Transmission networks and population turnover of echovirus 30.

Globally, echovirus 30 (E30) is one of the most frequently identified enteroviruses and a major cause of meningitis. Despite its wide distribution, little is known about its transmission networks or the dynamics of its recombination and geographical spread. To address this, we have conducted an extensive molecular epidemiology and evolutionary study of E30 isolates collected over 8 years from a geographically wide sample base (11 European countries, Asia, and Australia). 3Dpol sequences fell into several distinct phylogenetic groups, interspersed with other species B serotypes, enabling E30 isolates to be classified into 38 recombinant forms (RFs). Substitutions in VP1 and 3Dpol regions occurred predominantly at synonymous sites (ratio of nonsynonymous to synonymous substitutions, 0.05) with VP1 showing a rapid substitution rate of 8.3 x 10(-3) substitutions per site per year. Recombination frequency was tightly correlated with VP1 divergence; viruses differing by evolutionary distances of >0.1 (or 6 years divergent evolution) almost invariably (>97%) had different 3Dpol groups. Frequencies of shared 3Dpol groups additionally correlated with geographical distances, with Europe and South Asia showing turnover of entirely distinct virus populations. Population turnover of E30 was characterized by repeated cycles of emergence, dominance, and disappearance of individual RFs over periods of 3 to 5 years, although the existence and nature of evolutionary selection underlying these population replacements remain unclear. The occurrence of frequent "sporadic" recombinants embedded within VP1 groupings of other RFs and the much greater number of 3Dpol groups than separately identifiable VP1 lineages suggest frequent recombination with an external diverse reservoir of non-E30 viruses.

Parainfluenza type 3 infection post stem cell transplant: high prevalence but low mortality.

Parainfluenza type 3 (PIV 3) is a well-recognized cause of respiratory illness after stem cell transplantation (SCT), with an estimated incidence of 2-7% and a high mortality rate associated with lower respiratory tract infection (LRTI). A 12-month retrospective study was undertaken in which 23 positive cases of PIV 3 occurred in SCT recipients. The frequency of infection was 36.1% in matched unrelated donor SCT recipients, 23.8% in sibling allogeneic SCT recipients and 2.3% in autologous transplant recipients. Seventeen cases were outpatient or community acquired despite standard infection control measures. Eleven patients only developed upper respiratory tract symptoms. LRTI symptoms developed in 12 patients, of whom eight had a new infiltrate on chest X-ray. Overall mortality at 30 days from PIV 3 diagnosis was 4% (one patient). Four patients died within 100 days of PIV 3 diagnosis, but PIV 3 was not believed to be the primary cause of death in any of these patients. Early ribavirin was used in eight patients and only one patient who received ribavirin died. These results suggest a higher prevalence of PIV 3 but a lower mortality than documented previously, particularly in allogeneic transplant recipients. The authors propose that the high prevalence reflects the unit's policy of active surveillance for respiratory viruses and the difficulty in preventing transmission of PIV 3, especially in the outpatient setting during an outbreak period. Ribavirin treatment may improve outcome in patients with LRTI but is not required in all patients with PIV 3.

Serotype-specific detection of coxsackievirus A16 in clinical specimens by reverse transcription-nested PCR.

We describe the development of a coxsackievirus A16 (CVA16) serotype-specific PCR which correctly differentiated between CVA16 and other enterovirus serotypes of both laboratory isolates and clinical specimens. The assay will be useful for monitoring CVA16 outbreaks and studying the disease association, epidemiology, and evolution of this common enterovirus serotype.

Enterovirus sequences resembling coxsackievirus A2 detected in stool and spleen from a girl with fatal myocarditis.

A 10-year-old girl who died suddenly was found at post mortem to have myocarditis. Virus could not be cultured from post-mortem stool, spleen or heart but enterovirus RNA was detected in stool and spleen by PCR, and the stool caused flaccid paralysis in newborn suckling mice. A 654 base pair (bp) sequence from the capsid-coding region of the viral genome was amplified from an affected mouse and sequenced. Using this sequence, strain-specific nested primers were designed and used to amplify viral sequences directly from stool and spleen. These sequences were identical to each other and to that obtained from the infected mouse, and most closely resembled Coxsackievirus A2, an uncommon serotype rarely associated with myocarditis. Testing spleen tissue may be useful in etiological investigation of suspected viral myocarditis. PCR proved more sensitive than suckling mouse inoculation in detecting this Coxsackievirus, but a combination of both methods was required for genotypic characterization.

Molecular signal transduction by conformational transmission: use of tetrasubstituted perhydroanthracenes as transducers.

2,3,6,7-Tetrasubstituted cis-anti-cis perhydroanthracenes have been studied as conformational transducers for molecular signal transduction. 2,2'-Bipyridine groups attached to the perhydroanthracene through ether linkages were chosen as receptor substituents, while pyrene groups were selected as effectors. A chelation-induced triple ring flip of the perhydroanthracene could be achieved by the complexation of zinc(II) ions at the bipyridine sites of ligands 13 and 15. It was found that two pyrene substituents attached to the perhydroanthracene via a linker with an E double bond and an ester group could be used to monitor the triple ring flip. In the equatorial positions, the pyrenes are sufficiently close to form an excimer in the excited state, giving a fluorescence signal at 480 nm. In the axial positions, they are far away from each other and give mainly a monomer fluorescence signal at 380 nm. Both the bipyridine receptor and the pyrene effector are present in compound 33. The conformational switching 34-->35 (the two conformers of 33) has successfully been used for a signal transduction over a signal distance of 2 nm.

Molecularly imprinted polymer membranes for substance-selective solid-phase extraction from water by surface photo-grafting polymerization.

Hydrophilized polyvinylidene fluoride microfiltration membranes were surface-modified in the presence of a template (terbumeton) in methanol with a graft copolymer of a functional monomer (2-acrylamido-2-methyl-1-propane sulfonic acid, AMPS, methacrylic acid, MAA, or acrylic acid, AA) and a cross-linker (N,N'-methylene-bis-acrylamide) using UV irradiation and benzophenone as photoinitiator. As result, membranes covered with a thin layer of imprinted polymer selective to terbumeton were obtained. Blank membranes were prepared with the same monomer composition, but in the absence of the template. The membranes' capacity to adsorb terbumetone from aqueous solution was evaluated yielding information regarding the effect of polymer synthesis (type and concentration of functional monomer, concentration of cross-linker) on the resulting membranes' recognition properties. UV spectroscopic studies of the interactions with terbumetone revealed that AMPS forms a stronger complex than MAA and AA. In agreement with that finding, imprinting with AMPS gave higher affinities than with MAA and AA. The terbumeton-imprinted membranes showed significantly higher sorption capability to this herbicide than to similar compounds (atrazine, desmetryn, metribuzine). With the novel surface modification technology, the low non-specific binding properties of the hydrophilized microfiltration membrane could successfully be combined with the receptor properties of molecular imprints, yielding substance-specific molecularly imprinted polymer composite membranes. The high affinity of these synthetic affinity membranes to triazine herbicides together with their straightforward and inexpensive preparation provides a good basis for the development of applications of imprinted polymers in separation processes such as solid-phase extraction.

Dimethylphenylsulfonium trifluoromethanesulfonate and methyldiphenylsulfonium trifluoromethanesulfonate.

The bonding geometry of sulfur in the cations of the title compounds, C(8)H(11)S(+).CF(3)SO(3)(-) and C(13)H(13)S(+).CF(3)SO(3)(-), respectively, is similar and is independent of the ratio of the Me/Ph substituents. As expected, in both cations, the S-Ph bonds are somewhat shorter than the S-Me bonds. In both crystal structures, the interaction between cations and anions is similar.

Enterovirus infections in England and Wales: laboratory surveillance data: 1975 to 1994.

Microbiology laboratories in England and Wales reported 40,366 culture confirmed isolates of echovirus (24,628; 61%) and coxsackievirus (B 11,714; 29%, A 4024; 10%) infections to the PHLS Communicable Disease Surveillance Centre (CDSC) in the 20 years from 1975 to 1994. Nearly half of the organisms were isolated from faeces, and 5741 were isolated from cerebrospinal fluid (75% of them echovirus, 13% coxsackie B, and 12% coxsackie A). Isolation rates for all enteroviruses were highest among infants aged 1 to 2 months. Sixty per cent of patients were aged under 5 years, 10% 5 to 9 years, and only 6% 35 years or over. Predominant serotypes were similar to those reported in other countries including the United States, Finland, and Belgium. Seventy-one per cent of reports were made between July and mid December. Periodicity varied between groups and serotypes: some demonstrated peaks at intervals of two to five years. There was evidence of spread of epidemic serotypes across Europe in certain years. Data collected between March and May each year enabled the strains circulating in the following 'season' to be predicted. Such information might be used to warn clinicians to anticipate particular clinical presentations.

Synthesis, photochemistry and application of (7-methoxycoumarin-4-yl)methyl-caged 8-bromoadenosine cyclic 3',5'-monophosphate and 8-bromoguanosine cyclic 3',5'-monophosphate photolyzed in the nanosecond time region.

New caged derivatives of hydrolysis-resistant 8-bromoadenosine cyclic 3',5'-monophosphate (8-Br-cAMP) and 8-bromoguanosine cyclic 3',5'-monophosphate (8-Br-cGMP) are described. The compounds are the axial and equatorial isomers of the (7-methoxycoumarin-4-yl)methyl (MCM) esters of cyclic nucleotides. Synthesis is accomplished by treatment of 4-bromomethyl-7-methoxycoumarin with the tetra-n-butylammonium salts of the 8-bromo-substituted cyclic nucleotides or with the free acids of 8-Br-cAMP and 8-Br-cGMP in the presence of silver(I) oxide. MCM-caged 8-Br-cAMP and MCM-caged 8-Br-cGMP liberate 8-Br-cAMP and 8-Br-cGMP during irradiation with ultraviolet light within a few nanoseconds. They show favorable absorption properties and quantum yields and are resistant to hydrolysis in aqueous buffer solutions. The moderate fluorescence properties of the caged compounds in comparison with the strongly fluorescent 4-hydroxymethyl-7-methoxycoumarin (MCM-OH) photoproduct allow the indirect estimation of the amount of photolytically released cyclic nucleotides in aqueous buffer solutions using fluorescence measurements. Their usefulness for physiological studies has been examined in a mammalian cell line expressing the cyclic nucleotide-gated ion channel of bovine olfactory sensory neurons using the patch-clamp technique and confocal laser scanning microscopy. The caged compounds serve as efficient and rapid intracellular sources of 8-Br-cAMP and 8-Br-cGMP. However, at least in HEK 293 cells, fluorescence signals cannot be used to monitor the photolysis of MCM-caged 8-Br-cAMP and 8-Br-cGMP, due to quenching of the fluorescence of MCM-OH.

Novel caged compounds of hydrolysis-resistant 8-Br-cAMP and 8-Br-cGMP: photolabile NPE esters.

The application of the 1-(2-nitrophenyl)ethyl (NPE) moiety as a photolabile ligand for the release of hydrolysis-resistant 8-Br-cAMP and 8-Br-cGMP was examined. NPE-caged 8-Br-cAMP and 8-Br-cGMP liberate 8-Br-cAMP and 8-Br-cGMP during irradiation with ultraviolet light. The synthesis procedure resulted in diastereoisomeric mixtures, which were chromatographically separated into the axial and equatorial isomers of NPE-caged 8-Br-cAMP and 8-Br-cGMP. The hydrolytic stability, solubility and photochemical properties of these derivatives were compared to the previously reported 4.5-dimethoxy-2-nitrobenzyl (DMNB) compounds. We found that the axial isomers of NPE-caged 8-Br-cAMP and 8-Br-cGMP had a considerably better solvolytic stability than the respective equatorial isomers as well as the DMNB-caged derivatives. Their usefulness for physiological studies was examined in a mammalian cell line expressing the cyclic nucleotide-gated (CNG) ion channel of bovine olfactory sensory neurons.

Caged compounds of hydrolysis-resistant analogues of cAMP and cGMP: synthesis and application to cyclic nucleotide-gated channels.

Photolabile compounds which rapidly release cAMP or cGMP after photolysis are widely used for in situ studies of signaling pathways inside cells. We synthesized two novel caged compounds, 4,5-dimethoxy-2-nitrobenzyl 8-Br-cAMP (caged 8-Br-cAMP) and 4,5-dimethoxy-2-nitrobenzyl 8-Br-cGMP caged 8-BR-cGMP), which respectively release the hydrolysis-resistant analogues 8-Br-cAMP and 8-Br-cGMP. Their usefulness for physiological studies was examined in a mammalian cell line expressing the cyclic nucleotide-gated (CNG) ion channel of bovine olfactory sensory neurons. The synthesis procedure resulted in diastereomeric mixtures which were chromatographically separated into the axial and equatorial isomers of caged 8-BR-cAMP and of caged 8-BR-cGMP. The axial isomers which have a higher solubility and better solvolytic stability than the equatorial forms were used for experiments with CNG channels. Flashes of UV light produced steps in the concentration of 8-Br-cGMP which activated currents through CNG channels. Concentration steps inside the cell could be calibrated precisely using the relation between the ligand concentration and the normalized current. Similar results were obtained with caged 8-Br-cAMP. Control experiments with caged cGMP showed that flash-induced currents decayed within a few minutes because photoreleased cGMP was degraded by endogenous phosphodiesterase activity. The rise time of the 8-Br-cGMP-activated whole-cell current was consistent with a bimolecular reaction between channel and ligand.

Sensitivity and specificity of mu-capture ELISA for detection of enterovirus IgM.

The sensitivity and specificity of an in-house mu-capture enzyme linked immunosorbent assay (ELISA) for enterovirus IgM in routine use was determined by analysing the results of 77 serum samples from 55 enterovirus culture-positive patients with aseptic meningitis and single serum samples from 140 patients with other infections. In addition, sera from 10 laboratory staff pre- and post-polio virus vaccination and 20 rheumatoid factor positive sera were tested for specificity. On testing the first serum specimen received, only 21 of 55 patients (38%) with aseptic meningitis yielded a positive result, rising to 33 of 55 (60%) on testing a second sample, where available. Out of 14 patients from whom multiple serum samples were tested and negative results obtained with the first serum, 12 were positive with the second sample (86%). Only patients with acute hepatitis A produced a significant number of false positives by the enterovirus ELISA (12 out of 20), but the reverse was not true: patients with enterovirus IgM did not produce false positive results in tests for hepatitis A IgM. Excluding samples positive for hepatitis A IgM, the number of non-enterovirus infections correctly reported as negative was 118 out of 120--a specificity of 98%. This test is probably the most useful serological test available at present for diagnosing recent enterovirus infection, although the limited sensitivity needs to be borne in mind.

Epidemiological, virological, and clinical features of an epidemic of hand, foot, and mouth disease in England and Wales.

We describe the epidemiological, virological, and clinical features of an epidemic of hand, foot, and mouth disease, attributed to coxsackie A virus serotype 16, that occurred throughout England and Wales in the last quarter of 1994. Nine hundred and fifty-two cases were reported by spotter practices that make weekly returns to the Royal College of General Practitioners, which made this the largest epidemic of hand, foot, and mouth disease in England and Wales reported to date. Most patients were aged 1 to 4 years and lived in central or southern regions. Clinical features were unavailable from the weekly returns but were described in detail for 39 patients, mostly by means of a questionnaire to general practitioners near the PHLS Coxsackie Reference Laboratory. All cases had a rash on their hands and 23 also had rashes on their feet and in their mouths. Most cases were mild. Severity was associated with the degree of mouth involvement. Secondary cases in family members were rare. Data from the Royal College of General Practitioners since 1963 reveal a period between epidemics of two to three years. The epidemics in 1988 and 1990 also occurred in the last quarters of these years and cases were concentrated in the central and southern regions.

Comparison of two immunoassay procedures for detecting enterovirus IgM.

Enteroviruses cause significant illness in man but viral diagnosis is problematic. Enterovirus-specific IgM tests have been developed but due to the difficulties of obtaining reliable control sera the interpretation of assay data remains mainly arbitrary and empirical. The present study was undertaken to assess the reliability of such assays by comparing two tests performed independently in two different laboratories: a mu-capture radioimmunoassay (MACRIA) which utilizes 35S-labelled Coxsackie virus antigens and an enzyme immunoassay (EIA). A feature of the MACRIA was that sera were tested in one large batch whereas the EIA was in routine use in a reference laboratory. The MACRIA was easy to perform but more suitable for research investigations than routine diagnostic use. Similar results were detected in the majority of sera tested in the two assays with 85% concordance achieved on testing 120 sera. Of the 18 discrepant results, 11 were positive by EIA only and 7 by MACRIA only. 89-95% concordance was obtained on testing sera against individual Coxsackie B1-5 serotypes, moreover 52% of the sera positive in MACRIA were reactive against only one viral antigen and the results on certain of the more strongly reactive sera suggested the existence of a measure of type specificity in the MACRIA test. Qualitative differences between the two tests highlighted problems of interpretation in the absence of a gold standard and cautioned against sole reliance on serology for diagnosis of enteroviral infections.