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Gyeltshen S, Dorji T, Dorji K, Wangchuk S, Tshering D, Poolpanichupatam Y, Chinnawirotpisan P, Manasatienkij W, Wuertz KAM, Farmer AR, Klungthong C. Coxsackievirus A24 variant associated with acute hemorrhagic conjunctivitis outbreak in Bhutan, 2023. Sci Rep 2025; 15:14864. [PMID: 40295540 PMCID: PMC12037851 DOI: 10.1038/s41598-025-94776-7] [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: 07/26/2024] [Accepted: 03/17/2025] [Indexed: 04/30/2025] Open
Abstract
In 2023, Bhutan detected an outbreak of acute hemorrhagic conjunctivitis (AHC) in southern and central regions, coinciding with similar outbreaks reported in South and Southeast Asia. Laboratory results from clinical specimens were initially inconclusive in identifying the etiological agent. To address this, 18 clinical samples, comprising conjunctival swabs and throat/nasal swabs from nine patients were collected and sent to WRAIR-AFRIMS for further analysis. Specimens were tested using multiplex real-time RT-PCR (Fast-track respiratory 21 kit, FTD21) and hybrid-capture-based next-generation sequencing (NGS) with the Illumina Viral Surveillance Panel. FTD21 testing identified human adenovirus, human bocavirus, influenza A, enterovirus, and/or human rhinovirus in 10/18 specimens (56%). A higher detection rate was observed in conjunctival specimens (78%, 7/9) compared to throat/nasal specimens (33%, 3/9) from the same patients, highlighting the increased sensitivity of conjunctival samples in identifying causative agents of conjunctivitis. Further assessment by NGS detected only coxsackievirus A24 variant (CVA24v) genotype IV in 9/17 specimens (53%), with detection primarily from conjunctival samples. Phylogenetic analyses of CVA24v VP1 sequences revealed genetic distinctions in the 2023 isolates compared to prior outbreaks from 2002-2017, suggesting re-emergence driven by novel genetic mutations. These findings suggest that conjunctival samples are more reliable for detecting the etiological agent in AHC outbreaks compared to throat/nasal swabs. Additionally, the identification of a novel strain of CVA24v genotype IV underscores the importance of genomics.
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Affiliation(s)
- Sonam Gyeltshen
- Royal Centre for Disease Control, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - Tshering Dorji
- Royal Centre for Disease Control, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan.
| | - Kunzang Dorji
- Royal Centre for Disease Control, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - Dorji Tshering
- Phuntsholing General Hospital, National Medical Services, Royal Government of Bhutan, Phuntsholing, Bhutan
| | - Yongyuth Poolpanichupatam
- Department of Virology, Walter Reed Army Institute of Research-Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Piyawan Chinnawirotpisan
- Department of Virology, Walter Reed Army Institute of Research-Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
| | - Wudtichai Manasatienkij
- Department of Virology, Walter Reed Army Institute of Research-Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Kathryn A McGuckin Wuertz
- Department of Virology, Walter Reed Army Institute of Research-Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Aaron R Farmer
- Department of Virology, Walter Reed Army Institute of Research-Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Chonticha Klungthong
- Department of Virology, Walter Reed Army Institute of Research-Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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Sun W, Chen Y, Qin S, Miao Z. Epidemiology and spatiotemporal analysis of acute hemorrhagic conjunctivitis in Zhejiang province, China (2004-2023). Front Public Health 2025; 13:1509495. [PMID: 39968230 PMCID: PMC11833792 DOI: 10.3389/fpubh.2025.1509495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Accepted: 01/13/2025] [Indexed: 02/20/2025] Open
Abstract
Background Acute hemorrhagic conjunctivitis (AHC) has become a significant public health issue in Zhejiang province. However, the analysis of epidemiological characteristics and spatio-temporal patterns of AHC in Zhejiang province has not been studied yet. Methods Monthly cases of AHC from 2004 to 2023 reported at the county level in Zhejiang province were obtained from the China Information System for Disease Control and Prevention. Demographic features, yearly county incidence, global spatial autocorrelation, local spatial autocorrelation analyses, and temporal and space-time cluster analysis were performed to identify and visualize the spatiotemporal patterns of AHC cases in Zhejiang province. The epidemiological characteristics of AHC outbreaks in the same period in Zhejiang province were also compared. Results A total of 52,119 AHC cases were reported in Zhejiang province, yielding an average incidence rate of 5.37 per 100,000. No fatalities were reported. The average age of those affected was 25.44 ± 4.37 years, with the highest incidence (16.70%) among individuals aged between 10 and 19 years. Seasonal peaks occur from August to October each year. Students and farmers experienced the highest incidence rates of infection. Significant positive spatial correlations for AHC were observed in Zhejiang province in the years 2007 (Moran's I = 0.095, p = 0.039), 2009 (Moran's I = 0.075, p = 0.031), and 2011 (Moran's I = 0.173, p = 0.034), indicating spatial clustering. Spatiotemporal scanning identified two distinct clusters: Cluster 1 and Cluster 2. Cluster 1, characterized by a relative risk of 21.44 (p < 0.001), was located in northeastern Zhejiang province, comprising 30 counties, with an active period from 1st September 2010 to 30th September 2010. Compared to low-risk regions, high-risk counties exhibited a different demographic profile with a higher proportion of men, older people, and farmers. Among the affected students during outbreaks, the predominant symptoms were conjunctival congestion, increased eye secretions, eye swelling, eye pain, photophobia and tearing, while the incidence of fever was relatively low. Conclusion The results of this study demonstrate the spatiotemporal heterogeneity of AHC cases in Zhejiang province and underscore the necessity for targeted prevention and control measures in high-risk areas to mitigate transmission and occurrence.
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Affiliation(s)
| | | | | | - Ziping Miao
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Thakur A, Sharma D, Singh MP, Chauhan P, Shah A, Angra V, Ghosh A, Malhotra C, Goyal K, Gupta A. Clinical and molecular investigation of acute haemorrhagic conjunctivitis outbreak in North India (2023). Int Ophthalmol 2024; 44:444. [PMID: 39633189 DOI: 10.1007/s10792-024-03368-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Accepted: 11/23/2024] [Indexed: 12/07/2024]
Abstract
PURPOSE The study aims to investigate an outbreak of acute haemorrhagic conjunctivitis (AHC) reported in North India. METHODS All patients presenting to the outpatient clinic department with signs and symptoms (symptoms onset within 36 h) of AHC were enrolled in the study. The conjunctival swab samples were tested for the presence of enteroviruses and adenoviruses. Detailed clinical features of all positive patients were noted. Representative enterovirus-positive samples were sequenced for viral; protein 1 (VP1) gene for type identification. The sequences were analysed by the Basic Local Alignment Search Tool (BLAST) software and enterovirus genotyping tool v1.0. A maximum likelihood tree was constructed using MEGA11. RESULTS Out of 133 samples tested, 75.1% (n = 100) samples were positive for enterovirus by real-time PCR. The average duration of onset was 16.9 h. Subconjunctival haemorrhage was observed in 67% of the patients, while 30% of cases had conjunctival chemosis. The causative agent of the current outbreak was identified as Coxsackievirus A24v G-IV. A sequence homology of 96-99% and pairwise distance divergence of 2.9% was observed between study sequences and recent sequences of China outbreak. Mutation analysis showed four common mutations (T281C, A311G, T332C, and T395C) with those of Chinese sequences, however no new mutations were identified in current study sequences, suggesting a close relatedness to CVA24 sequences from China. CONCLUSIONS Coxsackievirus A24v continues to be an important agent of Acute Haemorrhagic conjunctivitis in North India. In view of its highly contagious nature, effective and timely public health measures are required to limit its spread.
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Affiliation(s)
- Anchal Thakur
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepanjli Sharma
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mini P Singh
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Poonam Chauhan
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aryan Shah
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vani Angra
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnab Ghosh
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Chintan Malhotra
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kapil Goyal
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Aishwarya A, Agarwal A, Saxena D, Jain V, Singh A, Agarwal R. Clinical Features and Epidemiological Insights of Acute Epidemic Conjunctivitis: A Multicentric Cross-Sectional Study in North Central India. Rom J Ophthalmol 2024; 68:372-378. [PMID: 39936060 PMCID: PMC11809833 DOI: 10.22336/rjo.2024.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2024] [Indexed: 02/13/2025] Open
Abstract
Purpose To gain epidemiological insights by investigating the age, risk factors, and clinical features of individuals affected by the conjunctivitis outbreak. Methods The study was conducted at various ophthalmic centers, involving participants with clinical symptoms of acute conjunctivitis within one week from 15 June 2024 to 15 July 2024. Demographic information, clinical features, signs, and symptoms were recorded and analyzed using SPSS version 21.0 and MedCalc software. Results The study included 920 patients (1722 eyes), 56% males and 44% females, and most cases were bilateral (94%). Among the affected groups, hospital staff (43%) were the most affected, followed by school-going children (31%), those in direct contact with infected individuals (17%), or others (11%). The median age of onset was 26 years, with a range spanning from 2 to 76 years. The age group most affected was 19-49 years (52%), followed by <18 years (34%) and the elderly group (14%). The most common and first symptom was foreign body sensation (92%), and additional symptoms included ocular itching (81%) and watering (80%). The most prevalent signs were conjunctival congestion (99%), follicles (96%), subconjunctival bleeding (43%), eyelid swelling (51%), chemosis (39%), and pre-auricular lymph node enlargement (6%). Corneal involvement was not observed. Discussions Acute Epidemic Conjunctivitis (AEC) outbreaks have significant implications for public health, particularly regarding healthcare resource utilization, economic burden, and disruption of daily life. Timely identification, effective communication, and coordinated response strategies are essential to managing AEC outbreaks and preventing their escalation. Conclusion This study provides crucial insights into epidemic conjunctivitis in North Central India. The study findings can guide targeted interventions and healthcare resource allocation to manage the outbreak effectively.
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Affiliation(s)
- Ankita Aishwarya
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
| | - Amit Agarwal
- Agarwal Netralaya, Aishbagh, D.A.V College Market, Lucknow
| | - Deepti Saxena
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
| | - Vaibhav Jain
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
| | - Adarsh Singh
- CBMR, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
| | - Rachna Agarwal
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
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Tran H, Ha T, Hoang L, Tran Y, Ruder K, Zhong L, Chen C, Liu Y, Yu D, Abraham T, Hinterwirth A, Deiner M, Porco TC, Lietman TM, Doan T, Seitzman GD. Coxsackievirus A24 causing acute conjunctivitis in a 2023 outbreak in Vietnam. Int J Infect Dis 2024; 146:107133. [PMID: 38876162 PMCID: PMC11847566 DOI: 10.1016/j.ijid.2024.107133] [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: 04/15/2024] [Revised: 05/19/2024] [Accepted: 06/07/2024] [Indexed: 06/16/2024] Open
Abstract
OBJECTIVES To determine the associated pathogen during the 2023 conjunctivitis outbreak in Vietnam METHODS: RNA-sequencing was used to identify pathogens before and during the outbreak. RESULTS 24 patients with infectious conjunctivitis between March and October 2023 from Hai Yen Vision Institute in Vietnam were swabbed. Coxsackievirus A24v was the most common pathogen identified. Phylogenetic analysis of these strains demonstrates similarities to the Coxsackievirus identified in the 2022 India outbreak. Human adenovirus D was also circulating. Ocular findings of tearing, purulence, and itching were common in this outbreak. CONCLUSIONS Multiple viruses can co-circulate during conjunctivitis outbreaks. Hemorrhagic conjunctivitis, commonly associated with coxsackievirus conjunctivitis, was not a common clinical sign in this outbreak. Repeat genetic surveillance, with the notable inclusion of RNA virus detection strategies, is important for outbreak detection.
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Affiliation(s)
- Huy Tran
- Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
| | - Thao Ha
- Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
| | - Linh Hoang
- Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
| | - Yen Tran
- Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
| | - Kevin Ruder
- Francis I. Proctor Foundation, University of California, San Francisco, USA
| | - Lina Zhong
- Francis I. Proctor Foundation, University of California, San Francisco, USA
| | - Cindi Chen
- Francis I. Proctor Foundation, University of California, San Francisco, USA
| | - YuHeng Liu
- Francis I. Proctor Foundation, University of California, San Francisco, USA
| | - Danny Yu
- Francis I. Proctor Foundation, University of California, San Francisco, USA
| | - Thomas Abraham
- Francis I. Proctor Foundation, University of California, San Francisco, USA
| | - Armin Hinterwirth
- Francis I. Proctor Foundation, University of California, San Francisco, USA
| | - Michael Deiner
- Department of Ophthalmology, University of California, San Francisco, USA
| | - Travis C Porco
- Department of Ophthalmology, University of California, San Francisco, USA
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, USA; Department of Ophthalmology, University of California, San Francisco, USA
| | - Thuy Doan
- Francis I. Proctor Foundation, University of California, San Francisco, USA; Department of Ophthalmology, University of California, San Francisco, USA.
| | - Gerami D Seitzman
- Francis I. Proctor Foundation, University of California, San Francisco, USA; Department of Ophthalmology, University of California, San Francisco, USA
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Aishwarya A, Agarwal R, Garg A, Jain V. Clinical insights and real-time PCR analysis of the first adeno-enterovirus conjunctivitis outbreak in India: A comprehensive cross-sectional study. J Postgrad Med 2024; 70:143-148. [PMID: 39108093 PMCID: PMC11458071 DOI: 10.4103/jpgm.jpgm_256_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/15/2024] [Indexed: 09/01/2024] Open
Abstract
OBJECTIVE This cross-sectional study aimed to investigate the emergence of adeno-enterovirus conjunctivitis, with a focus on its clinical manifestations, prevalence, and implications within the context of acute epidemic conjunctivitis. METHODS Real-time PCR analysis was employed to precisely identify the viral strain in conjunctival swab samples. A total of 80 patients were tested, and specific clinical symptoms were assessed. RESULTS The study revealed the first documented case in India and the second worldwide of adeno-enterovirus conjunctivitis. The prevalence among the tested patients was significant, with 15% testing positive. Those infected with adeno-enterovirus exhibited shorter illnesses (≤3 days). Notably, clinical symptoms such as subconjunctival hemorrhage, chemosis, swelling, photophobia, and epiphora were significantly linked to this viral variant. Multivariable logistic regression analysis highlighted swelling and photophobia as robust predictors for identifying adeno-enterovirus conjunctivitis cases. CONCLUSION The findings underscore the urgent need to recognize adeno-enterovirus conjunctivitis as a potential threat, capable of causing significant ocular morbidity. Swelling and photophobia emerged as robust predictors for identifying cases, emphasizing the importance of vigilant monitoring and comprehension of this viral variant. Proactive measures are essential to address its clinical implications and mitigate its impact on affected populations. Ongoing research is crucial to unravel the complete spectrum of adeno-enterovirus conjunctivitis and guide effective management strategies.
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Affiliation(s)
- A Aishwarya
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - R Agarwal
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - A Garg
- Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - V Jain
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Gui SY, Qiao JC, Wang XC, Yang F, Hu CY, Tao FB, Yi XL, Jiang ZX. Long-term effects of meteorological factors and extreme weather on daily outpatient visits for conjunctivitis from 2013 to 2020: a time-series study in Urumqi, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:58041-58057. [PMID: 36977878 PMCID: PMC10047460 DOI: 10.1007/s11356-023-26335-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/03/2023] [Indexed: 05/07/2023]
Abstract
Conjunctivitis is a common multifactorial inflammatory ocular surface disease characterized by symptoms such as congestion, edema, and increased secretion of conjunctival tissue, and the potential effects of meteorological factors as well as extreme meteorological factors on conjunctivitis and their lagging effects have not been fully evaluated. We obtained the electronic case information of 59,731 outpatients with conjunctivitis from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China) for the period from January 1, 2013, to December 31, 2020. Meteorological data for daily mean temperature (°C), daily relative humidity (%), daily average wind speed (m/s), and atmospheric pressure (hPa) were obtained from the China Meteorological Data Sharing Service. The air pollutant data were obtained from 11 standard urban background fixed air quality monitors. A time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) were used to fit the effects of exposure to different meteorological factors and extreme weather on conjunctivitis outpatient visits. Subgroup analyses were performed on gender, age and season, and type of conjunctivitis. Univariate and multifactorial model results indicated that each 10-unit increase in mean temperature and relative humidity was associated with an increased risk of conjunctivitis outpatient visits, while each 10-unit increase in atmospheric pressure was associated with a decreased risk. The results of the extreme weather analysis suggested that extremely low levels of atmospheric pressure and relative humidity as well as extreme levels of temperature were associated with an increased risk of outpatient conjunctivitis visits, and extreme wind speeds were associated with a decreased risk. The results of the subgroup analysis suggested gender, age, and seasonal differences. We conducted the first large sample size time-series analysis in the large city furthest from the ocean in the world and confirmed for the first time that elevated mean temperature and extreme low levels of relative humidity in Urumqi were risk factors for local conjunctivitis outpatient visits, while elevated atmospheric pressure and extreme low levels of wind speed were protective factors, and there were lagged effects of temperature and atmospheric pressure. Multicenter studies with larger sample sizes are needed.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fan Yang
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiang-Long Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyu Shan Road, Ürümqi, 830011, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
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Muto T, Imaizumi S, Kamoi K. Viral Conjunctivitis. Viruses 2023; 15:v15030676. [PMID: 36992385 PMCID: PMC10057170 DOI: 10.3390/v15030676] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Viruses account for 80% of all cases of acute conjunctivitis and adenovirus; enterovirus and herpes virus are the common causative agents. In general, viral conjunctivitis spreads easily. Therefore, to control the spread, it is crucial to quickly diagnose illnesses, strictly implement hand washing laws, and sanitize surfaces. Swelling of the lid margin and ciliary injection are subjective symptoms, and eye discharge is frequently serofibrinous. Preauricular lymph node swelling can occasionally occur. Approximately 80% of cases of viral conjunctivitis are caused by adenoviruses. Adenoviral conjunctivitis may become a big global concern and may cause a pandemic. Diagnosis of herpes simplex viral conjunctivitis is crucial for using corticosteroid eye solution as a treatment for adenovirus conjunctivitis. Although specific treatments are not always accessible, early diagnosis of viral conjunctivitis may help to alleviate short-term symptoms and avoid long-term consequences.
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Affiliation(s)
- Tetsuaya Muto
- Department of Ophthalmology, Dokkyo Medical University Saitama Medical Center, Koshigaya 343-8555, Japan
- Imaizumi Eye Hospital, Koriyama 963-8877, Japan
- Correspondence:
| | | | - Koju Kamoi
- Department of Ophthalmology and Visual Science, Tokyo Medical Dental University, Tokyo 113-8519, Japan
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Chen P, Lin XJ, Ji F, Li Y, Wang ST, Liu Y, Tao ZX, Xu AQ. Evolutionary phylogeography reveals novel genotypes of coxsackievirus A24 variant and updates the spatiotemporal dynamics in the population with acute hemorrhagic conjunctivitis. Int J Infect Dis 2022; 124:227-239. [DOI: 10.1016/j.ijid.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/19/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022] Open
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Epidemiological Investigation and Risk Factor Analysis of Acute Hemorrhagic Conjunctivitis in Huangshi Port District, Huangshi City. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3009589. [PMID: 35547568 PMCID: PMC9085324 DOI: 10.1155/2022/3009589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/17/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022]
Abstract
Objective This study is aimed at investigating the epidemiology and risk factors of acute hemorrhagic conjunctivitis (pinkeye) in Huangshi Port District of Huangshi City. Methods A total of 593 cases of acute hemorrhagic conjunctivitis from January 2019 to December 2021 were selected as the observation group. The epidemiological characteristics (age of onset, season, occupation, clinical manifestations, and etiological characteristics) were analyzed. A total of 425 healthy subjects (nonacute hemorrhagic conjunctivitis) were selected as the control group. The general data of the two groups were compared, and the risk factors affecting the occurrence of acute hemorrhagic conjunctivitis were analyzed by logistic regression. Results The onset age of acute hemorrhagic conjunctivitis was mainly concentrated in 0-20-year-old and 60-year-old age groups, and the onset season was mainly concentrated in April to August, with the highest incidence in May. The proportions of middle school students and workers in patients with acute hemorrhagic conjunctivitis were higher than those of other occupations (both P < 0.05). Ocular conjunctival congestion, tingling, and foreign body sensation were the main clinical manifestations of patients with acute hemorrhagic conjunctivitis. Among the 593 conjunctival swab samples collected in this study, the positive rates of HEV70 and CVA24v were higher than those of adenovirus nucleic acid (both P < 0.05). The proportion of people aged ≤40 years old, male, working outdoors, using potable water equipment, contact history of patients with acute conjunctivitis, history of chemical substances entering eyes, combined with immune system diseases, and public toilet utilization rate ≥ 1 times/d in the observation group was higher than that in the control group (all P < 0.05), and the proportion of people washing hands before eating and after toilet was lower than that in the control group (P < 0.05). Multiple logistic regression analysis showed that working place outdoors, use of potable water equipment, contact history of patients with acute conjunctivitis (all P < 0.05), and use of public toilets ≥ once a day were risk factors for the occurrence of acute hemorrhagic conjunctivitis, and washing hands before eating and after toilet was a protective factor (P < 0.05). Conclusion The onset age of acute hemorrhagic conjunctivitis was mainly concentrated in 0-20-year-old and 60-year-old age; the onset season was mainly concentrated in summer and autumn; adenovirus is the main pathogenic bacteria; ocular conjunctivitis congestion, tingling, and foreign body sensation were the main clinical manifestations; working place outdoors, use of potable water equipment, contact history of patients with acute conjunctivitis (all P < 0.05), and use of public toilets ≥ once a day were risk factors for the occurrence of acute hemorrhagic conjunctivitis, while washing hands before eating and after toilet was a protective factor.
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Liu R, Chen Y, Liu H, Huang X, Zhou F. Epidemiological trends and sociodemographic factors associated with acute hemorrhagic conjunctivitis in mainland China from 2004 to 2018. Virol J 2022; 19:34. [PMID: 35232483 PMCID: PMC8889670 DOI: 10.1186/s12985-022-01758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Acute hemorrhagic conjunctivitis (AHC) is classified as a class C notifiable infectious disease in China and poses a great threat to public health. This study aimed to investigate the epidemiological trends and hotspots of AHC in mainland China. Sociodemographic factors that could contribute to early warning of AHC were further explored. METHODS Yearly and monthly incidences of acute hemorrhagic conjunctivitis by date and region from 2004 to 2018 were extracted from the Data Center of China Public Health Science. Joinpoint regression and spatial autocorrelation analysis were performed to explore the epidemiological trends and hotspots of AHC. A generalized linear model was then applied to explore the relationship between sociodemographic factors and AHC incidence. RESULTS The average annual AHC incidence was 3.58/100,000 in mainland China. The first-level spatial and temporal aggregation areas were distributed in Guangxi, Hainan, Guangdong, Guizhou, Hunan, Jiangxi, Fujian, Chongqing, Hubei, Anhui, and Zhejiang, with gathering times from 2010/1/1 to 2010/12/31 (RR = 20.13, LLR = 474,522.89, P < 0.01). After 2010, the AHC incidence was stable (APC = - 8.37, 95% CI: - 23.02-9.06). However, it was significantly increased in low- and middle-income provinces (AAPC = 10.65, 95% CI: 0.62-21.68, AAPC = 11.94, 95% CI: 0.62-24.53). The peak of AHC occurred during the August to October period. Children who age 0-3 years are identified as high-risk group with AHC incidence significantly increased (APC = 31.54, 95% CI: 0.27-72.56). Birth rate, population ages 0-14 (% of total population), passenger traffic, and urban population (% of total population) were positively associated with the AHC incidence, while per capita gross domestic product was negatively associated with the AHC incidence. CONCLUSION Overall, the AHC incidence was stable after 2010 in China, but it was significantly increased in low- and middle-income provinces. Regions with a high birth rate, population ages 0-14 (% of the total population), passenger traffic, urban population (% of the total population) and low per capita gross domestic product are at high risk of incidences of AHC. In the future, public health policy and resource priority for AHC in regions with these characteristics are necessary.
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Affiliation(s)
- Rong Liu
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, 610000, China
| | - Yuxing Chen
- Institute of Chronic and Non-Communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, No. 35 Zhuodaoquan North Road, Hongshan District, Wuhan, 430079, China
| | - Hao Liu
- Institute of Chronic and Non-Communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, No. 35 Zhuodaoquan North Road, Hongshan District, Wuhan, 430079, China
| | - Xihui Huang
- Subject Teaching (English), College of Foreign Languages, Fujian Normal University, Fuzhou, 350000, China
| | - Fang Zhou
- Institute of Chronic and Non-Communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, No. 35 Zhuodaoquan North Road, Hongshan District, Wuhan, 430079, China.
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12
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Johansson E, Caraballo R, Zocher G, Mistry N, Arnberg N, Stehle T, Elofsson M. Exploring divalent conjugates of 5- N-acetyl-neuraminic acid as inhibitors of coxsackievirus A24 variant (CVA24v) transduction. RSC Adv 2022; 12:2319-2331. [PMID: 35425270 PMCID: PMC8979015 DOI: 10.1039/d1ra08968d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/05/2022] [Indexed: 11/21/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v) is responsible for several outbreaks and two pandemics of the highly contagious eye infection acute hemorrhagic conjunctivitis (AHC). Currently, neither prevention (vaccines) nor treatments (antivirals) are available for combating this disease. CVA24v attaches to cells by binding Neu5Ac-containing glycans on the surface of cells which facilitates entry. Previously, we have demonstrated that pentavalent Neu5Ac conjugates attenuate CVA24v infection of human corneal epithelial (HCE) cells. In this study, we report on the structure-based design of three classes of divalent Neu5Ac conjugates, with varying spacer lengths, and their effect on CVA24v transduction in HCE cells. In relative terms, the most efficient class of divalent Neu5Ac conjugates are more efficient than the pentavalent Neu5Ac conjugates previously reported.
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Affiliation(s)
- Emil Johansson
- Department of Chemistry, Umeå University SE90187 Umeå Sweden
| | - Rémi Caraballo
- Department of Chemistry, Umeå University SE90187 Umeå Sweden
| | - Georg Zocher
- Interfaculty Institute of Biochemistry, University of Tübingen 72076 Tübingen Germany
| | - Nitesh Mistry
- Department of Clinical Microbiology, Umeå University SE90185 Umeå Sweden
| | - Niklas Arnberg
- Department of Clinical Microbiology, Umeå University SE90185 Umeå Sweden
| | - Thilo Stehle
- Interfaculty Institute of Biochemistry, University of Tübingen 72076 Tübingen Germany
- Vanderbilt University School of Medicine Nashville Tennessee 37232 USA
| | - Mikael Elofsson
- Department of Chemistry, Umeå University SE90187 Umeå Sweden
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13
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Singh S, Mane SS, Kasniya G, Cartaya S, Rahman MM, Maheshwari A, Motta M, Dudeja P. Enteroviral Infections in Infants. NEWBORN (CLARKSVILLE, MD.) 2022; 1:297-305. [PMID: 36304567 PMCID: PMC9599990 DOI: 10.5005/jp-journals-11002-0036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Enteroviruses (EVs) are major pathogens in young infants. These viruses were traditionally classified into the following four subgenera: polio, coxsackie A and B, and echoviruses. Now that poliomyelitis seems to be controlled in most parts of the world, coxsackie and echoviruses are gaining more attention because (i) the structural and pathophysiological similarities and (ii) the consequent possibilities in translational medicine. Enteroviruses are transmitted mainly by oral and fecal-oral routes; the clinical manifestations include a viral prodrome including fever, feeding intolerance, and lethargy, which may be followed by exanthema; aseptic meningitis and encephalitis; pleurodynia; myopericarditis; and multi-system organ failure. Laboratory diagnosis is largely based on reverse transcriptase-polymerase chain reaction, cell culture, and serology. Prevention and treatment can be achieved using vaccination, and administration of immunoglobulins and antiviral drugs. In this article, we have reviewed the properties of these viruses, their clinical manifestations, and currently available methods of detection, treatment, and prognosis.
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Affiliation(s)
- Srijan Singh
- Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Sushant Satish Mane
- Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Gangajal Kasniya
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, New York, United States of America
| | - Sofia Cartaya
- Department of Pediatrics, University of South Florida, Tampa, Florida, United States of America
| | - Mohd Mujibur Rahman
- Department of Neonatology, Institute of Child and Mother Health, Dhaka, Bangladesh
| | - Akhil Maheshwari
- Global Newborn Society, Clarksville, Maryland, United States of America
| | - Mario Motta
- Neonatologia e Terapia Intensiva Neonatale ASST Spedali Civili di Brescia, Italy
| | - Pradeep Dudeja
- Department of Gastroenterology, University of Illinois at Chicago, Illinois, United States of America
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14
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Zhang L, Jiang H, Wang K, Yuan Y, Fu Q, Jin X, Zhao N, Huang X, Wang S, Zhang T, Yao K, Chan TC, Xu W, Liu S. Long-term effects of weather condition and air pollution on acute hemorrhagic conjunctivitis in China: A nationalwide surveillance study in China. ENVIRONMENTAL RESEARCH 2021; 201:111616. [PMID: 34233156 DOI: 10.1016/j.envres.2021.111616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/14/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Global climate change could have potential impact on enterovirus (EV)-induced infectious diseases. However, the environmental factors promoting acute hemorrhagic conjunctivitis (AHC) circulation remain inconclusive. This study aimed to quantify the relationship between the environment and AHC. METHODS We retrieved the monthly counts and incidence of AHC, meteorological variables and air quality in mainland China between 2013 and 2018. Exposure risks were evaluated by multivariate distributed lag nonlinear models. RESULTS A total of 219,599 AHC cases were reported in 31 provinces of China, predominantly in southern and central China, seasonally increased in summer. AHC incidence increased by 7% between 2013 and 2018, from 2.6873 to 2.7570 per 100,000 people. A moderate positive correlation was seen between AHC and monthly mean temperature, relative humidity (RH) and precipitation. Each unit increment was associated with a relative risk for AHC of 1.058 at 17°-32 °C at lag 0 months, 1.017 at 65-71% RH at lag 1.4 months, and 1.039 at 400-569 mm at lag 2.4 months. By contrast, a negative correlation was seen between monthly ambient NO2 and AHC. CONCLUSION Long-term exposure to higher mean temperature, RH and precipitation were associated with an increased risk of AHC. The general public, especially susceptible populations, should pay close attention to weather changes and take protective measures in advance to any AHC outbreak as the above situations occur.
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Affiliation(s)
- Li Zhang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Hui Jiang
- Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China
| | - Kehan Wang
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China
| | - Yuan Yuan
- Department of Geriatrics, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Qiuli Fu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Xiuming Jin
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Na Zhao
- Collaborative Innovation Center of Recovery and Reconstruction of Degraded Ecosystem in Wanjiang Basin Co-founded by Anhui Province and Ministry of Education, School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui Province, 241002, China
| | - Xiaodan Huang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Supen Wang
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu, Anhui Province, 241000, China
| | - Tao Zhang
- Nanjing Jiliang Information Technology Co., Ltd, Nanjing, Jiangsu Provice, 210002, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China.
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, 115, Taiwan.
| | - Wangli Xu
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China.
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, 310051, China.
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15
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Exploring the Effect of Structure-Based Scaffold Hopping on the Inhibition of Coxsackievirus A24v Transduction by Pentavalent N-Acetylneuraminic Acid Conjugates. Int J Mol Sci 2021; 22:ijms22168418. [PMID: 34445134 PMCID: PMC8395083 DOI: 10.3390/ijms22168418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/26/2021] [Accepted: 07/31/2021] [Indexed: 11/17/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v) is the primary causative agent of the highly contagious eye infection designated acute hemorrhagic conjunctivitis (AHC). It is solely responsible for two pandemics and several recurring outbreaks of the disease over the last decades, thus affecting millions of individuals throughout the world. To date, no antiviral agents or vaccines are available for combating this disease, and treatment is mainly supportive. CVA24v utilizes Neu5Ac-containing glycans as attachment receptors facilitating entry into host cells. We have previously reported that pentavalent Neu5Ac conjugates based on a glucose-scaffold inhibit CVA24v infection of human corneal epithelial cells. In this study, we report on the design and synthesis of scaffold-replaced pentavalent Neu5Ac conjugates and their effect on CVA24v cell transduction and the use of cryogenic electron microscopy (cryo-EM) to study the binding of these multivalent conjugates to CVA24v. The results presented here provide insights into the development of Neu5Ac-based inhibitors of CVA24v and, most significantly, the first application of cryo-EM to study the binding of a multivalent ligand to a lectin.
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16
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Fonseca MC, Pupo-Meriño M, García-González LA, Muné M, Resik S, Norder H, Sarmiento L. Molecular Characterization of Coxsackievirus A24v from Feces and Conjunctiva Reveals Epidemiological Links. Microorganisms 2021; 9:531. [PMID: 33807540 PMCID: PMC7998715 DOI: 10.3390/microorganisms9030531] [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: 02/12/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v), the main causative agent of acute hemorrhagic conjunctivitis (AHC), can be isolated from both the eyes and lower alimentary tract. However, the molecular features of CVA24v in feces is not well-documented. In this study, we compared the VP1 and 3C sequences of CVA24v strains isolated from feces during AHC epidemics in Cuba in 1997, 2003, and 2008-2009 with those obtained from conjunctival swabs during the same epidemic period. The sequence analyses of the 3C and VP1 region of stool isolates from the three epidemics showed a high degree of nucleotide identity (ranging from 97.3-100%) to the corresponding conjunctival isolates. The phylogenetic analysis showed that fecal CVA24v isolates from the 1997 and 2003 Cuban outbreaks formed a clade with CVA24v strains isolated from conjunctival swabs in Cuba and other countries during the same period. There were three amino acid changes (3C region) and one amino acid change (VP1 region) in seven CVA24v strains isolated sequentially over 20 days from fecal samples of one patient, suggesting viral replication in the intestine. Despite these substitutions, the virus from the conjunctival swab and fecal samples were genetically very similar. Therefore, fecal samples should be considered as a reliable alternative sample type for the routine molecular diagnosis and molecular epidemiology of CVA24v, also during outbreaks of AHC.
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Affiliation(s)
- Magilé C. Fonseca
- Virology Department, Center for Research Diagnosis, and Reference, Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba; (M.M.); (S.R.)
| | - Mario Pupo-Meriño
- Departamento de Bioinformática, Universidad de las Ciencias Informáticas (UCI), Habana 19370, Cuba;
| | - Luis A. García-González
- Centro de Estudios de Matemática Computacional, Universidad de las Ciencias Informáticas (UCI), Habana 19370, Cuba;
- Departamento de Ciencias de la Computación, Centro de Investigación Científica y de Educación Superior de Ensenada, 22860 Ensenada, Mexico
| | - Mayra Muné
- Virology Department, Center for Research Diagnosis, and Reference, Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba; (M.M.); (S.R.)
| | - Sonia Resik
- Virology Department, Center for Research Diagnosis, and Reference, Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba; (M.M.); (S.R.)
| | - Heléne Norder
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden;
- Department of Clinical Microbiology, Region Västra Götaland, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Luis Sarmiento
- Immunovirology Unit, Department of Clinical Sciences, Skåne University Hospital, Lund University, 22185 Malmo, Sweden
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17
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Brown DM, Zhang Y, Scheuermann RH. Epidemiology and Sequence-Based Evolutionary Analysis of Circulating Non-Polio Enteroviruses. Microorganisms 2020; 8:microorganisms8121856. [PMID: 33255654 PMCID: PMC7759938 DOI: 10.3390/microorganisms8121856] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023] Open
Abstract
Enteroviruses (EVs) are positive-sense RNA viruses, with over 50,000 nucleotide sequences publicly available. While most human infections are typically associated with mild respiratory symptoms, several different EV types have also been associated with severe human disease, especially acute flaccid paralysis (AFP), particularly with endemic members of the EV-B species and two pandemic types—EV-A71 and EV-D68—that appear to be responsible for recent widespread outbreaks. Here we review the recent literature on the prevalence, characteristics, and circulation dynamics of different enterovirus types and combine this with an analysis of the sequence coverage of different EV types in public databases (e.g., the Virus Pathogen Resource). This evaluation reveals temporal and geographic differences in EV circulation and sequence distribution, highlighting recent EV outbreaks and revealing gaps in sequence coverage. Phylogenetic analysis of the EV genus shows the relatedness of different EV types. Recombination analysis of the EV-A species provides evidence for recombination as a mechanism of genomic diversification. The absence of broadly protective vaccines and effective antivirals makes human enteroviruses important pathogens of public health concern.
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Affiliation(s)
- David M Brown
- Department of Synthetic Biology, J. Craig Venter Institute, Rockville, MD 20850, USA
| | - Yun Zhang
- Department of Informatics, J. Craig Venter Institute, La Jolla, CA 92037, USA
| | - Richard H Scheuermann
- Department of Informatics, J. Craig Venter Institute, La Jolla, CA 92037, USA
- Department of Pathology, University of California San Diego, La Jolla, CA 92093, USA
- La Jolla Institute for Immunology, La Jolla, CA 92065, USA
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18
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Johansson E, Caraballo R, Mistry N, Zocher G, Qian W, Andersson CD, Hurdiss DL, Chandra N, Thompson R, Frängsmyr L, Stehle T, Arnberg N, Elofsson M. Pentavalent Sialic Acid Conjugates Block Coxsackievirus A24 Variant and Human Adenovirus Type 37-Viruses That Cause Highly Contagious Eye Infections. ACS Chem Biol 2020; 15:2683-2691. [PMID: 32845119 PMCID: PMC7586296 DOI: 10.1021/acschembio.0c00446] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
![]()
Coxsackievirus A24
variant (CVA24v) and human adenovirus 37 (HAdV-37)
are leading causative agents of the severe and highly contagious ocular
infections acute hemorrhagic conjunctivitis and epidemic keratoconjunctivitis,
respectively. Currently, neither vaccines nor antiviral agents are
available for treating these diseases, which affect millions of individuals
worldwide. CVA24v and HAdV-37 utilize sialic acid as attachment receptors
facilitating entry into host cells. Previously, we and others have
shown that derivatives based on sialic acid are effective in preventing
HAdV-37 binding and infection of cells. Here, we designed and synthesized
novel pentavalent sialic acid conjugates and studied their inhibitory
effect against CVA24v and HAdV-37 binding and infection of human corneal
epithelial cells. The pentavalent conjugates are the first reported
inhibitors of CVA24v infection and proved efficient in blocking HAdV-37
binding. Taken together, the pentavalent conjugates presented here
form a basis for the development of general inhibitors of these highly
contagious ocular pathogens.
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Affiliation(s)
- Emil Johansson
- Department of Chemistry, Umeå University, SE90187 Umeå, Sweden
| | - Rémi Caraballo
- Department of Chemistry, Umeå University, SE90187 Umeå, Sweden
| | - Nitesh Mistry
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE90185 Umeå, Sweden
| | - Georg Zocher
- Interfaculty Institute of Biochemistry, University of Tübingen, 72076 Tübingen, Germany
| | - Weixing Qian
- Department of Chemistry, Umeå University, SE90187 Umeå, Sweden
| | | | - Daniel L. Hurdiss
- Virology Division, Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, 3584CL Utrecht, The Netherlands
| | - Naresh Chandra
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE90185 Umeå, Sweden
| | - Rebecca Thompson
- Astbury Centre for Structural Molecular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Lars Frängsmyr
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE90185 Umeå, Sweden
| | - Thilo Stehle
- Interfaculty Institute of Biochemistry, University of Tübingen, 72076 Tübingen, Germany
- Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
| | - Niklas Arnberg
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE90185 Umeå, Sweden
| | - Mikael Elofsson
- Department of Chemistry, Umeå University, SE90187 Umeå, Sweden
- Umeå Centre for Microbial Research, Umeå University, SE90187 Umeå, Sweden
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19
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Azari AA, Arabi A. Conjunctivitis: A Systematic Review. J Ophthalmic Vis Res 2020; 15:372-395. [PMID: 32864068 PMCID: PMC7431717 DOI: 10.18502/jovr.v15i3.7456] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/25/2020] [Indexed: 01/10/2023] Open
Abstract
Conjunctivitis is a commonly encountered condition in ophthalmology clinics throughout the world. In the management of suspected cases of conjunctivitis, alarming signs for more serious intraocular conditions, such as severe pain, decreased vision, and painful pupillary reaction, must be considered. Additionally, a thorough medical and ophthalmic history should be obtained and a thorough physical examination should be done in patients with atypical findings and chronic course. Concurrent physical exam findings with relevant history may reveal the presence of a systemic condition with involvement of the conjunctiva. Viral conjunctivitis remains to be the most common overall cause of conjunctivitis. Bacterial conjunctivitis is encountered less frequently and it is the second most common cause of infectious conjunctivitis. Allergic conjunctivitis is encountered in nearly half of the population and the findings include itching, mucoid discharge, chemosis, and eyelid edema. Long-term usage of eye drops with preservatives in a patient with conjunctival irritation and discharge points to the toxic conjunctivitis as the underlying etiology. Effective management of conjunctivitis includes timely diagnosis, appropriate differentiation of the various etiologies, and appropriate treatment.
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Affiliation(s)
- Amir A Azari
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Arabi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Forecasting the incidence of acute haemorrhagic conjunctivitis in Chongqing: a time series analysis. Epidemiol Infect 2020; 148:e193. [PMID: 32807257 PMCID: PMC7482188 DOI: 10.1017/s095026882000182x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Acute haemorrhagic conjunctivitis is a highly contagious eye disease, the prediction of acute haemorrhagic conjunctivitis is very important to prevent and grasp its development trend. We use the exponential smoothing model and the seasonal autoregressive integrated moving average (SARIMA) model to analyse and predict. The monthly incidence data from 2004 to 2017 were used to fit two models, the actual incidence of acute haemorrhagic conjunctivitis in 2018 was used to validate the model. Finally, the prediction effect of exponential smoothing is best, the mean square error and the mean absolute percentage error were 0.0152 and 0.1871, respectively. In addition, the incidence of acute haemorrhagic conjunctivitis in Chongqing had a seasonal trend characteristic, with the peak period from June to September each year.
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21
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Fonseca MC, Pupo-Meriño M, García-González LA, Resik S, Hung LH, Muné M, Rodríguez H, Morier L, Norder H, Sarmiento L. Molecular evolution of coxsackievirus A24v in Cuba over 23-years, 1986-2009. Sci Rep 2020; 10:13761. [PMID: 32792520 PMCID: PMC7427094 DOI: 10.1038/s41598-020-70436-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/21/2020] [Indexed: 12/29/2022] Open
Abstract
Coxsackievirus A24 variant (CVA24v) is a major causative agent of acute hemorrhagic conjunctivitis outbreaks worldwide, yet the evolutionary and transmission dynamics of the virus remain unclear. To address this, we analyzed and compared the 3C and partial VP1 gene regions of CVA24v isolates obtained from five outbreaks in Cuba between 1986 and 2009 and strains isolated worldwide. Here we show that Cuban strains were homologous to those isolated in Africa, the Americas and Asia during the same time period. Two genotypes of CVA24v (GIII and GIV) were repeatedly introduced into Cuba and they arose about two years before the epidemic was detected. The two genotypes co-evolved with a population size that is stable over time. However, nucleotide substitution rates peaked during pandemics with 4.39 × 10-3 and 5.80 × 10-3 substitutions per site per year for the 3C and VP1 region, respectively. The phylogeographic analysis identified 25 and 19 viral transmission routes based on 3C and VP1 regions, respectively. Pandemic viruses usually originated in Asia, and both China and Brazil were the major hub for the global dispersal of the virus. Together, these data provide novel insight into the epidemiological dynamics of this virus and possibly other pandemic viruses.
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Affiliation(s)
- Magilé C Fonseca
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba.
| | - Mario Pupo-Meriño
- Departamento de Bioinformática, Centro de Matemática Computacional, Universidad de las Ciencias Informáticas (UCI), Havana, Cuba
| | - Luis A García-González
- Departamento de Ciencias de la Computación, Centro de Investigación Científica y de Educación Superior de Ensenada, Ensenada, Baja California, México
| | - Sonia Resik
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Lai Heng Hung
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Mayra Muné
- Virology Department, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Novia del Mediodía Km 61/2, La Lisa, Marianao 13, P.O. Box: 601, Havana, Cuba
| | - Hermis Rodríguez
- Cell Culture Laboratory, Center for Research, Diagnosis and Reference, Institute of Tropical Medicine "Pedro Kourí" (IPK), Havana, Cuba
| | - Luis Morier
- Department of Microbiology and Virology, Biology Faculty, Havana University, Havana, Cuba
| | - Heléne Norder
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Luis Sarmiento
- Immunovirology Unit, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
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Epidemiological Characteristics and Spatiotemporal Analysis of Acute Hemorrhagic Conjunctivitis from 2004 to 2018 in Chongqing, China. Sci Rep 2020; 10:9286. [PMID: 32518362 PMCID: PMC7283237 DOI: 10.1038/s41598-020-66467-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 05/21/2020] [Indexed: 12/02/2022] Open
Abstract
Chongqing is one of the five provinces in China that has the highest incidence of acute hemorrhagic conjunctivitis (AHC). Data of AHC cases from 2004 to 2018 were obtained from National Notifiable Diseases Reporting Information System (NNDRIS). Descriptive statistical methods were used to analyze the epidemiological characteristics; incidence maps were used to reflect incidence trends in each district; spatial autocorrelation was used to identify hotspot regions and spatiotemporal patterns of AHC outbreaks; spatiotemporal scan were conducted to identify AHC clusters. A total of 30,686 cases were reported with an annual incidence of 7.04 per 100,000. The incidence rates were high in 2007 and 2014, and large epidemics were observed in 2010 with the seasonal peak in September. Individuals aged 10–19 years, males, students and farmers were the prime high-risk groups. Except for 2012 and 2013, the spatial distribution of AHC did not exhibit significant global spatial autocorrelation. Local indicators of spatial association showed that the high-risk regions are Chengkou and Wuxi. The spatiotemporal scan indicated that all clusters occurred in September 2010, and the high-incidence clusters were mainly distributed in the northeast of Chongqing. The results could assist public health agencies to consider effective preventive measures based on epidemiological factors and spatiotemporal clusters in different regions.
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Liu X, Qiu S, Liu Z, Chen D, Liu H, Ding G. Effects of Floods on the Incidence of Acute Hemorrhagic Conjunctivitis in Mengshan, China, from 2005 to 2012. Am J Trop Med Hyg 2020; 102:1263-1268. [PMID: 32228794 DOI: 10.4269/ajtmh.19-0164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This study aimed to examine the association between floods and the morbidity of acute hemorrhagic conjunctivitis (AHC) in Mengshan, China. Relying on the longitudinal data, a generalized additive model (GAM) was applied to quantify the relationship between the morbidity of AHC and floods from 2005 to 2012, controlling for other meteorological variables. Years lived with disability (YLDs) and attributable YLDs were used as the measure of the burden of AHC because of the floods. Multivariable analysis showed that floods were significantly associated with an increased risk of the morbidity of AHC (rate ratio [RR] = 2.136, 95% CI: 2.109-2.163). The total YLDs per 1,000 in Mengshan was 0.2001, although the value in females was higher than that in males (0.2351 versus 0.1686). The YLD per 1,000 of AHC in Mengshan was highest between the ages of 5 and 14 years (0.6530), followed by the age of 0-4 years (0.3325). The attributable YLD per 1,000 of AHC due to the floods in Mengshan was 0.0434 (95% CI: 0.0425-0.0442). Our study confirms that floods have significantly increased the risks of AHC in the selected study area. Females and youngsters may be the vulnerable populations to develop the flood-related disease.
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Affiliation(s)
- Xuena Liu
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, P.R. China
| | - Shuo Qiu
- Shandong Yingcai University, Jinan, P.R. China
| | - Zhidong Liu
- School of Public Health, Shandong University, Jinan, P.R. China
| | - Dongzhen Chen
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, P.R. China
| | - Hui Liu
- Shandong Yingcai University, Jinan, P.R. China
| | - Guoyong Ding
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, P.R. China
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Liu H, Li C, Shao Y, Zhang X, Zhai Z, Wang X, Qi X, Wang J, Hao Y, Wu Q, Jiao M. Forecast of the trend in incidence of acute hemorrhagic conjunctivitis in China from 2011-2019 using the Seasonal Autoregressive Integrated Moving Average (SARIMA) and Exponential Smoothing (ETS) models. J Infect Public Health 2020; 13:287-294. [PMID: 31953020 DOI: 10.1016/j.jiph.2019.12.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/11/2019] [Accepted: 12/17/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study aimed to explore the demographic and distributive features of acute hemorrhagic conjunctivitis (AHC). We constructed seasonal autoregressive integrated moving average (SARIMA) and exponential smoothing (ETS) models to predict its trend in incidence in mainland China and provided evidence for the government to formulate policies regarding AHC prevention. METHODS Data regarding the distribution and demographic characteristics of AHC in China from 2011-2016 were retrieved from the Public Health Scientific Data website. Monthly AHC data from January 2011 to June 2019 were used to establish and evaluate the SARIMA and ETS models. RESULTS During 2011-2016, a total of 213,325 cases were reported; 46.01% were farmers, patients aged ≤9 years had the highest risk, and the male:female ratio was 1.31:1. Guangxi and Guangdong had the highest number of reported AHC cases. The SARIMA (0, 0, 1) (2, 0, 0) 12 model with the minimum root mean squared error and mean absolute percentage error were finally selected for in-sample simulation. CONCLUSIONS AHC remains a serious public health problem in Southern and Eastern China that mainly affects farmers and children younger than 9 years. It is recommended that the health administration strengthen the publicity and education regarding AHC prevention among farmers and accelerate the development of related vaccines and treatment measures.
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Affiliation(s)
- Huan Liu
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Chenxi Li
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yingqi Shao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Xin Zhang
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Zhao Zhai
- Department of Gastrointestinal Surgery, Tumor Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Xing Wang
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Xinye Qi
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jiahui Wang
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yanhua Hao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Qunhong Wu
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China.
| | - Mingli Jiao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, China.
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25
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Zhang S, Hu Q, Deng Z, Hu S, Liu F, Yu S, Liu R, He C, Li H, Gao L, Chen T. Transmissibility of acute haemorrhagic conjunctivitis in small-scale outbreaks in Hunan Province, China. Sci Rep 2020; 10:119. [PMID: 31924848 PMCID: PMC6954223 DOI: 10.1038/s41598-019-56850-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/16/2019] [Indexed: 11/16/2022] Open
Abstract
Acute haemorrhagic conjunctivitis (AHC) outbreaks are reported frequently in China. However, the transmissibility of AHC remains unclear. This study aimed to calculate the transmissibility of the disease with and without interventions. An AHC outbreak dataset from January 2007 to December 2016 in different schools was built in Hunan Province. A Susceptible-Infectious-Recovered (SIR) model was adopted to calculate the effective reproduction number (Reff) of AHC. Reff was divided into two parts (Runc and Rcon) where Runc and Rcon represent the uncontrolled and controlled Reff , respectively. Based on Runc and Rcon, an index of effectiveness of countermeasures (Ieff) was developed to assess the effectiveness of countermeasures in each outbreak. During the study period, 34 AHC outbreaks were reported in 20 counties of 9 cities in Hunan Province, with a mean total attack rate of 7.04% (95% CI: 4.97–9.11%). The mean Runc of AHC outbreaks was 8.28 (95% CI: 6.46–10.11). No significance of Runc was observed between rural and urban areas (t = −1.296, P = 0.205), among college, secondary, and primary schools (F = 0.890, P = 0.459), different levels of school population (F = 0.738, P = 0.538), and different number of index cases (F = 1.749, P = 0.180). The most commonly implemented countermeasures were case isolation, treatment, and health education, followed by environment disinfection, symptom surveillance, and school closure. Social distance, prophylaxis, and stopping eye exercises temporary were implemented occasionally. The mean value of Rcon was 0.16 (range: 0.00–1.50). The mean value of Ieff was 97.16% (range: 71.44–100.00%). The transmissibility of AHC is high in small-scale outbreaks in China. Case isolation, treatment, and health education are the common countermeasures for controlling the disease.
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Affiliation(s)
- Siyu Zhang
- Hunan Provincial Center for Disease Control and Prevention, 450 Middle Furong Road section 1, Changsha, 410005, Hunan, People's Republic of China
| | - Qingqing Hu
- Division of Public Health, School of Medicine, University of Utah, 201 Presidents Circle, Salt Lake City, 84112, Utah, USA
| | - Zhihong Deng
- Hunan Provincial Center for Disease Control and Prevention, 450 Middle Furong Road section 1, Changsha, 410005, Hunan, People's Republic of China
| | - Shixiong Hu
- Hunan Provincial Center for Disease Control and Prevention, 450 Middle Furong Road section 1, Changsha, 410005, Hunan, People's Republic of China
| | - Fuqiang Liu
- Hunan Provincial Center for Disease Control and Prevention, 450 Middle Furong Road section 1, Changsha, 410005, Hunan, People's Republic of China
| | - Shanshan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People's Republic of China
| | - Ruoyun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People's Republic of China
| | - Chunlei He
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People's Republic of China
| | - Hongye Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People's Republic of China
| | - Lidong Gao
- Hunan Provincial Center for Disease Control and Prevention, 450 Middle Furong Road section 1, Changsha, 410005, Hunan, People's Republic of China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People's Republic of China.
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Li D, Zhou JN, Li H, He CY, Dai QS, Li XL, He JF, He H, Li MB, Jiang LIL, Chen YY, Xu W. An outbreak of epidemic keratoconjunctivitis caused by human adenovirus type 8 in primary school, southwest China. BMC Infect Dis 2019; 19:624. [PMID: 31307413 PMCID: PMC6631456 DOI: 10.1186/s12879-019-4232-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/28/2019] [Indexed: 01/20/2023] Open
Abstract
Background Two outbreaks of epidemic keratoconjunctivitis (EKC) occurred successively with an interval of 5 days in two primary boarding schools in Weixi Lisu Autonomous County, Diqing, and Tibetan Autonomous Prefecture, Yunnan. The aims of this study were to determine the intensity and characteristics of the outbreaks, as well as the clinical manifestations in the patients, the risk factors for infection and the pathogen responsible for the two outbreaks. Methods An outbreak investigation was conducted in two primary schools, and a case-control study including patients from the Weixi County Ethnic Primary School was performed. Relevant specimens were collected according to the case definition, and next-generation sequencing was employed to identify the pathogen. An epidemiological investigation method was used to analyse the related epidemiological characteristics, such as risk factors. The phylogenetic tree was constructed by MEGA 7.0. Results A total of 331 acute conjunctivitis cases, including probable cases of EKC, were reported in the two schools, and the attack rates were 30.59% (171/559, 95%CI: 26.76–34.42) and 20.41% (160/784, 95%CI: 17.58–23.24), respectively. Cases occurred in all grades and classes in both schools, and only one staff member in each school presented illness. The epidemics lasted for 54 days and 45 days, respectively. The patients had typical manifestations of EKC, such as acute onset, follicular hyperplasia, pseudomembrane formation, preauricular lymphadenopathy, corneal involvement and blurred vision, and a relatively long disease course (average 9.40 days, longest 23 days and shortest 7 days). The risk factor for infection was close contact with a patient or personal items contaminated by a patient. The pathogen responsible for the outbreaks was HAdV-8. The virus was highly similar to the 2016 HAdV-8 strain from Tibet, China. Conclusions This study strongly suggests that HAdV-8 could lead to serious consequences. This is the second report of a HAdV-8-associated EKC outbreak in mainland China. Tibetan HAdV-8 might be circulating in southwest China; therefore, it is necessary to monitor the pathogens causing acute conjunctivitis in this area.
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Affiliation(s)
- Duo Li
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People's Republic of China
| | - Jie-Nan Zhou
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People's Republic of China
| | - Hong Li
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People's Republic of China
| | - Cun-Ying He
- Diqing Tibetan Autonomous Prefecture Center for Disease Control and Prevention, Shangri-La City, Yunnan, People's Republic of China
| | - Qing-Shan Dai
- Weixi Lisu Autonomous County Center for Disease Control and Prevention, Weixi Lisu Autonomous County, Diqing Tibetan Autonomous Prefecture, Yunnan, People's Republic of China
| | - Xiang-Lan Li
- Diqing Tibetan Autonomous Prefecture Center for Disease Control and Prevention, Shangri-La City, Yunnan, People's Republic of China
| | - Jian-Fang He
- Weixi Lisu Autonomous County Center for Disease Control and Prevention, Weixi Lisu Autonomous County, Diqing Tibetan Autonomous Prefecture, Yunnan, People's Republic of China
| | - Hong He
- Weixi Lisu Autonomous County Center for Disease Control and Prevention, Weixi Lisu Autonomous County, Diqing Tibetan Autonomous Prefecture, Yunnan, People's Republic of China
| | - Ming-Bao Li
- Weixi Lisu Autonomous County Center for Disease Control and Prevention, Weixi Lisu Autonomous County, Diqing Tibetan Autonomous Prefecture, Yunnan, People's Republic of China
| | - L I-Li Jiang
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People's Republic of China
| | - Yao-Yao Chen
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People's Republic of China
| | - Wen Xu
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, People's Republic of China.
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Re-emergence of a coxsackievirus A24 variant causing acute hemorrhagic conjunctivitis in Brazil from 2017 to 2018. Arch Virol 2019; 164:1181-1185. [PMID: 30725183 DOI: 10.1007/s00705-019-04157-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A large outbreak (over 200,000 cases) of acute hemorrhagic conjunctivitis (AHC) took place in Brazil during the summer of 2017/2018, seven years after a nationwide epidemic, which occurred in 2011. To identify the etiological agent, 80 conjunctival swabs from patients with a clinical presentation suggestive of AHC were analyzed at the national enterovirus laboratory. Real-time RT-PCR for human enteroviruses was performed, and enterovirus RNA was detected in 91.25% (73/80) of the specimens. Twenty-nine swab fluids were used to inoculate cell cultures (RD and Hep2C), and 72.4% (21/29) yielded a cytopathic effect. Genotype IV coxsackievirus A24v (CV-A24v) was identified as the causative agent of the outbreak. Phylogenetic analysis based on the VP1 gene revealed that Brazilian isolates were genetically related to strains that caused an outbreak in French Guiana in 2017. Our results show the re-emergence of CV-A24v causing AHC outbreaks in Brazil between the end of 2017 and the beginning of 2018.
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28
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Enfissi A, Joffret ML, Delaune D, Delpeyroux F, Rousset D, Bessaud M. Coxsackievirus A24 Variant Associated with Acute Haemorrhagic Conjunctivitis Cases, French Guiana, 2017. Intervirology 2018; 60:271-275. [DOI: 10.1159/000489339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/17/2018] [Indexed: 12/14/2022] Open
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Burr SE, Sillah A, Joof H, Bailey RL, Holland MJ. An outbreak of acute haemorrhagic conjunctivitis associated with coxsackievirus A24 variant in The Gambia, West Africa. BMC Res Notes 2017; 10:692. [PMID: 29208044 PMCID: PMC5717804 DOI: 10.1186/s13104-017-3007-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/28/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE An outbreak of acute haemorrhagic conjunctivitis occurred in The Gambia, West Africa in 2011. Affected individuals presented with conjunctival haemorrhages, swelling and ocular discharge. In an effort to identify a causative agent of the disease, ocular swabs were taken from patients during the acute and convalescent phases. Total RNA was extracted from all samples and reverse-transcriptase PCR performed using primers specific for all enteroviruses. Resulting amplicons were sequenced and data compared to known sequences using the BLAST algorithm. RESULTS Forty-eight swabs were included in the analysis. Of these, 21 acute and 9 convalescent swabs (65% of the total) gave positive PCR results. Sequence analysis of the resulting amplicons indicated 99% sequence identity with coxsackievirus A24 variant identified during independent outbreaks of acute haemorrhagic conjunctivitis around the world and suggest the Gambian outbreak was due to this virus.
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Affiliation(s)
- Sarah E. Burr
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Disease Control and Elimination Theme, Medical Research Council Unit, The Gambia, Fajara, Banjul, The Gambia
| | - Ansumana Sillah
- National Eye Health Programe, Ministry of Health and Social Welfare, Kanifing, The Gambia
| | - Hassan Joof
- Disease Control and Elimination Theme, Medical Research Council Unit, The Gambia, Fajara, Banjul, The Gambia
| | - Robin L. Bailey
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin J. Holland
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
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