Comparison of diagnostic clinical samples and environmental sampling for enterovirus and parechovirus surveillance in Scotland, 2010 to 2012

Abstract

Human enteroviruses (EV) and parechoviruses (HPeV) within the family Picornaviridae are the most common causes of viral central nervous system (CNS)associated infections including meningitis and neonatal sepsis-like disease. The frequencies of EV and HPeV types identified in clinical specimens collected in Scotland over an eight-year period were compared to those identified in sewage surveillance established in Edinburgh. Of the 35 different EV types belonging to four EV species (A to D) and the four HPeV types detected in this study, HPeV3 was identified as the most prevalent picornavirus in cerebrospinal fluid samples, followed by species B EV. Interestingly, over half of EV and all HPeV CNS-associated infections were observed in young infants (younger than three months). Detection of species A EV including coxsackievirus A6 and EV71 in clinical samples and sewage indicates that these viruses are already widely circulating in Scotland. Furthermore, species C EV were frequently identified EV in sewage screening but they were not present in any of 606 EV-positive clinical samples studied, indicating their likely lower pathogenicity. Picornavirus surveillance is important not only for monitoring the changing epidemiology of these infections but also for the rapid identification of spread of emerging EV and/or HPeV types.

Polio and Measles Down the Drain: Environmental Enterovirus Surveillance in the Netherlands, 2005 to 2015

“…The EEVS in the Bible Belt and Ter Apel show a high diversity of NPEV types in the sewage, similar to previous reports about sewage waters (22). In the Bible Belt and Ter Apel surveillance EV-B strains prevailed, and in the Ter Apel sewage EV-C viruses were detected relatively frequently.…”

Laboratory Surveillance of Polio and Other Enteroviruses in High-Risk Populations and Environmental Samples

“…Contrary to our study, in which fecal specimens were collected from healthy individuals, clinical samples analyzed in the above-referenced studies were obtained from patients with enterovirus-compatible disease. A wider introduction of molecular methods of enterovirus typing could provide more accurate information on circulating enteroviruses, as Harvala et al indicated (30). Implementation of molecular methods for EV screening could be beneficial in terms of increased sensitivity of detection and speed with which results can be reported, as well as reduced workload and total cost due to the exclusion of EV-negative samples from further analysis.…”

Detection of Human Parechoviruses in Clinical and Municipal Wastewater Samples in Miyagi, Japan, in 2012–2014

“…High detection frequencies (41-78z) and high nucleotide sequence diversity of HPeVs in wastewater samples suggest that analysis of wastewater is a practical approach to detection and research on this virus (13,14). In contrast, lower detection frequencies (2.2-7.4z) have been reported for the stool samples collected from patients with suspected viral infections (3,5).…”

“…Environmental surveillance, either alone or with clinical analyses, has been conducted to better understand the epidemiology of HPeV infections (13,14). High detection frequencies (41-78z) and high nucleotide sequence diversity of HPeVs in wastewater samples suggest that analysis of wastewater is a practical approach to detection and research on this virus (13,14).…”

“…In contrast, lower detection frequencies (2.2-7.4z) have been reported for the stool samples collected from patients with suspected viral infections (3,5). Nonetheless, the burden of HPeV diseases may be underestimated (13,14) because sero-epidemiological studies revealed that more than a half of infants aged 7-11 months have a neutralizing antibody against HPeV1 (15), and the seroprevalence increases rapidly with age, reaching 97-100z among adults (16,17). As for HPeV3, more than 80z of individuals over 30 years of age have the neutralizing antibody (6).…”