Environmental Surveillance of Human Enteroviruses in Córdoba City, Argentina: Prevalence and Detection of Serotypes from 2009 to 2014.

Environmental surveillance is an effective approach to investigate the circulation of human enteroviruses (EVs) in the population. EVs excreted by patients who present diverse clinical syndromes can remain infectious in the environment for several weeks, and limited data on circulating environmental EVs are available. A 6-year (2009-2014) surveillance study was conducted to detect non-polio enteroviruses (NPEVs) in the urban sewage of Cordoba city, Argentina. Echovirus 6 (E-6) was the most prevalent (28%), followed by E-14 (17%), E-16 (14%), Coxsackievirus (CV) A9 (11%), E-20 (9%), and CVA24 (6%). Other minority serotypes (E-7, E-13, E-21, E-25, and CVB4) were found, which together represented 14% of the total. In the absence of a systematic EV disease surveillance system, the detection and characterization of sewage-borne NPEVs will help us better understand the changes in EV disease trends and the epidemic background of circulating EVs, which could help interpret the EV trends and warn of future outbreaks in this area.

Environmental Surveillance of Enteroviruses in Central Argentina: First Detection and Evolutionary Analyses of E14.

Environmental surveillance is an effective approach to investigate the circulation of human enteroviruses in the population. Enteroviruses E14, CVA9, E-6, E16, E20, E25, E13, and CVA24 were detected in sewage and a watercourse in central Argentina. E14 was the most frequent serotype and was found for the first time in environmental samples in our region. Phylogenetic and coalescence analyses showed at least two recent introduction events.

Specific detection of all members of the Venezuelan Equine Encephalitis complex: development of a RT-Nested PCR.

Venezuelan Equine Encephalitis (VEE) complex belongs to alphavirus genus in the family Togaviridae. Several species of this complex are pathogenic to humans. VEE infections can produce severe or mild disease, and many cases remain undiagnosed. A specific and sensitive reverse transcriptase nested polymerase chain reaction (RT-Nested PCR) method was developed for the detection of all VEE subtypes, including Rio Negro Virus (RNV) (subtype VI), which circulates only in Argentina. Degenerated primers were designed and thermal cycling parameters were standardized. This technique is suitable for rapid and specific detection of these viruses, and may be useful for diagnosis and surveillance.

Phylodynamics of hepatitis C virus subtype 2c in the province of Córdoba, Argentina.

The Hepatitis C Virus Genotype 2 subtype 2c (HCV-2c) is detected as a low prevalence subtype in many countries, except in Southern Europe and Western Africa. The current epidemiology of HCV in Argentina, a low-prevalence country, shows the expected low prevalence for this subtype. However, this subtype is the most prevalent in the central province of Córdoba. Cruz del Eje (CdE), a small rural city of this province, shows a prevalence for HCV infections of 5%, being 90% of the samples classified as HCV-2c. In other locations of Córdoba Province (OLC) with lower prevalence for HCV, HCV-2c was recorded in about 50% of the samples. The phylogenetic analysis of samples from Córdoba Province consistently conformed a monophyletic group with HCV-2c sequences from all the countries where HCV-2c has been sequenced. The phylogeographic analysis showed an overall association between geographical traits and phylogeny, being these associations significant (α = 0.05) for Italy, France, Argentina (places other than Córdoba), Martinique, CdE and OLC. The coalescence analysis for samples from CdE, OLC and France yielded a Time for the Most Common Recent Ancestor of about 140 years, whereas its demographic reconstruction showed a "lag" phase in the viral population until 1880 and then an exponential growth until 1940. These results were also obtained when each geographical area was analyzed separately, suggesting that HCV-2c came into Córdoba province during the migration process, mainly from Europe, which is compatible with the history of Argentina of the early 20th century. This also suggests that the spread of HCV-2c occurred in Europe and South America almost simultaneously, possibly as a result of the advances in medicine technology of the first half of the 20th century.

Perfil epidemiologico de la infección por el virus de la hepatitis C en la región central de Argentina / Molecular epidemiology pattern of hepatitis C virus infection in central region of Argentina

La presencia de RNA-HCV y la distribución de genotipos se detectaron mediante técnicas moleculares (RT-nested PCR y RFLP) en 310 muestras de individuos de la región centro de Argentina. Se halló 11,8% de coinfección HCV/HIV, con mayor prevalencia de genotipo 1 (73%). La distribución de los genotipos 1 y 2 entre individuos monoinfectados fue de 49,4% y 43,9%, respectivamente. El análisis de regresión logística multivariado mostró que la edad y el uso de drogas endovenosas (UDEV) condicionó la distribución de genotipos. El genotipo 2 se halló frecuentemente entre adultos mayores y su diseminación no se pudo asociar a ninguna vía de transmisión. El genotipo 1 se lo halló principalmente en adultos jóvenes y asociados al UDEV. El notable incremento de genotipo 1, homogéneamente distribuido en todas las edades posee importantes implicancias en las decisiones terapéuticas, considerando que posee baja respuesta a laterapia antiviral.

Perfil epidemiologico de la infección por el virus de la hepatitis C en la región central de Argentina / Molecular epidemiology pattern of hepatitis C virus infection in central region of Argentina

La presencia de RNA-HCV y la distribución de genotipos se detectaron mediante técnicas moleculares (RT-nested PCR y RFLP) en 310 muestras de individuos de la región centro de Argentina. Se halló 11,8% de coinfección HCV/HIV, con mayor prevalencia de genotipo 1 (73%). La distribución de los genotipos 1 y 2 entre individuos monoinfectados fue de 49,4% y 43,9%, respectivamente. El análisis de regresión logística multivariado mostró que la edad y el uso de drogas endovenosas (UDEV) condicionó la distribución de genotipos. El genotipo 2 se halló frecuentemente entre adultos mayores y su diseminación no se pudo asociar a ninguna vía de transmisión. El genotipo 1 se lo halló principalmente en adultos jóvenes y asociados al UDEV. El notable incremento de genotipo 1, homogéneamente distribuido en todas las edades posee importantes implicancias en las decisiones terapéuticas, considerando que posee baja respuesta a laterapia antiviral.(AU)

Human outbreak of St. Louis encephalitis detected in Argentina, 2005.

BACKGROUND: An outbreak of flavivirus encephalitis occurred in 2005 in Córdoba province, Argentina. OBJECTIVES: To characterize the epidemiologic and clinical features of that outbreak and provide the serologic results that identified St. Louis encephalitis virus (SLEV) as the etiologic agent. STUDY DESIGN: From January to May 2005, patients with symptoms of encephalitis, meningitis, or fever with severe headache were evaluated and an etiologic diagnosis achieved by detection of flavivirus-specific antibody sera and cerebrospinal fluid. RESULTS: The epidemic curve of 47 cases showed an explosive outbreak starting in January 2005 with one peak in mid-February and a second peak in mid-March; the epidemic ended in May. Cases occurred predominantly among persons 60 years and older. Nine deaths were reported. SLEV antibodies, when detected in 47 patients studied, had a pattern characteristic of a primary SLEV infection. CONCLUSIONS: Even though isolated cases of St. Louis encephalitis have been reported in Argentina, this is the first description of a large SLEV encephalitis outbreak in Argentina.