Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.218
Filtrar
1.
Orv Hetil ; 160(40): 1574-1583, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31565975

RESUMO

Introduction: Despite advancements in diagnostic capabilities and the availability of effective antimicrobial agents, community-acquired infections of the central nervous system (CNS) are still associated with high mortality rates. Aim: To assess the epidemiological and clinical characteristics of community-acquired CNS infections treated in the West Pannonian region between 2010 and 2016. Method: Clinical data of 176 patients were retrospectively analysed in two age cohorts: 15 to 65 and more than 65 years of age. Results: Neuroinfections were found to be bacterial in 81, viral in 91, parasitic in 1 and mixed in 3 cases during the observation period. The most frequent bacterial pathogens isolated were Streptococcus pneumoniae (20%) and Borrelia burgdorferi (16%). The most frequent viral pathogens isolated were tick-borne encephalitis virus (37%), herpes simplex virus (10%) and enterovirus (7%). Aetiology was unknown in 40 percent of all cases. The average incidence rate was 9.8/100 000 person/year with a mortality rate of 12%. In the cohort of patients aged >65 years, significantly higher frequencies of immunocompromising factors, lower Glasgow Coma Scale values at admission and confusion were observed (p-values: 0.008, 0.017, and 0.050, respectively). Prognosis was negatively influenced by low Glasgow Coma Scale values at admission (OR = 1.6 CI95%: 1.3-1.9; p<0.001), old age (OR = 6.5 CI95%: 2.5-17.1; p<0.001) and immunodeficiency (OR = 3.1 CI95%: 1.2-8.1; p = 0.019). Conclusions: S. pneumoniae remains the most frequently observed causative bacterial pathogen associated with community-acquired CNS infections. Incidence of tick-borne encephalitis in our county is higher than the national average (2.3 versus 0.35/100 000 person/year). Orv Hetil. 2019; 160(40): 1574-1583.


Assuntos
Infecções Bacterianas do Sistema Nervoso Central/microbiologia , Infecções do Sistema Nervoso Central/epidemiologia , Viroses do Sistema Nervoso Central/virologia , Infecções Comunitárias Adquiridas , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Borrelia burgdorferi/isolamento & purificação , Infecções Bacterianas do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/diagnóstico , Estudos de Coortes , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/virologia , Encefalite , Encefalite Transmitida por Carrapatos/epidemiologia , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Feminino , Humanos , Hungria/epidemiologia , Incidência , Doença de Lyme/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções Pneumocócicas/epidemiologia , Estudos Retrospectivos , Simplexvirus/isolamento & purificação , Streptococcus pneumoniae , Adulto Jovem
2.
Zhonghua Er Ke Za Zhi ; 57(6): 445-451, 2019 Jun 02.
Artigo em Chinês | MEDLINE | ID: mdl-31216802

RESUMO

Objective: To study the clinical characteristics of outpatients with hand, foot and mouth disease (HFMD) caused by different serotypes of enteroviruses. Methods: This was a prospective study. From February 2017 to March 2018, 563 outpatients with HFMD were enrolled by systematic sampling in the Department of Infectious Diseases, Henan Children's Hospital. Throat swabs were collected to determine the serotypes via PCR. Demographic, clinical, and laboratory data were collected by standard questionnaire. All cases were followed up twice at 2 and 9 weeks after the initial outpatient visit through telephone interview. A total of 563 cases were enrolled and 555 (98.6%) cases were positive for human enteroviruses, including 338 (60.9%) males. Analyses were stratified by enterovirus serotypes, Chi square test or Fisher's exact test, Rank sum test was used for comparison among different groups. Results: The age of 555 cases was 24.2 (16.4, 41.3) months. Among them 44.0% (224 cases) were identified as coxsackievirus (CV)-A6, while 189 cases, 35 cases, 14 cases and 73 cases were identified as CV-A16, enterovirus (EV)-A71, CV-A10 and other serotypes, respectively. Fever (≥37.5 ℃) was present in 51.4% (285/555) of laboratory confirmed cases. The proportions of fever in cases of CV-A6 (68.9%(168/244)) and CV-A10 (12/14) were significantly higher than those in cases of CV-A16 (31.7%(60/189),χ(2)=57.344,14.313,both P=0.000), other serotypes (43.8%(32/73),χ(2)=15.101 and 8.242, P=0.000 and 0.004) and EV-A71 (37.1%(13/35), χ(2)=13.506 and 9.441, P=0.000 and 0.002) respectively. There was no significant difference between CV-A6 and CV-A10 in presentation of fever (χ(2)=1.785, P=0.182). There were 359 cases (64.7%) with eruptions in mouth, hands, feet and buttocks. Cases infected with EV-A71 had the highest proportions (74.3%(26/35)) of rash emerging simultaneously in mouth, hands, feet, and buttocks. The proportion in cases of CV-A16, CV-A6, CVA10 and other serotype were 73.5% (139/189), 61.9% (151/244), 7/14 and 49.3% (36/73), respectively. The proportion of rash on other parts of body, such as face, limbs or torso in cases infected with CV-A6 (16.8% (41/244)) was the higherest and the proportion in cases of CV-A16, EV-A71, CV-A10 or other serotypes were 8.5% (16/189) , 5.7% (2/35) , 1/14, 6.8% (5/73) , respectively. None of these cases developed serious complications. Desquamation occurred in 45.5% (179/393) cases 7.5 (5.0, 9.0) days after disease onset and 13.5% (53/393) cases showed onychomadesis 31.0 (18.0, 33.5) days after disease onset. The proportion of desquamation and onychomadesis associated with CV-A6 (64.2% (95/148) and 31.8% (47/148)) was significantly higher than CV-A16 (31.8% (49/154) and 1.3% (2/154), χ(2)=33.601 and 52.482, both P=0.000) and other serotypes (38.0%(19/50) and 6.0%(3/50),χ(2)=10.236 and 12.988, P=0.001 and 0.000). Desquamation appeared more in cases of CV-A6 than in cases of CV-A10 (2/11,χ(2)=9.386, P=0.002), with the proportion of onychomadesis higher in CV-A6 than in EV-A71 (3.3% (1/30),χ(2)=11.088, P=0.001). Conclusion: Clinical manifestation such as fever, rash emerging parts, desquamation and onychomadesis are different among outpatient HFMD cases infected with CV-A16, CV-A6, EV-A71, CV-A10 and other enteroviruses.


Assuntos
Infecções por Enterovirus/diagnóstico , Enterovirus/isolamento & purificação , Doença de Mão, Pé e Boca/epidemiologia , Pré-Escolar , China/epidemiologia , Infecções por Enterovirus/epidemiologia , Doença de Mão, Pé e Boca/virologia , Hospitalização , Humanos , Pacientes Internados , Masculino , Pacientes Ambulatoriais , Estudos Prospectivos
3.
Mayo Clin Proc ; 94(5): 875-881, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31054607

RESUMO

Acute flaccid myelitis (AFM) is characterized by flaccid paralysis of one or more limbs, often following a viral illness, with magnetic resonance imaging findings consistent with inflammation of the spinal cord gray matter. It is unclear whether all patients with AFM will have full recovery of neurologic function. Since 2014, there have been several clusters of AFM in the United States, with a 3-fold increase in reported AFM cases recorded in 2018 compared with the previous year. Epidemiological evidence supports a temporal association between respiratory enteroviral illness, particularly with enteroviruses D68 and A71, and clustering of AFM cases. However, causality has yet to be established. Treatment of AFM is primarily supportive. Adjunctive therapies such as intravenous immunoglobulin, corticosteroids, plasmapheresis, and fluoxetine have not been found to improve long-term outcomes. Further research is urgently needed to characterize and optimize management of this emerging, yet poorly understood, condition.


Assuntos
Infecções por Enterovirus/epidemiologia , Hipotonia Muscular/etiologia , Mielite/etiologia , Doença Aguda , Enterovirus Humano D , Infecções por Enterovirus/líquido cefalorraquidiano , Infecções por Enterovirus/diagnóstico , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Hipotonia Muscular/virologia , Mielite/virologia , Paralisia , Medula Espinal/diagnóstico por imagem , Estados Unidos/epidemiologia
4.
PLoS Negl Trop Dis ; 13(4): e0007335, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31002713

RESUMO

Enteroviruses (EVs) are among the most common viruses infecting humans worldwide but only a few Non-Polio Enterovirus (NPEV) isolates have been characterized in the Democratic Republic of Congo (DR Congo). Moreover, circulating vaccine-derived polioviruses (PVs) [cVDPVs] isolated during multiple outbreaks in DR Congo from 2004 to 2018 have been characterized so far only by the sequences of their VP1 capsid coding gene. This study was carried to i) investigate the circulation and genetic diversity of NPEV and polio vaccine isolates recovered from healthy children and Acute Flaccid Paralysis (AFP) patients, ii) evaluate the occurrence of genetic recombination among EVs belonging to the Enterovirus C species (including PVs) and iii) identify the virological factors favoring multiple emergences of cVDPVs in DR Congo. The biological material considered in this study included i) a collection of 91 Sabin-like PVs, 54 cVDPVs and 150 NPEVs isolated from AFP patients between 2008 and 2012 in DR Congo and iii) a collection of 330 stool specimens collected from healthy children in 2013 in the Kasai Oriental and Maniema provinces of DR Congo. Studied virus isolates were sequenced in four distinct sub-genomic regions 5'-UTR, VP1, 2CATPase and 3Dpol. Resulting sequences were compared through comparative phylogenetic analyses. Virus isolation showed that 19.1% (63/330) healthy children were infected by EVs including 17.9% (59/330) of NPEVs and 1.2% (4/330) of type 3 Sabin-like PVs. Only one EV-C type, EV-C99 was identified among the NPEV collection from AFP patients whereas 27.5% of the 69 NPEV isolates typed in healthy children belonged to the EV-C species: CV-A13 (13/69), A20 (5/69) and A17 (1/69). Interestingly, 50 of the 54 cVDPVs featured recombinant genomes containing exogenous sequences in at least one of the targeted non-structural regions of their genomes: 5'UTR, 2CATPase and 3Dpol. Some of these non-vaccine sequences of the recombinant cVDPVs were strikingly related to homologous sequences from co-circulating CV-A17 and A20 in the 2CATPase region as well as to those from co-circulating CV-A13, A17 and A20 in the 3Dpol region. This study provided the first evidence uncovering CV-A20 strains as major recombination partners of PVs. High quality AFP surveillance, sensitive environmental surveillance and efficient vaccination activities remain essential to ensure timely detection and efficient response to recombinant cVDPVs outbreaks in DR Congo. Such needs are valid for any epidemiological setting where high frequency and genetic diversity of Coxsackieviruses A13, A17 and A20 provide a conducive viral ecosystem for the emergence of virulent recombinant cVDPVs.


Assuntos
Enterovirus Humano C/genética , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/virologia , Evolução Molecular , Poliovirus/genética , Recombinação Genética , Linhagem Celular , Criança , República Democrática do Congo/epidemiologia , Humanos , Filogenia , Vacina Antipólio Oral , Estudos Prospectivos , RNA Viral/genética , RNA Viral/isolamento & purificação , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de DNA , Homologia de Sequência
5.
Future Microbiol ; 14: 499-507, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31033351

RESUMO

Aim: To describe the genetic diversity of enteroviruses (EV) causing hand, foot and mouth disease (HFMD) and herpangina, especially of coxsackievirus (CV)-A6, from patients attended at pediatric primary care centers during the 2017-2018 season. Methods: Phylogenetic analysis of partial VP1 region was performed for genetic characterization. The complete VP1 and 3Dpol proteins were sequenced for lineage determination and detection of recombination events. Results: An 80% of samples were EV laboratory-confirmed. CV-A6 was the most detected (70%) and associated with atypical HFMD (78%). The comparison of VP1 and 3Dpol phylogenies showed evidence of recombination in three strains, in which two shifted to CV-A16 3Dpol. Conclusion: The study provides recent information regarding the nonrecombinant and recombinant EVs related to HFMD at primary care centers.


Assuntos
Enterovirus/genética , Enterovirus/patogenicidade , Doença de Mão, Pé e Boca/virologia , Herpangina/virologia , Atenção Primária à Saúde , Proteínas do Capsídeo/genética , Pré-Escolar , Surtos de Doenças , Enterovirus/classificação , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/virologia , Feminino , Genótipo , Doença de Mão, Pé e Boca/epidemiologia , Herpangina/epidemiologia , Humanos , Lactente , Masculino , Filogenia , Estudos Prospectivos , Espanha/epidemiologia
6.
MMWR Morb Mortal Wkly Rep ; 68(12): 277-280, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-30921299

RESUMO

In the fall of 2014, an outbreak of enterovirus D68 (EV-D68)-associated acute respiratory illness (ARI) occurred in the United States (1,2); before 2014, EV-D68 was rarely reported to CDC (2,3). In the United States, reported EV-D68 detections typically peak during late summer and early fall (3). EV-D68 epidemiology is not fully understood because testing in clinical settings seldom has been available and detections are not notifiable to CDC. To better understand EV-D68 epidemiology, CDC recently established active, prospective EV-D68 surveillance among pediatric patients at seven U.S. medical centers through the New Vaccine Surveillance Network (NVSN) (4). This report details a preliminary characterization of EV-D68 testing and detections among emergency department (ED) and hospitalized patients with ARI at all NVSN sites during July 1-October 31, 2017, and the same period in 2018. Among patients with ARI who were tested, EV-D68 was detected in two patients (0.8%) in 2017 and 358 (13.9%) in 2018. Continued active, prospective surveillance of EV-D68-associated ARI is needed to better understand EV-D68 epidemiology in the United States.


Assuntos
Surtos de Doenças , Enterovirus Humano D/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Vigilância da População/métodos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Adolescente , Criança , Pré-Escolar , Enterovirus Humano D/genética , Infecções por Enterovirus/virologia , Feminino , Humanos , Lactente , Masculino , Estados Unidos/epidemiologia
7.
BMC Infect Dis ; 19(1): 285, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30917800

RESUMO

BACKGROUND: Hand, foot and mouth disease (HFMD) is a transmissible infectious disease caused by human enteroviruses (EV). Here, we described features of children with severe HFMD caused by EV-A71 or coxsackievirus A16 (CV-A16) in Shanghai, China. METHODS: Severe EV-A71 or CV-A16 caused HFMD children admitted to the Xinhua Hospital from January 2014 and December 2016, were recruited retrospectively to the study. Symptoms and findings at the time of hospitalization, laboratory tests, treatments, length of stay and residual findings at discharge were systematically recorded and analyzed. RESULTS: Of 19,995 children visited clinic service with probable HFMD, 574 children (2.87%) were admitted, 234 children (40.76%) were confirmed with EV-A71 (90/574) or CV-A16 (144/574) disease. Most (91.02%) of the patients were under 5 years. Initial clinical symptoms of EV-A71 and CV-A16 cases were: fever > 39 °C in 81 (90%) and 119 (82.63%), vomiting in 31 (34.44%) and 28 (19.44%), myoclonic twitching in 19 (21.11%) and 11(7.64%), startle in 21 (23.33%) and 20 (13.69%), respectively. Serum levels of interleukin-1ß (IL-1ß), IL-2, IL-6, IL-8, interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α) were significantly upregulated in severe HFMD subjects. Forty-seven children (20.08%) treated with intravenous gamma globulin (IVIG) showed decreased duration of illness episodes. All children were discharged without complications. CONCLUSIONS: EV-A71 and CV-A16 accounted 40.76% of admitted HFMD during 2014 to 2016 in Xinhua Hospital. IVIG appeared to be beneficial in shortening the duration of illness episodes of severe HFMD.


Assuntos
Infecções por Coxsackievirus/epidemiologia , Infecções por Coxsackievirus/terapia , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/terapia , Enterovirus , Doença de Mão, Pé e Boca/epidemiologia , Doença de Mão, Pé e Boca/terapia , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , Enterovirus/fisiologia , Enterovirus Humano A/fisiologia , Infecções por Enterovirus/complicações , Infecções por Enterovirus/diagnóstico , Feminino , Doença de Mão, Pé e Boca/diagnóstico , Doença de Mão, Pé e Boca/microbiologia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
8.
Food Environ Virol ; 11(2): 198-203, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30895523

RESUMO

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.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/isolamento & purificação , Argentina/epidemiologia , Enterovirus/classificação , Enterovirus/genética , Infecções por Enterovirus/epidemiologia , Monitoramento Ambiental , Humanos , Filogenia , Sorogrupo , Esgotos/virologia
9.
BMJ ; 364: l231, 2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30760441

RESUMO

OBJECTIVE: To determine whether infection with human enterovirus or adenovirus, both common intestinal viruses, predicts development of coeliac disease. DESIGN: Case-control study nested within Norwegian birth cohort recruited between 2001 and 2007 and followed to September 2016. SETTING: Norwegian population. PARTICIPANTS: Children carrying the HLA genotype DR4-DQ8/DR3-DQ2 conferring increased risk of coeliac disease. EXPOSURES: Enterovirus and adenovirus detected using real time polymerase chain reaction in monthly stool samples from age 3 to 36 months. MAIN OUTCOME MEASURE: Coeliac disease diagnosed according to standard criteria. Coeliac disease antibodies were tested in blood samples taken at age 3, 6, 9, and 12 months and then annually. Adjusted odds ratios from mixed effects logistic regression model were used to assess the relation between viral infections before development of coeliac disease antibodies and coeliac disease. RESULTS: Among 220 children, and after a mean of 9.9 (SD 1.6) years, 25 children were diagnosed as having coeliac disease after screening and were matched to two controls each. Enterovirus was found in 370 (17%) of 2135 samples and was significantly more frequent in samples collected before development of coeliac disease antibodies in cases than in controls (adjusted odds ratio 1.49, 95% confidence interval 1.07 to 2.06; P=0.02). The association was restricted to infections after introduction of gluten. High quantity samples (>100 000 copies/µL) (adjusted odds ratio 2.11, 1.24 to 3.60; P=0.01) and long lasting infections (>2 months) (2.16, 1.16 to 4.04; P=0.02) gave higher risk estimates. Both the commonly detected enterovirus species Enterovirus A and Enterovirus B were significantly associated with coeliac disease. The association was not found for infections during or after development of coeliac disease antibodies. Adenovirus was not associated with coeliac disease. CONCLUSIONS: In this longitudinal study, a higher frequency of enterovirus, but not adenovirus, during early childhood was associated with later coeliac disease. The finding adds new information on the role of viral infections in the aetiology of coeliac disease.


Assuntos
Doença Celíaca/virologia , Infecções por Enterovirus/complicações , Autoanticorpos/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Fezes/virologia , Feminino , Genótipo , Humanos , Lactente , Estudos Longitudinais , Masculino , Noruega/epidemiologia , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco
10.
Virol Sin ; 34(1): 50-58, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30790201

RESUMO

Echovirus 18 (E18), a serotype of Enterovirus B (EV-B) species, is an important pathogen in aseptic meningitis. E18 had rarely been detected in mainland China, but became the predominant pathogen associated with viral encephalitis (VE) and meningitis in Hebei province for the first time in 2015. To investigate the molecular epidemiology and genetic characteristics of E18 in mainland China, sixteen E18 strains from patient throat swabs with hand, foot, and mouth disease (HFMD) in six provinces in China collected between 2015 and 2016, and four E18 strains isolated from 18 patient cerebrospinal fluid specimens with VE in Hebei Province in 2015 were obtained and sequenced. Combined with the sequences from the GenBank database, we performed an extensive genetic analysis. Phylogenetic analysis of VP1 gene sequences revealed that all E18 strains from mainland China after 2015 belonged to subgenotype C2. There were no obvious specific differences in phylogenetic and variation analyses of E18 genome sequences between HFMD and VE/meningitis strains. Potential multiple recombination may have occurred in the 5'-untranslated region and in the P2 and P3 nonstructural protein-encoding regions of E18 strains from China. The current E18 strains were potential multiple-recombinant viruses. Overall, these findings supported that E18 caused HFMD, VE, and meningitis, although there were no significant associations between clinical features and viral genomic characteristics.


Assuntos
Enterovirus Humano B/genética , Infecções por Enterovirus/epidemiologia , Genoma Viral , Genótipo , Proteínas do Capsídeo/genética , China/epidemiologia , Surtos de Doenças , Encefalite Viral/epidemiologia , Enterovirus Humano B/patogenicidade , Infecções por Enterovirus/virologia , Doença de Mão, Pé e Boca/epidemiologia , Humanos , Meningite Viral/epidemiologia , Filogenia , RNA Viral/genética , Recombinação Genética
11.
Emerg Infect Dis ; 25(3): 585-588, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30789123

RESUMO

We evaluated enterovirus D68 seroprevalence in Kansas City, Missouri, USA, from samples obtained during 2012-2013. Neutralizing antibodies against Fermon and the dominant 2014 Missouri isolate were universally detected. Titers increased with age. Widespread circulation of enterovirus D68 occurred before the 2014 outbreak. Research is needed to determine a surrogate of protection.


Assuntos
Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Surtos de Doenças , Enterovirus Humano D/imunologia , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Enterovirus Humano D/classificação , Enterovirus Humano D/genética , Infecções por Enterovirus/história , Infecções por Enterovirus/virologia , Feminino , História do Século XXI , Humanos , Masculino , Pessoa de Meia-Idade , Missouri/epidemiologia , Filogenia , Estudos Soroepidemiológicos , Adulto Jovem
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(1): 79-83, 2019 Jan 10.
Artigo em Chinês | MEDLINE | ID: mdl-30669736

RESUMO

Objective: To estimate the serotype and age-specific hospitalization burden associated with hand, foot and mouth disease (HFMD) in Anhua county of Hunan province, between October 2013 and September 2016. Methods: We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals, and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua. Combined with the results of virological surveillance, the serotype-specific hospitalization burden of HFMD in Anhua, was estimated. Results: During the three years, it was estimated that 3 541 clinical diagnosed HFMD cases, including 3 146 laboratory-confirmed HFMD cases, were hospitalized in Anhua, but only one was diaguosed as being severe. The estimated average hospitalization rate was 723/100 000(95%CI: 699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95%CI: 620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016. The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000), Cox A10 (38/100 000) and other enterovirus (64/100 000), and the difference was statistically significant (P<0.001). HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000), and then decreased with age. Compared with the hospitalized HFMD caused by EV71 and Cox A16, Cox A6-associated hospitalizations mainly occurred in younger age groups (P<0.001). Conclusion: Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71, Cox A16, Cox A6 and Cox A10, especially in young children, in Anhua.


Assuntos
Enterovirus Humano A/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Doença de Mão, Pé e Boca/epidemiologia , Doença de Mão, Pé e Boca/virologia , Hospitalização/estatística & dados numéricos , Criança , China/epidemiologia , Enterovirus , Enterovirus Humano A/genética , Infecções por Enterovirus/virologia , Doença de Mão, Pé e Boca/etnologia , Hospitais/estatística & dados numéricos , Humanos , Lactente , Sorogrupo
14.
BMC Infect Dis ; 19(1): 32, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621623

RESUMO

BACKGROUND: Viruses are commonly found in patients with acute respiratory infections (ARIs). However, the viral etiologies and clinical characteristics of outpatients with ARIs are poorly understood in China. Here, we identified the viral etiologies in outpatients with ARIs in Huzhou, China. RESULTS: Our results indicated that of 426 outpatients, 246 were positive for viruses. Of them, 221 were positive for a single virus, including influenza A, which comprised H3N2 (28.5%) and pandemic H1N1 (2009) (19.0%), enterovirus (10.4%), and influenza B (8.6%). Other single viruses were detected at less than 8.0%. Twenty-five patients were positively coinfected with two viruses. The prevalent viruses in coinfections were rhinovirus and H3N2 virus (28.0%). Viruses were major pathogens in young children (< 5 years) (75.0%). Coinfections were prevalent in older adults (11.9%) and young children (9.5%). Virus-positive outpatients presented higher temperatures and more sore throat, fatigue and shortness of breath than virus-negative outpatients. ARIs and most virus detections peaked during the winter, but enteroviruses emerged between April and September. CONCLUSION: Viruses are major agents of ARIs among outpatients in Huzhou, China. There was a variation in the distribution of viruses across different age groups and seasons. These findings are beneficial for planning prevention and treatment services for outpatients with ARIs.


Assuntos
Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Coinfecção/epidemiologia , Coinfecção/virologia , Enterovirus/isolamento & purificação , Infecções por Enterovirus/complicações , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/virologia , Feminino , Humanos , Lactente , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Prevalência , Estudos Retrospectivos , Rhinovirus/isolamento & purificação , Estações do Ano , Adulto Jovem
15.
PLoS One ; 14(1): e0208902, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30699113

RESUMO

Despite polio eradication, nonpolio enterovirus (NPEV) detection amid polio surveillance, which is considered to have implications in paralysis, requires attention. The attributes of NPEV infections in nonpolio-AFP (NPAFP) cases from Uttar Pradesh (UP), India, remain undetermined and are thus investigated. A total of 1839 stool samples collected from patients with acute flaccid paralysis (AFP) from UP, India, between January 2010 and October 2011 were analyzed as per the WHO algorithm. A total of 359 NPAFP cases yielded NPEVs, which were subjected to microneutralization assay, partial VP1 gene-based molecular serotyping and phylogenetic analysis. Demographic and clinical-epidemiological features were also ascertained. Echoviruses (29%) and Coxsackievirus (CV)-B (17%) were the most common viruses identified by the microneutralization assay. The molecular genotyping characterized the NPEVs into 34 different serotypes, corresponding to Enterovirus (EV)-A (1.6%), EV-B (94%) and EV-C (5.3%) species. The rarely described EV serotypes, such as EV-C95, CV-A20, EV-C105, EV-B75, EV-B101, and EV-B107, were also identified. NPEV-associated AFP was more prevalent in younger male children, peaked in the monsoon months and was predominantly found in the central part of the state. The NPEV strains isolated in the study exhibited genetic diversity from those isolated in other countries. These form part of a different cluster or subcluster existing in cocirculation, limited to India only. This study augments the understanding of epidemiological features and demonstrates the extensive diversity exhibited by the NPEV strains in NPAFP cases from the polio-endemic region. It also underscores the need or effective long-term strategies to monitor NPEV circulation and its associated health risks in the post-polio eradication era.


Assuntos
Infecções por Enterovirus/genética , Infecções por Enterovirus/virologia , Enterovirus/patogenicidade , Poliomielite/genética , Poliomielite/virologia , Distribuição de Qui-Quadrado , Enterovirus/genética , Infecções por Enterovirus/epidemiologia , Feminino , Genótipo , Humanos , Índia , Masculino , Paralisia , Filogenia , Poliomielite/epidemiologia , Sorogrupo
16.
Emerg Infect Dis ; 25(3): 573-576, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30602120

RESUMO

After a 2014 outbreak of severe respiratory illness caused by enterovirus D68 in the United States, sporadic cases of acute flaccid myelitis have been reported worldwide. We describe a cluster of acute flaccid myelitis cases in Argentina in 2016, adding data to the evidence of association between enterovirus D68 and this polio-like illness.


Assuntos
Enterovirus Humano D , Infecções por Enterovirus/epidemiologia , Mielite/epidemiologia , Mielite/virologia , Fatores Etários , Argentina/epidemiologia , Proteínas do Capsídeo/genética , Pré-Escolar , Infecções por Enterovirus/história , Infecções por Enterovirus/terapia , Infecções por Enterovirus/virologia , Feminino , História do Século XXI , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Lactente , Masculino , Mielite/história , Mielite/terapia , Filogenia , Carga Viral
17.
J Trace Elem Med Biol ; 51: 150-158, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30466925

RESUMO

Few spatial ecological studies on selenoprotein P (SePP) and Keshan disease (KD) have been reported. The main objective of this study is to investigate the relationships of SePP with KD, economic indicators and soil selenium and to visualize the evidence for KD precise prevention and control. An ecological study design was employed. The serum SePP of 2351 subjects living in rural areas, general cities and developed cities in 15 KD endemic provinces and 13 KD non-endemic provinces in China were measured. Spatial description and spatial analysis of SePP were conducted. The subjects were adults aged. The mean serum SePP level of KD endemic area residents was 14.20 mg/L, significantly lower than that in non-endemic areas, 15.30 mg/L (t = - 3.19, P = 0.0010). Serum SePP levels were low among the people in the KD endemic provinces of Shandong, Inner Mongolia, Heilongjiang, etc. The mean serum SePP level of the 2351 people was 15.04 (95% CI: 14.76 and 15.31) mg/L. The mean serum SePP levels of residents in developed cities, general cities and rural areas were 16.54 mg/L, 14.98 mg/L and 14.44 mg/L, respectively, and were significantly different (F = 17.00, P < 0.0010). Spatial regression analysis showed that the spatial distribution of SePP was positively correlated with per capita consumption expenditure and soil selenium. Selenium deficiency may still exist among residents living in the KD endemic provinces. Shandong, Inner Mongolia, and Heilongjiang should be the target provinces, visualized by spatial analysis, for KD precise prevention and control.


Assuntos
Cardiomiopatias/sangue , Cardiomiopatias/epidemiologia , Infecções por Enterovirus/sangue , Infecções por Enterovirus/epidemiologia , Selenoproteína P/sangue , Adolescente , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Adulto Jovem
18.
Emerg Infect Dis ; 25(1)2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30560775

RESUMO

We conducted an observational study from January 2016 through January 2017 of patients admitted to a reference pediatric hospital in Madrid, Spain, for neurologic symptoms and enterovirus infection. Among the 30 patients, the most common signs and symptoms were fever, lethargy, myoclonic jerks, and ataxia. Real-time PCR detected enterovirus in the cerebrospinal fluid of 8 patients, nasopharyngeal aspirate in 17, and anal swab samples of 5. The enterovirus was genotyped for 25 of 30 patients; enterovirus A71 was the most common serotype (21/25) and the only serotype detected in patients with brainstem encephalitis or encephalomyelitis. Treatment was intravenous immunoglobulins for 21 patients and corticosteroids for 17. Admission to the pediatric intensive care unit was required for 14 patients. All patients survived. At admission, among patients with the most severe disease, leukocytes were elevated. For children with brainstem encephalitis or encephalomyelitis, clinicians should look for enterovirus and not limit testing to cerebrospinal fluid.


Assuntos
Encefalite Viral/virologia , Encefalomielite/virologia , Enterovirus Humano A/isolamento & purificação , Infecções por Enterovirus/virologia , Epidemias , Doenças do Sistema Nervoso/virologia , Criança , Pré-Escolar , Encefalite Viral/epidemiologia , Encefalomielite/epidemiologia , Infecções por Enterovirus/epidemiologia , Feminino , Humanos , Lactente , Masculino , Doenças do Sistema Nervoso/epidemiologia , Estudos Prospectivos , Espanha/epidemiologia
20.
J Pediatric Infect Dis Soc ; 7(suppl_2): S49-S53, 2018 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-30590621

RESUMO

Enterovirus D68 (EV-D68) is a pathogen that causes outbreaks of respiratory illness across the world, mostly in children, and can be especially severe in those with asthma. Clusters of acute flaccid myelitis, a poliomyelitis-like neuromuscular weakness syndrome, often occur concurrent with EV-D68 respiratory outbreaks. Seroepidemiologic studies have found that the serum of nearly everyone older than 2 to 5 years contains anti-EV-D68 neutralizing antibodies, which suggests that EV-D68 is a ubiquitous pathogen of childhood. However, knowledge of the viral epitopes against which the humoral immune response is directed is only inferred from previous studies of related viruses. Although neutralizing antibodies protect newborn mice from lethal EV-D68 inoculation via nonphysiologic routes, cotton rats have a mixed phenotype of both benefit and possible exacerbation when inoculated intranasally. The human antibody response to EV-D68 needs to be studied further to clarify the role of antibodies in protection versus pathogenesis, which might differ among respiratory and neurologic disease phenotypes.


Assuntos
Enterovirus Humano D/imunologia , Infecções por Enterovirus/imunologia , Imunidade Humoral , Doenças do Sistema Nervoso/imunologia , Infecções Respiratórias/imunologia , Animais , Anticorpos Neutralizantes/sangue , Modelos Animais de Doenças , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/prevenção & controle , Epitopos/imunologia , Humanos , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/prevenção & controle , Doenças do Sistema Nervoso/virologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , Estudos Soroepidemiológicos , Vacinação , Vacinas Virais/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA