum.
Collapse
|
39
|
Chen J, Fu Y, Ju L, Miao X, Shen Y, He L, Wang W, Jin J, Shao L, Sampath R, Ecker DJ, Zhang Y, Li M, Cheng X, Zhang W. Detection and identification of viral pathogens in patients with hand, foot, and mouth disease by multilocus PCR, reverse-transcription PCR and electrospray ionization mass spectrometry. J Clin Virol 2014; 59:115-9. [DOI: 10.1016/j.jcv.2013.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 11/11/2013] [Accepted: 11/18/2013] [Indexed: 11/25/2022]
|
40
|
Pellegrinelli L, Binda S, Chiaramonte I, Primache V, Fiore L, Battistone A, Fiore S, Gambino M, Bubba L, Barbi M. Detection and distribution of culturable Human Enteroviruses through environmental surveillance in Milan, Italy. J Appl Microbiol 2013; 115:1231-9. [PMID: 23910458 DOI: 10.1111/jam.12321] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/05/2013] [Accepted: 07/28/2013] [Indexed: 12/22/2022]
Abstract
AIMS Human Enteroviruses (HEVs) infections have a significant impact on public health, being implicated in outbreaks of meningitis, encephalitis, hand-foot-mouth disease and other acute and chronic manifestation. In the strategic plan for poliomyelitis eradication, the environmental surveillance of poliovirus (PV) has been identified by the World Health Organization (WHO) as an activity that can complement the surveillance of polio. Having wastewater samples available for PV surveillance allows us to study nonpolio enteroviruses (NPEVs) circulating in the study population, which are widely spread. METHODS AND RESULTS This study was carried out according to the WHO guidelines for environmental surveillance of PV and analysed the circulation of PV and NPEVs through the isolation of viruses in cell cultures in Milan area; from 2006 to 2010, 321 wastewater samples were collected, regularly over time, at the inlet of three diverse waste water treatment plants (WWTPs). Culturable HEVs were isolated in 80% of sewage samples: all isolates belonged to the HEV-B group and those circulating more intensely were CVB5 and Echo 6, while CVB4 was the predominant serotype found in 2010. In this study, two type 2 PVs were isolated, both characterized as Sabin like. CONCLUSION Environmental monitoring of HEVs in Milan has proved to be an interesting tool to investigate the circulation and distribution of viruses. SIGNIFICANCE AND IMPACT OF THE STUDY The detection of PV and other NPEV could be predictive of possible re-emergence of these viruses with an impact on public health. NPEV monitoring could also be a powerful public health tool to investigate the possible role of NPEV in different clinical manifestations.
Collapse
Affiliation(s)
- L Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|