Epidemiological characteristics and etiological changes of hand-foot-mouth disease in Shijiazhuang City in 2009-2021 / 公共卫生与预防医学

Objective To understand the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in Shijiazhuang City from 2009 to 2021, and to provide scientific evidence for the prevention and control of HFMD. Methods The epidemic data and etiological data of HFMD in Shijiazhuang City from 2009 to 2021 were collected, and descriptive epidemiological methods were used for data analysis. Results The reported incidence of HFMD in Shijiazhuang showed a fluctuating downward trend from 2009 to 2021, with a high incidence every other year in most years. The proportion of severe cases and the mortality rate showed a decreasing trend (χ2severe cases=282.09, P2mortality=51.33, P2=4 507.84，Pr=-2.85，P22 =521.86，P2proportion of severe cases=93.71，P=0.000，χ2mortality rate=26.62，P=0.000，χ2proportion of EV71=1060.86，P=0.000). Conclusion The incidence of HFMD in Shijiazhuang presented a declining trend, and the dominant etiological changes of different cases were different. It is necessary to continue to strengthen the etiological monitoring, health education and EV71 vaccination for the prevention and control of HFMD.

Genotype analysis of enteroviruses causing hand, foot and mouthdisease in Shaoxing City / 预防医学

Objective@#To investigate the genotypes of enteroviruses causing hand, foot and mouth disease ( HFMD ) in Shaoxing City, so as to provide insights into HFMD control.@*Methods@#The anal and pharyngeal swab specimens were collected from HFMD cases under 14 years of age reported by sentinel hospitals of HFMD in Shaoxing City from 2018 to 2020. The enterovirus genotypes were determined by quantitative real-time PCR (qPCR) assay and sequenced by BLAST, and the constitution and temporal distribution of enterovirus genotypes were descriptively analyzed.@*Results@#A total of 1 267 anal and pharyngeal swab specimens were collected from children with HFMD, and 661 specimens were positive for enteroviruses, with a positive rate of 52.17%. Among the 661 enterovirus-positive specimens, 70 specimens were tested positive for EV71 ( 5.52% ), 208 specimens tested positive for CoxA16 ( 16.42% ), 239 specimens tested positive for CoxA6 ( 18.86% ); 23 specimens tested positive for CoxA10 (1.82%), and 121 specimens tested positive for other 10 genotypes, including CoxA2, CoxA4, and CoxA5. The prevalence rates of EV71 were 14.08%, 0.72% and 1.84% from 2018 to 2020, and the detection of EV71 peaked during the period between April and July, 2018. The prevalence rates of CoxA16 were 10.98%, 26.57% and 11.98 from 2018 to 2020, and the detection of CoxA16 peaked during the period between April and August, and between November and December, 2019. The prevalence rates of CoxA6 were 10.50%, 14.73% and 30.88% from 2018 to 2020, and the detection of CoxA6 peaked during the period between May and December, 2020.@*Conclusions@#EV71, CoxA16 and CoxA6 were predominant enterovirus genotypes causing HFMD in Shaoxing City from 2018 to 2020, and the detection of CoxA6 appeared a tendency towards a rise.

Molecular identification of non-polio enteroviruses in acute flaccid paralysis cases in Henan Province of China in 2021 / 中华微生物学和免疫学杂志

Objective:To investigate the serotypes and epidemic characteristics of non-polio enteroviruses (NPEV) in acute flaccid paralysis (AFP) cases in Henan Province in 2021.Methods:Fecal specimens of 529 AFP cases reported in Henan Province in 2021 were collected for virus isolation. The VP1 regions of NPEV were sequenced. MEGA5.1 software was used for sequence alignment and a phylogenetic tree was constructed as well. The epidemiological data were organized and statistically analyzed using Excel2016 and SPSS26 software.Results:A total of 30 strains of NPEV were isolated from the fecal specimens of 529 AFP cases, with an isolation rate of 5.67% (30/529). They were belonged to group A and group B with 15 strains in each group, and no group C or group D viruses were isolated. Group A contained six serotypes and was dominated by coxsackievirus A2 (CVA2) and CVA6. Group B contained tree serotypes and was dominated by CVB3. In the population distribution, the separation rate of NPEV was the highest among children under 5 years old, which was 76.67% (23/30), and the ratio of male to female was 1.51∶1. In the regional distribution, group A viruses were mainly distributed in the central, southern and southwestern parts of Henan Province with CVA2 and CVA4 being the most widely distributed, while group B viruses were relatively concentrated, mainly distributed in the central, northern and southwestern parts of Henan Province with CVB3 being the predominant. In terms of time distribution, NPEV could be isolated throughout the year except from January to February, showing the epidemic characteristics of high incidence in spring and summer and low incidence in autumn and winter. The peak of group A virus infection was in May and the peak period of group B virus infection was from June to July.Conclusions:CVB3 was the main serotype of NPEV isolated in Henan Province in 2021. The pathogenic spectrum and regional distribution of NPEV had changed significantly compared with those in 2018-2019. In order to provide reference for the diagnosis and surveillance of AFP and maintain the polio-free status in Henan Province, much attention should be paid to the current epidemic trend of NPEV.

In vitro antiviral activity of medicinal mushroom Ganoderma neo-japonicum Imazeki against enteroviruses that caused hand, foot and mouth disease

@# Hand, foot and mouth disease (HFMD) is a highly contagious viral disease that predominantly affects children younger than 5 years old. HFMD is primarily caused by enterovirus A71 (EVA71) and coxsackievirus A16 (CV-A16). However, coxsackievirus A10 (CV-A10) and coxsackievirus A6 (CV-A6) are being increasingly reported as the predominant causative of HFMD outbreaks worldwide since the past decade. To date, there are still no licensed multivalent vaccines or antiviral drugs targeting enteroviruses that cause HFMD, despite HFMD outbreaks are still being frequently reported, especially in Asia-Pacific countries. The high rate of transmission, morbidity and potential neurological complications of HFMD is indeed making the development of broad-spectrum antiviral drugs/agents against these enteroviruses a compelling need. In this study, we have investigated the in vitro antiviral effect of 4 Ganoderma neo-japonicum Imazeki (GNJI) crude extracts (S1-S4) against EV-A71, CV-A16, CV-A10 and CV-A6. GNJI is a medicinal mushroom that can be found growing saprophytically on decaying bamboo clumps in Malaysian forests. The antiviral effects of this medicinal mushroom were determined using cytopathic inhibition and virus titration assays. The S2 (1.25 mg/ml) hot aqueous extract demonstrated the highest broad-spectrum antiviral activity against all tested enteroviruses in human primary oral fibroblast cells. Replication of EV-A71, CV-A16 and CVA10 were effectively inhibited at 2 hours post-infection (hpi) to 72 hpi, except for CV-A6 which was only at 2 hpi. S2 also has virucidal activity against EV-A71. Polysaccharides isolated and purified from crude hot aqueous extract demonstrated similar antiviral activity as S2, suggesting that polysaccharides could be one of the active compounds responsible for the antiviral activity shown by S2. To our knowledge, this study demonstrates for the first time the ability of GNJI to inhibit enterovirus infection and replication. Thus, GNJI is potential to be further developed as an antiviral agent against enteroviruses that caused HFMD.

Epidemiologic characteristics and pathogen surveillance of hand, foot and mouth disease in Hebei province from 2008 to 2017 / 中华疾病控制杂志

Objective To analyze the epidemiological and pathogenic characteristics of hand-foot-mouth disease (HFMD) in Hebei Province from 2008 to 2017, so as to provide scientific evidence for prevention and control of HFMD. Methods The epidemic data and laboratory detection data of HFMD from 2008 to 2017 were collected and analyzed by descriptive epidemiology. Results From 2008 to 2017,a total of 690 368 cases of hand, foot and mouth disease, including 4 939 severe cases and 208 deaths were reported in Hebei Province, with an average annual incidence of 95.53/100 000. The largest number of reported light cases were 2009, while severe cases and deaths were in 2010. The number of reported cases increased every other year but decreased in general. In 2008, 2009 and 2012, the main peak of the onset of spring and summer was formed from April to June. In 2010, 2011 and 2013-2017, the main peak of the onset of spring and summer was from May to July. Main peak value in spring and summer showed a backward delayed trend. The sex ratio between men and women was 1.59:1.The majority of deaths case were scattered children and preschool case. Other enteroviruses, human enterovirus 71,(EV-A71) and coxasckievirus A16,(CV-A16) alternately became the main pathogens of common cases. The pathogenic composition of different cases was different and the difference was statistically significant ( 2=2274.17, P<0.001). Conclusion The number of reported deaths and severe cases has decreased significantly. It is necessary to adjust the focus of prevention and control, pay more attention to the mild cases of FHMD, and further strengthen the monitoring of other enteroviruses pathogenic spectrum.

Circulation of enteroviruses among healthy children under 5 years of age and clinical features of infection / Монголын Анагаах Ухаан

Introduction@#Major outbreaks of infectious diseases caused by enteroviruses (EV) have been reported in recent years. As of 2017, in Mongolia, hand, foot and mouth disease, or HFMD, accounts for 13.7% of all infectious diseases. The purpose of this study was to investigate the circulation of EV among healthy children, and clinical characteristics of infection.@*Materials and Methods @#The analysis of EV circulation was conducted on Polio Laboratory data of 1172 specimens, collected in 2013-2018, from 9 districts of UB and 21 provinces of Mongolia. Also specimens of 239 patients, who underwent outpatient and inpatient treatment at the NCCD in 2014-2018, were randomly selected and stool samples were collected. Clinical symptoms of patients were analyzed and virus isolation analysis was performed in order to confirm the diagnosis.@*Results@#Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months. The enterovirus rate among healthy children was 20.1%. Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. </br> Out of selected patients 52.7% (n=126) were diagnosed with HFMD, rash infection occurred in 28.5% (n=68), acute flaccid paralysis-18.8% (n=45). EV was detected in 56.4% (n=135) of the collected stool samples.</br> Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months (95% CI:2.5 ±0.1). 49% (n=578) of participants were female, 50.7% (n=594) were male. The enterovirus rate among healthy children were 20.1% (n=236; 95% CI: 20.1 ± 0.55). Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. Although the enterovirus isolation rate was relatively high among children under 3, there was no statistically significant difference (p>0.05), as well as there was no difference in gender (p>0.05). As for the EV circulation by region, the highest prevalence rate is found in Central region (27.5%), while the lowest is in the Eastern region (12.7%) with no statistical significance by regions (p>0.05).@*Conclusions@#Among children, HFMD is a common disease, that caused by EV. Enterovirus infection can often cause fever, flu like symptoms as well as spotted, maculopapular rash. The EV isolation rate of 20.1% indicates that the incidence of enterovirus is characterized by symptoms of influenza-like illness or is asymptomatic.

Hand, foot, and mouth disease in Guangzhou, 2016-2017: an epidemiological study and genotype analysis of non-enterovirus group A 71 non-coxsackievirus group A 16 enterovirus / 中华传染病杂志

Objective To study the epidemiology of hand,foot,and mouth disease (HFMD) and the spectrum of serotypes in the other enterovirus (EV) (non-EV-A71 and non-Coxsaekievirus group A 16,CV-A 16) from 2016 to 2017 in Guangzhou,to provide the basis for its treatment,prevention and control.Methods Enteroviruses universal type,EV-A71 and CV-A16 were detected by real time reverse transeription-polymerase chain reaction in the specimens from HFMD suspected patients from 2016 to 2017.The positive specimens of non-EV-A71 and non-CV-A16 were amplified and sequenced based on 5'-untranslated region (UTR) region.The spectrum of serotypes was analyzed with BLAST in NCBI on the basis of 5'-UTR region.Results A total of 25779 specimens from HFMD patients were collected during 2016-2017,16 300 (63.23 ％) of which were positive.The positive rates of EV-A71,CV-A16,non-EV-A71 and non-CV-A16 were 4.57％ (1 178/25 779),12.70％ (3 274/25 779) and 45.96％ (11 848/25779),respectively.The average positive rate of non-EV-A71 and non-CV-A16 in 2017 was 55.68％,which was higher than that in 2016.Sequence analysis showed that there were 16 genotypes in 95 non-EV-A71 and non-CV-A16 positive specimen,including CV-A6,CV-A10,CV-A4,CV-A2,CV-A8,CV-A12,CV-A9,Coxsakievirus B5 (CV-B5),CV-B2,CV-B4,CV-B3,Echovirus 1 (E1),E16,E30,E2 and E18.CV-A6 (26.32％),and CV-A10 (15.79％) were the most common genotypes,followed by CV-A4 (6.32％)、CV-A8(4.21％),and CV-A2 (4.21％).Conclusions The infection rate of EV-A71 is very low during 2016-2017.From April to July 2016,there is a small peak of CV-A16 infection.The non-EV-A71 and non-CV-A16 enterovirus becomes the main causative agent of HFMD during 2016 to 2017.CV-A6 and CV-A10 are the most prevalent pathogens of non-EV-A71 and non-CV-A16 enterovirus.Research and monitoring of CV-A6,CV-A10 as the main non-EV-A71and non-CV-A16 virus should be strengthened.

Molecular epidemiology of HFMD in mainland China and discussion on prevention and control measures / 中华微生物学和免疫学杂志

Objective To summarize the epidemiological data of hand, foot and mouth disease (HFMD) in China from 2013 to 2017 and to analyze its molecular epidemiological characteristics in order to provide scientific basis for improving prevention and control measures. Methods China National Knowledge In-frastructure,Wanfang Database of China,Chinese VIP Journal Net and Pubmed were used to search epidemio-logical data of HFMD published in recent years. National notification data and surveillance data of HFMD in ma-inland China were obtained from the National Health and Family Planning Commission of China and the World Health Organization. Basic statistic tools were used for data analysis. Results From 2013 to 2016, the inci-dence rates of HFMD were 134. 37/100 000, 203. 16/100 000, 145. 30/100 000, 176. 62/100 000 and 140.46/100 000,respectively. Enterovirus 71(EV71),coxsackievirus A16(CA16),CA6 and CA10 were the predominant pathogens causing HFMD in the first half of 2013-2017. CA6 was the main epidemic strain in most areas of China. EV71 remained the predominant pathogen causing severe HFMD, but CA6, CA16 and CA10 were also critical pathogens of concern. The predominant strains of enteroviruses varied with year and region. Conclusion Although the EV71 vaccine has been approved since 2016, HFMD has not been controlled com-pletely in China. It is badly in need of more comprehensive surveillance of other types of enteroviruses and HFMD polyvaccine to improve the prevention and control of HFMD.

Análisis filogenético y de presión evolutiva de secuencias nucleotídicas del gen VP4 de especies de enterovirus humanos / Phylogenetic and evolutive pressure analyses of nucleotide sequences of VP4 gene of human enterovirus species

El género Enterovirus es un grupo viral que afecta a un amplio rango de hospederos, entre ellos los humanos (especies A, B, C, y D), causan enfermedades respiratorias, gastrointestinales, neurológicas, y otras, y son altamente contagiosos. Los síntomas pueden ser leves o graves. El objetivo del trabajo fue analizar la variación nucleotídica, filogenética y de presión evolutiva de secuencias nucleotídicas del gen VP4 de las cuatro especies que afectan a los humanos. Se emplearon 92 secuencias nucleotídicas disponibles en la base de datos GenBank; éstas se editaron con el software BioEdit y se alinearon con Clustal W; las relaciones filogenéticas se determinaron con MEGA6, y las presiones evolutivas con los algoritmos SNAP y SLAC. Se encontró que la identidad nucleotídica mínima intra-especie fue de 43,2% (especie B) a 72,6% (especie D). Los genotipos más variables por especie fueron EV-71 (A), Echovirus 2 (B), EV-118 (C), y EV-94 (D). El análisis de presión evolutiva mostró que el gen VP4 en las cuatro especies evoluciona bajo presión selectiva negativa. Esto indicaría que la alta tasa mutacional y eventos de recombinación no tienen un rol significativo en la evolución de este gen, debido probablemente a la localización interna de la proteína VP4.

The Enterovirus genus is a viral group that affects a wide host range, including humans (species A, B, C and D), cause respiratory, gastrointestinal, and neurologic disease, amongothers, and are highly contagious. The symptoms range from mild to severe. The objectiveof this study was to perform a nucleotidic variation, phylogenetic and selective pressureanalyses of the VP4 gene from the four enterovirus species that affect humans. Ninety-twonucleotide sequences (available in the GenBank database) were employed; they were edited with Bio Edit software and aligned with Clustal W; the phylogenetic relationships weredetermined with MEGA6, and the evolutive pressures with SNAP and SLAC algorithms. Itwas found an intra-species nucleotide identity of at least 43,2% (species B) to 72,6% (species D). The more variable genotypes by species were EV-71 (A), Echovirus 2 (B), EV-118 (C), and EV-94 (D). The selective pressure analysis showed that VP4 gene of the fourspecies evolves by negative pressure. This would indicate that the high mutation rate andrecombination events do not have a significant role in the evolution of this gene, probablydue to the internal localization of the VP4 protein.

Non‑polio Enteroviruses in Karnataka, India: Virological surveillance of acute flaccid paralysis cases (July 1997–2013).

Background and Objectives: Since 1997 National Institute of Virology, Bangalore Unit involved in WHO's Acute flaccid paralysis paediatric cases surveillance programme to isolate and detect polioviruses. Stool samples yielded not only polioviruses but also Non-Polio enteroviruses. This report is an overview of non‑polio Enterovirus (NPEV) epidemiology in Karnataka state, India for the period of 16‑years and 6 months from July 1997–2013. Methods: A total of 19,410 clinical samples were processed for virus isolation as a part of acute flaccid paralysis (AFP) surveillance for Global Polio Eradication Programme in India at National Polio Laboratory, at Bengaluru. NPEV detection was performed by virus isolation on cell culture according to World Health Organisation recommended protocols. Results: A total of 4152 NPEV isolates were obtained. The NPEV isolation rate varied from year to year but with a total NPEV rate of 21.39%. Conclusion: A seasonal variation was noted with high transmission period between April and October with peaks in June–July. The male to female ratio was 1:1.2. The isolation of NPEV decreased significantly with the increase in age. Epidemiology of NPEVs from AFP cases in Karnataka is described.

Identification and genetic characteristics of non-polio enteroviruses isolated from patients with acute flaccid paralysis in 2015, Yunnan province, China / 中华微生物学和免疫学杂志

Objective To investigate the virus-carrying rate of non-polio enteroviruses ( NPEV) in patients with acute flaccid paralysis ( AFP) in Yunnan province of China in 2015 and to analyze the genetic characteristics of enterovirus 71 (EV71) strains. Methods A total of 213 cases under 15 years old with AFP were reported by Center for Disease Control and Prevention ( CDC) of Yunnan Province of China. Virus isolation was conducted for all samples and the serotypes of isolated NPEV strains were identified by VP1 se-quencing. The isolation rates of NPEV in the past consecutive 5 years were analyzed by SPSS22. 0 software. Phylogenetic trees of NPEV and EV71 strains were constructed by MEGA6. 06 software based on neighbor-joining algorithm and Kimura 2-parameter substitution model and the reliability of the phylogenetic trees was determined by bootstrap analysis with 100 pseudo replicate datasets. Results Altogether, 23 NPEV strains were isolated from 213 AFP cases. Among the 23 strains, 7 strains belonged to EV-A group (2 serotypes, 6 strains of which were EV71 ) , 14 strains belonged to EV-B group ( 8 serotypes ) and the other 2 strains belonged to EV-C group. No NPEV strains of EV-D group were identified. Statistical analysis showed that no significant differences in the isolation rates were observed in the past 5 years ( P=0. 101 ) . Conclusion The isolation rate of NPEV in patients with AFP in Yunnan province in 2015 was similar to that of the previ-ous years. The EV71 strains of C4 subgenotype were the predominant strains circulating in Yunnan province.

Moving beyond classical markers of water quality: detection of enteric viruses and genotoxicity in water of the Sinos River / Indo além dos marcadores clássicos de qualidade da água: detecção de vírus entéricos e genotoxicidade na água do Rio dos Sinos

It is well recognized that the classical biological and chemical markers of environmental pollution do not necessarily indicate the presence or absence of emerging threats to public health, such as waterborne viruses and genotoxicants. The purpose of this preliminary study was to evaluate the presence of material of enteroviruses (EV), rotavirus (RV) and adenovirus (AdV) and genotoxicity in water samples from points of routine monitoring of water quality in the main course of the Sinos River. The points are classified into different levels of pollution in accordance to the Brazilian federal regulations. Viral genomes from EV, AdV were detected in two of the 4 collection points regardless of the level of urbanisation of the surrounding areas. In contrast, genotoxicity was not observed in piava (Leporinus obtusidens) fingerlings cultivated on these same water samples. Results were compared with classical physical, chemical and microbiological parameters. There was no clear evidence of association between any of the classical markers and the presence of viral genomes in the water samples tested.

É amplamente reconhecido que os marcadores biológicos e químicos clássicos para a poluição ambiental não necessariamente indicam a presença ou ausência de ameaças emergentes à saúde pública, tais como vírus transmitidos pela água e genotoxicantes. Este estudo preliminar teve por objetivo detectar material genético de enterovírus (EV), rotavírus (RV) e adenovírus (AdV) e genotoxicidade em amostras de água de pontos de monitoramento de rotina da qualidade da água no curso principal do rio dos Sinos. Os pontos são classificados em níveis diferentes de poluição, de acordo com as normativas federais brasileiras. Genomas virais de EV, RV e RV foram detectados em dois dos quatro pontos de coleta, independente do nível de urbanização das áreas adjacentes. Por outro lado, não foi observada genotoxicidade em alevinos de piava (Leporinus obtusidens) cultivados nestas mesmas amostras de água. Os resultados são comparados com marcadores físicos, químicos e microbiológicos clássicos, não há nenhuma evidência clara da associação entre qualquer um dos marcadores clássicos e da presença de genomas virais nas amostras de água testadas.

Enterovirus types and clinical characteristics of 5 070 cases with hand,foot and mouth disease in Shen-yang area,2014 / 中国小儿急救医学

Objective To study the epidemic characteristics,distribution of pathogen and clinical characteristics of hand,foot and mouth disease in Shenyang area,2014.Methods Swab specimens was collected from 5 070 cases of hand,foot and mouth disease caces,the F-PCR method was adopted for entero-virus 71 (EV71 ),coxsackievirus A 16(CA16)and universal enteroviruses(EU)detection,and combining the relevant clinical data for comparative analysis .Results June to August was the peak epidemic period.5 070 nasopharyngeal swab specimens were detected positive 3 715 intestinal virus nucleic acid,and the detection rate was 73.27%,including CA16 positive 1 481 (39.87%),EU positive 1 148 (30.90%),EV71 positive 1 086(29.23%).The proportion of EU positive was highest in June(29.71 %).The proportion of EV71 pos-itive(24.78%)and CA16 positive(33.27%)were highest in July,respectively .The proportion of nervous system symptoms in EV71 infection group(88 /1 12,78.57%)was higher than those in EU infection group (97 /147,65.99%)and CA16 infection group (44 /78,56.41 %).The proportion of abnormal myocardial enyzme in CA16 infection group (37 /78,47.44%)was higher than those in EU infection group (48 /147, 32.65%)and EV71 infection group(34 /1 12,30.36%).Conclusion CA16 is the major pathogen causing hand,foot and mouth disease in Shenyang area,2014.Severe hand,foot and mouth is still dominated by EV71 .

Performance Evaluation of Real-Q Enterovirus Quantification Kit for Enterovirus by Real-time PCR / 대한진단검사의학회지

BACKGROUND: Molecular methods have enabled rapid diagnosis of aseptic meningitis and have reduced both unnecessary therapeutic interventions and medical costs. In this study, we evaluated the analytical performance of the recently developed Real-Q Enterovirus Quantification kit (BioSewoom Inc., Korea). METHODS: We evaluated the detection limit, precision, linearity, and cross-reactivity of the Real-Q Enterovirus Quantification kit and compared it with the conventional PCR method. From March to September 2009, we tested 91 CSF specimens from patients who visited the pediatrics department of the university hospital with symptoms of aseptic meningitis or infantile sepsis, and we also tested 48 CSF specimens from patients with febrile convulsion for differential diagnosis. RESULTS: The Real-Q Enterovirus Quantification kit showed good linearity (r=0.997) within a range from 3x10(2) to 3x10(10) copies/mL, and the detection limit of the kit was 83 copies/mL. The within-run, between-run, and between-day CVs were 5.3-7.6%, 9.5-12.3%, and 11.4-13.4%, respectively. There was no cross reactivity between enteroviruses and various microorganisms. Positive results were obtained for 39.1% (25/64) of the patients suspected of aseptic meningitis and 44.4% (12/27) of the patients suspected of infantile sepsis. However, among the 48 children with febrile conversion, only 4 were positive for enterovirus. Further, the concordance with conventional PCR was high (73/74). CONCLUSIONS: The Real-Q Enterovirus Quantification kit showed excellent linearity and high reliability with a broad reportable range. It showed good detection rate when used with clinical specimens and also showed a high concordance with the conventional method. Therefore, this assay would be clinically useful not only in diagnosis of aseptic meningitis but also in differential diagnosis of infantile sepsis.

Integrated Cell Culture-PCR Detection of Enteroviruses and Reoviruses in Water Sources in Gyeonggi-do

The integrated cell culture-PCR (ICC-PCR) method has been suggested as an improved method for detection of viruses in water environments. We tested 57 source waters including finished water samples in Gyeonggi-do for enteric viral contamination using total culturable virus assay (TCVA) using BGMK cells and ICC-PCR. Nineteen of the 57 source water samples (33.3%) exhibited the cytopathic effect (CPE) on BGMK cells and no finished water did exhibited CPE. Nineteen samples (33.3%) of the 57 were positive for reoviruses. For the enteroviruses, only 3 samples (5.3%) of the 57 samples showed positive results. By using ICC-PCR method, 202 flasks from source water samples were positive for enteroviruses and reoviruses. Three samples from source water were positive for both viruses. However, any flasks tested was not co-infected with two types of viruses. While the enteric viral frequencies in TCVA and ICC-PCR were similar, the viral frequency for reoviruses at first passage in two type of method was higher in ICC-PCR (94.7%) than TCVA (56.9%).

Enteroviruses isolated in patients with acute respiratory infections

Background: at present, some enterovirus also was considered causes of acute respiratory infections in children. In Vietnam, no studies were published on the enteroviruses causing acute respiratory infections in humans. The research results would contribute to control and prevention of respiratory tract infections. Objectives: to identify enteroviruses causing acute respiratory infection syndrome in children. Subjectives and Method: a descriptive, prospective study, virus isolation. 185 samples of patients with acute respiratory tract infections, collected from both private clinics and from Dak Lak provincial general hospital, in 2004. Cells: RD, Hep2, L20B, and Vero provided by the World Health Organization (WHO). Antisera for diagnosing enteroviruses, antisera for diagnosing adenoviruses: A1-A7. Results: the results showed that 10.8% were positive with enteroviruses. These isolated enteroviruses consist of 13 Coxsackievirus B, 1 Echovirus, 1 Poliosabin type 1, and 5 untyped Enteroviruses. The result also showed that 8.1% of isolated viruses were Adenoviruses. Enteroviruses isolated mainly in September, followed by in February and in July accounted for 60% of isolated viruses. Conclusions: enteroviruses may be one of causes of respiratory infections in children. Some viruses had been isolated in the study such as: Coxsackievirus B, Echovirus, Poliosabin type 1, and untyped Enteroviruses.

Enteroviruses isolated in patients with acute flaccid paralysis in 5 years after poliomylitis eradication, 2000-2004

In the period from 2000 to 2004, 393 non-polio enterovirus strains were isolated containing 140 Echoviruses, 35 coxsackie viruses and 218 untyped enteroviruses. These viral strains were isolated from 2,232 stool specimens of 1,116 patients with acute flaccid paralysis. 32 poliovirus isolates were all Sabin viruses. The result confirmed the free status of the sustaining of poliomyelitis between 2000 and 2004 in Vietnam.

Enteroviruses isolated in patients with acute respiratory infections

In 2004, 185 specimens of patients with acute respiratory illnesses that were tested negative to influenza viruses were isolated to determine enteroviruses. The results showed that 10.8% were positive with enteroviruses. These isolated enteroviruses consist of 13 Coxsackievirus B, 1 Echovirus, 1 Poliosabin type 1, and 5 untyped Enteroviruses. The result also showed that 8.1% of isolated viruses were Adenoviruses

Enteroviruses as etiological agents of meningitis in children

On 200 samples of CSF with negative reaction to cephalitis virus from children suffering from acute cephalitis at National Institute of Pediatry and 250 fecal samples of healthy children aged of 2-6 years in kindergartens and creches, an investigation was performed in the year 2001. 44% of CSF sample had positive reaction to enteroviruses, among them 96.6% were ECHO 30/virus, the rest samples were ECHO 6. The incidence was 1.7 time higher in boys than in girls, their 97% were 3-14 years old. The epidemy appeared in June-July. Clinical symptoms were headache 100%, fever and nausea 90%, stiff nape 72.7%. The rate of enterovirus in healthy children accounted for 70% in 2 year old age children and 6% in 5 years old children

An Epidemiological Study of Enteroviruses as Causative Agents of Aseptic Meningitis between 1993 and 1998 in Korea / 감염

BACKGROUND: To investigate the epidemiology of aseptic meningitis in Korea, we have isolated and characterized enteroviruses isolated from patients with acute meningitis from 1993 to 1998. METHODS: Stool and/or cerebrospinal fluid (CSF) samples from patients with aseptic meningitis were inoculated onto enterovirus-susceptible cell lines. The virus propagation was examined by the presence of cytopathic effects and each viral isolate was further characterized using a neutralization test. RESULTS: Out of 1,127 specimens, 197 enteroviral isolates were obtained mostly from stool samples (82.8 %) of children aged zero to ten years. At least 15 serotypes of enteroviruses, including echoviruses (EV) 3, 6, 7, 9, 25 and 30, coxsackieviruses (CV) B1~B6, and vaccine-derived polioviruses (PV) had circulated during the previous 6 years. The major serotypes that caused outbreaks of aseptic meningitis, were EV30 in 1997 and EV6 in 1998. Although the incidence of virus isolation peaked during summer, we had isolated enteroviruses all the year round in 1998. CONCLUSION: Since 1993, we had confirmed 197 cases of enteroviral meningitis. Outbreaks of aseptic meningitis were mainly caused by EVs, with peaks during the summer months. Our data emphasize that the nationwide surveillance of aseptic meningitis should be expanded and maintained throughout the year.