A Retrospective Overview of Enterovirus Infection Diagnosis and Molecular Epidemiology in the Public Hospitals of Marseille, France (1985–2005)

Abstract

Human enteroviruses (HEV) are frequent human pathogens and, associated in particular with large outbreaks of aseptic meningitis. Here, we have compiled a database of clinical HEV isolates from the Public Hospitals of Marseille, from 1985 to 2005. Amongst 654 isolates that could be characterized by complete sequencing of the VP1 gene, 98% belonged to species HEV-B; the most frequently isolated serotypes were Echovirus E30, E11, E7, E6 and E4. The high incidence of E30 and the recent emergence of E13 are consistent with reports worldwide and peak HEV isolation occurred mostly in the late spring and summer months. The proportion of echoviruses has decreased across the years, while that of coxsackieviruses has increased. Stool (the most frequent sample type) allowed detection of all identified serotypes. MRC5 (Human lung fibroblasts) cell line was the most conducive cell line for HEV isolation (84.9% of 10 most common serotype isolates, 96.3% in association with BGM (Buffalo green monkey kidney cells)). Previous seroneutralization-based serotype identification demonstrated 55.4% accuracy when compared with molecular VP1 analysis. Our analysis of a large number of clinical strains over 20 years reinforced the validity of VP1 serotyping and showed that comparative p-distance scores can be coupled with phylogenetic analysis to provide non-ambiguous serotype identification. Phylogenetic analysis in the VP1, 2C and 3D regions also provided evidence for recombination events amongst clinical isolates. In particular, it identified isolates with dissimilar VP1 but almost identical nonstructural regions.

Molecular Characterization of Human Enteroviruses in the Central African Republic: Uncovering Wide Diversity and Identification of a New Human Enterovirus A71 Genogroup

“…A huge diversity of serotypes was observed. Most of the isolates belonged to species HEV-B, consistent with previous observations in many epidemiological investigations on HEV circulating in other countries (3,6,8,13,59,63). This predominance could have been partly due to cell culture techniques, which may favor the detection of this species (19,25), as suggested by the significant increase in the isolation of non-B HEV since 2004, when the systematic testing of stool samples on HEp-2c cells was introduced (Fig.…”

“…In most of the epidemiological studies that have been performed on HEV-infected patients in developed countries, the proportions of HEV-C isolates ranged from 0% to 4.7% (6,8,32,52,59,63,64). The high proportion of HEV-C species isolates in this study could have been due to the selection of stool samples from children with acute flaccid paralysis: in an investigation carried out over a 5-year period in China, in the same clinical context, 195 isolates were typed and 32 (16.4%) were found to be HEV-C (13).…”

High Frequency and Diversity of Species C Enteroviruses in Cameroon and Neighboring Countries

“…As in healthy children, the rates of HEV-C infection were also high in AFP patients from all three countries (Table 3). Overall, the rate of HEV-C infections in Cameroon and neighboring countries was huge compared to rates reported by most studies of EV-infected patients in temperate countries, including North Africa (43)(44)(45). In our study, HEp-2c cells were systematically used for virus isolation, in addition to the primary RD and L20B cells recommended by the WHO for poliomyelitis surveillance (16).…”

“…Indeed, high rates of HEV-C isolation were repeatedly reported when isolation techniques made use of both the HEp-2c and RD cell lines in some tropical countries, including Cambodia (3), the Central African Republic (32), Madagascar (15), and China (49). In contrast to tropical countries, several previous epidemiological studies using the HEp2-c cell line in industrialized countries recurrently reported HEV-C isolation rates of less than 5% (43,45,(50)(51)(52). Overall, it appears that the high rate of HEV-C is linked to tropical conditions, where the use of the HEp2-c cell line for the NPEV surveillance would be of great interest.…”

Prevalencia de enterovirus en recién nacidos y lactantes que consultaron a un centro de atención de primer nivel, Armenia, Colombia, 2009

“…El E30 es el serotipo que se ha asociado con mayor frecuencia con meningoencefalitis viral, comprendiendo el 6,8 % de todos los aislamientos de enterovirus informados en los Estados Unidos de 1970 a 1983 (13) y, el 9,5 %, de los enterovirus aislados durante el período 1993 a 1996 (14). En Europa, también se ha informado una gran actividad de E30 y, recientemente, se han reportado brotes de meningoencefalitis por este agente en Serbia, España, Finlandia y Francia (15)(16)(17)(18). En la region de las Américas, también se han reportado brotes de meningoencefalitis por E30 en Argentina y Brasil (19,20 En un estudio en Cuba en el período de 1990 a 1995, en el que se analizaron 586 muestras de heces, se demostró la presencia de enterovirus en 32,4 % de los casos (27).…”