A cluster of salivirus A1 (Picornaviridae) infections in newborn babies with acute gastroenteritis in a neonatal hospital unit in Hungary.

Salivirus (family Picornaviridae) may be associated with acute gastroenteritis in humans, but there have been no reports of salivirus outbreaks. Salivirus A1 infection with faecal virus concentrations of 2.1-2.6 × 10(9)/g were identified retrospectively in newborn babies, between the ages of 1.5 and 5 days, with apparent clinical symptoms of diarrhea (100 %), fever (40 %), vomiting (40 %), and loss of appetite (40 %) in a neonatal hospital unit in Hungary in July 2013. The complete genome sequence of the salivirus (including the 5'-terminal end) was determined. Salivirus mono-infection may be associated with gastroenteritis in babies who are a few days old. Salivirus testing should be done in public health laboratories in gastroenteritis outbreaks with unknown etiology.

[First gastroenteritis outbreak caused by sapovirus (GI2) in Hungary - part of an international epidemic?]. / Sapovírus (GI2) okozta gastroenteritis-járvány elso hazai igazolása - Nemzetközi epidémia részjelensége?

UNLABELLED: Sapovirus belonging to Caliciviridae is one of the known pathogen of sporadic gastroenteritis infections in infants, children and rarely in elderly. Since the beginning of molecular monitoring of caliciviruses (mid 1990's) sapovirus was described rarely, once in approx. 5 years, as source of an outbreak. Circulation of caliciviruses has been monitored with molecular epidemiological methods by authors for 10 years in Hungary. Sapovirus has not been detected yet in the approximately 800 examined non-bacterial gastroenteritis outbreak. Based on the informal data supported by the international calicivirus surveillance study group, the number of outbreaks caused by sapovirus was increasing in Europe in 2008. Supposedly these outbreaks can be linked to genotype GI2 sapovirus. AIMS: To describe the first verified detection and molecular epidemiological description of a gastroenteritis outbreak caused by sapovirus in Hungary. MATERIALS AND METHODS: Stool samples originated from Bács-Kiskun County, from a mental deficiency day care center, where a gastroenteritis outbreak occurred in September, 2008. Amplification of the RNA polymerase gene of sapovirus was performed by RT-PCR method and the product was directly sequenced and phylogenetically analyzed. Clinical and epidemiological data were collected by epidemiological investigation. RESULTS: 17 of the 135 exposed people (12.6%) had gastroenteritis with vomiting and diarrhea in the period of September 11-22, 2008. Bacterial pathogens, rotavirus, adenovirus and norovirus were not detected, but sapovirus could be identified in 1 out of the 4 (25%) stool samples. The source of the outbreak was presumably the ill nurse and the virus spread with direct contact among the mentally deficient patients. Based on the RNA polymerase gene region the virus belongs to genotype GI2 sapovirus. CONCLUSIONS: This study reports on the first detection of sapovirus from gastroenteritis outbreak in Hungary. Epidemiologic and clinical characteristics of the outbreak in the mental deficiency day care center are described in details to prove that not every case is "calicivirus" infection and epidemic is caused by the norovirus, which is another calicivirus examined by diagnostic methods. The outbreak caused by genotype GI2 sapovirus might be the part of an international epidemic, extended into a larger geographic area.

[Molecular epidemiology of hepatitis E virus in Hungary: endemic, food-borne zoonosis]. / A hepatitis E-vírus molekuláris epidemiológiája hazánkban: endémiás, élelmiszer közvetítette zoonosis.

UNLABELLED: Hepatitis E virus (HEV) is one of a common cause of acute, fecally transmitted hepatitis in developing countries. Identification of HEV in indigenous human infection and in domestic pig raises the possibility that HEV infection is also a zoonosis. AIM/METHODS: Molecular detection and epidemiology of HEV in humans with acute hepatitis and in domestic (pig, cattle) and wild (boar and roe-deer) animals by ELISA and RT-PCR in Hungary. RESULTS: Between 2001 and 2006, a total of 116 (9.6%) human sera were positive by HEV IgM ELISA and 13 (24.5%) of 53 samples were also confirmed by RT-PCR and sequencing. Forty-two, 11 and 9 samples were RT-PCR-positive from swine (feces: 22.7%; liver: 30.8%), roe-deer (liver: 34.4%) and wild boar (liver: 12.2%), respectively. Except for an imported infection caused by genotype 1, 19 sequences (human: 12, swine: 4, roe-deer: 1, wild boar: 2) belong to genotype 3 HEV. Genetically identical strains were detected in human and roe-deer and in 2 other human clusters. CONCLUSIONS: HEV is an endemic agent in Hungary. Consumption of raw or undercooked meat-products is one of the possible sources of the indigenous HEV infections. Cross-species infection with genotype 3 HEV involves a food-borne transmission route in Hungary.

Identification of a novel variant of human hepatitis E virus in Hungary.

First human case of hepatitis E infection detected in Hungary is reported. This hepatitis E virus (HEV), Hungary1, belongs to genotype 3 and had 95% and 90% nucleotide identity within the capsid region of the European swine and human (Greece2) strains, respectively. Hungary1 represents a potential novel human variant of HEV in genus Hepevirus.

[Molecular detection of hepatitis E virus in non-imported hepatitis case--identification of a potential new human hepatitis E virus lineage in Hungary]. / Hepatitis E-virus molekuláris kimutatása nem importált heveny hepatitisbol--a hepatitis E-vírus potenciálisan új, humán genetikai vonalának azonosítása Magyarországon.

INTRODUCTION: Hepatitis E virus (HEV) one of the most common cause of hepatitis in endemic areas. However recently demonstrated that human infection may occur in developed countries without any travel history and that swine may act as a reservoir. AIMS: The objective of this study was to identified hepatitis E virus by molecular methods in patient with acute non-A-C hepatitis infection with no recent travel history in Hungary and to determine the viral genetic relationship to known HEV strains. MATERIALS: Laboratory diagnosis of hepatitis E virus infection was performed in patient sera by HEV IgM and IgG ELISA, IgM and IgG immunoblot and reverse transcription polymerase chain reaction using primers for partial viral capsid region. RESULTS: Patient with acute hepatitis with unknown origin was treated in Hospital of Szeged in June 2004. The acute patient's sera was positive by HEV IgM and IgG confirmed by immunoblot. Viral genome was successfully amplified in sera by RT-PCR. By sequence- and phylogenetic analysis the virus, designated Hungary-1, showed 95% nucleotide identity to genotype 3 hepatitis E viruses related to highest identity to swine HEV strain (Sp354-1-02) and having 90% nucleic acid identity to human strain (Greece2). DISCUSSION: Hepatitis E virus infection is present in Hungary without travelling to known endemic regions. The first identified HEV in Hungary, which is represent a new human genetic lineage, support the possibility of the endemic infections caused by genotype 3 strains in developed countries and that swine may act as reservoir of human HEV.

[Endemic hepatitis E infections in South-East Hungary]. / Hepatitis E-fertozések Csongrád megyében.

INTRODUCTION: Hepatitis E virus (HEV) one of the most important infectious agent in acute hepatitis in tropical and subtropical areas. Recently, it has been demonstrated that HEV infection also occur in developed countries without travel history. In these regions, transmission thought to be zoonotic. In this work hepatitis E cases are detected in South East Hungary. AIMS: Aims of the authors were the detection of HEV infection in acute hepatitis patients by enzyme-immunoassay (ELISA), and the introduction of clinical and epidemiological features. METHODS: Between January 2001 and October 2004, acute sera samples were tested by serological methods (enzyme-immunoassay for HEV IgM and IgG antibodies) from patients with acute hepatitis observed in Department of Infectology Hospital of Szeged. Samples from non-A-B-C infections hepatitis were tested. CONCLUSIONS: In the mentioned period the detected HEV infections (27) showed a similar incidence as known in other hepatitis in our region. Based upon our results, hepatitis E virus is one of the etiological agent in acute endemic hepatitis in South East Hungary, with special clinical features, which are not entirely similar, found in available literature. The gained data, with their conclusions may have wilder professional interest.

[Possibilities of postnatal diagnosis in congenital cytomegalovirus infection]. / A congenitalis cytomegalovirus-fertózés postnatalis diagnosztikájának lehetóségei két eset kapcsán.

The authors review two cases of suspected congenital cytomegalovirus (CMV) infections in which modern laboratory approaches were applied to establish the diagnosis postnatally. In the first case, intrauterine infection was suggested by ventriculomegaly, detected by means of a head ultrasonographic scan. The postnatal cranial ultrasonography and computed tomographic scans revealed intracerebral calcifications. CMV was detected in the blood and urine of the newborn. The postnatal serological tests proved that the mother had experienced a primary CMV infection during gestation. Abnormal neurological signs developed in the infant by the age of 9 months. In the second case, the mother had had an active CMV infection at 29 weeks of gestation involving a twin pregnancy. The CMV-specific serological tests demonstrated that this was a recurrent infection. The twins were born without signs or clinical symptoms and CMV was not detected in their urine samples. At 5 months of age, one of the twins excreted CMV in his urine, which must have been a consequence of a postnatal infection. The general screening of young women by CMV serology at the beginning of gestation is recommended. This would establish a CMV serostatus and provide an opportunity for the gynecologist to provide advice concerning the avoidance of infection, especially in cases where the patient is seronegative and therefore at risk of primary CMV infection.

Characterization and zoonotic potential of endemic hepatitis E virus (HEV) strains in humans and animals in Hungary.

BACKGROUND: Hepatitis E virus (HEV) is a common cause of acute, fecally transmitted hepatitis in developing countries. Identification of HEV in indigenous human infection and in domestic pig raising the possibility that HEV infection is also a zoonosis. OBJECTIVES/STUDY DESIGN: Molecular detection and epidemiology of HEV in humans (South-East Hungary) with acute hepatitis and in domestic (pig, cattle) and wild (boar and roe-deer) animals (countrywide) by ELISA and RT-PCR. RESULTS: Between 2001 and 2006, a total of 116 (9.6%) of 1203 human sera were positive by HEV IgM ELISA and 13 (24.5%) of 53 samples were also confirmed by RT-PCR and sequencing. Forty-two (27.3%) of 154, 11 (34.4%) of 32 and 9 (12.2%) of 74 samples were RT-PCR-positive from swine (feces: 22.7%; liver: 30.8%), roe-deer (liver) and wild boar (liver), respectively. Except for an imported infection caused by genotype 1, 19 sequences (human: 12, swine: 4, roe-deer: 1, wild boar: 2) belong to genotype 3 HEV. Genetically identical strains were detected in human and roe-deer and in 2 other human clusters. CONCLUSIONS: HEV is an endemic agent in Hungary. Consumption of raw or undercooked meat-products is one of the possible sources of the indigenous HEV infections. Cross-species infection with genotype 3 HEV potentially involves a food-borne transmission route in Hungary.