Coxsackieviruses in Ontario, January 2005 to December 2011

Peci, Adriana; Winter, Anne-Luise; Eshaghi, Alireza; Marchand-Austin, Alex; Olsha, Romy; Lombardi, Nino; Gubbay, Jonathan B.

doi:10.1016/j.ijid.2014.04.013

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Consequently, the control group had to be enrolled in another country because we were logistically unable to enrol a reasonable number of healthy young children in our institution or nearby hospitals. However, both Canada and Switzerland have a continental climate with a seasonal circulation of HEV and HPeV,7 8 17 22 37 38 whereas AdV and HHV-6 circulate throughout the year 9 10. Also, the enrolment breakdown according to seasons differed between study patients and controls, with most controls enrolled during the autumn; however, a subanalysis including only patients included in the autumn confirmed that viraemia was still significantly more frequent in study patients.…”

Section: Discussionmentioning

confidence: 94%

Enterovirus, parechovirus, adenovirus and herpes virus type 6 viraemia in fever without source

et al. 2019

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ObjectivesTo evaluate the potential associations between fever without a source (FWS) in children and detection of human enterovirus (HEV), human parechovirus (HPeV), adenovirus (AdV) and human herpesvirus type 6 (HHV-6) in the plasma; and to assess whether the detection of viruses in the plasma is associated with a reduced risk of serious bacterial infection (SBI) and antibiotic use.Design and settingBetween November 2015 and December 2017, this prospective, single-centre, diagnostic study tested the plasma of children <3 years old with FWS. Real-time (reverse-transcription) PCR for HEV, HPeV, AdV and HHV-6 was used in addition to the standardised institutional work-up. A control cohort was also tested for the presence of viruses in their blood.ResultsHEV, HPeV, AdV and HHV-6 were tested for in the plasma of 135 patients of median age 2.4 months old. At least one virus was detected in 47 of 135 (34.8%): HEV in 14.1%, HHV-6 in 11.1%, HPeV in 5.9% and AdV in 5.2%. There was no difference in antibiotic use between patients with or without virus detected, despite a relative risk of 0.2 for an SBI among patients with viraemia. Controls were less frequently viraemic than children with FWS (6.0% vs 34.8%; p<0.001).ConclusionsHEV, HPeV, AdV and HHV-6 are frequently detected in the plasma of children with FWS. Antibiotic use was similar between viraemic and non-viraemic patients despite a lower risk of SBI among patients with viraemia. Point-of-care viral PCR testing of plasma might reduce antibiotic use and possibly investigations and admission rates in patients with FWS.Trial registration numberNCT03224026.

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Section: Discussionmentioning

confidence: 94%

Enterovirus, parechovirus, adenovirus and herpes virus type 6 viraemia in fever without source

et al. 2019

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“…There are numerous reports of CVA9 as a significant causal agent of aseptic meningitis from around the world, including Japan (1961) [32], Northern Ireland (1970) [33], Poland (1974) [34, 35], Cuba (1990–1991) [36], Argentina (2007–2008) [37], Switzerland [38], Canada (2010) [39, 40], China (2006–2012) [41] as well South Africa [14]. Consistent with our study, the majority of cases occurred in children under 10 years of age.…”

Section: Discussionmentioning

confidence: 99%

Molecular characterization of an outbreak of enterovirus-associated meningitis in Mossel Bay, South Africa, December 2015–January 2016

Smuts

Cronje²,

Thomas³

et al. 2018

BMC Infect Dis

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BackgroundHuman enteroviruses (HEVs) are common causal agents of aseptic meningitis in young children. Laboratory and syndromic surveillance during December 2015 and January 2016 noted an unusually high number of paediatric aseptic meningitis cases at a hospital in Mossel Bay, Western Cape Province, South Africa. HEV was detected in clinical samples, prompting an outbreak investigation.MethodsEpidemiological investigations were conducted to ascertain possible linkage between cases. Amplification, sequencing and phylogenetic analysis of the 5’UTR and VP1 regions was undertaken to determine the HEV serotype associated with the outbreak as well as other cases of aseptic meningitis in the area in the preceding 6 weeks.ResultsOver the 2-month period, 63 CSF samples were available for testing. A total of 43 outbreak cases (68.3%) were observed, and the 26 (60.5%) that could be typed were coxsackie virus A9 (CVA9). Children attending three crèche facilities were epidemiologically linked, accounting for 60.5% (26/43) of the CVA9 cases. The majority of patients were under 10 years of age (55/63, 87.3%) and there was a male predominance (66%). Nucleotide sequence analysis of the 5’UTR and VP1 regions identified 2 lineages of CVA9 co-circulating during the outbreak, although the VP1 capsid protein sequence was identical as all nucleotide differences were synonymous. There was a unique isoleucine at position 64 and all outbreak viruses had a valine to threonine change in the hypervariable BC loop of VP1. Other HEV types circulating in the preceding period were echovirus 30 (n = 4), echovirus 5 (n = 3) and 1 each of echovirus 6, echovirus 9 and echovirus 15.ConclusionCVA9 was identified as the pathogen responsible for the large outbreak of aseptic meningitis, with 2 distinct co-circulating lineages.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3641-4) contains supplementary material, which is available to authorized users.

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“…A combination of active (stool samples for all cases of acute flaccid paralysis) and passive (EV genotyping) samples are used by the NML. Between Jaunary 1, 2005 and December 31, 2011, 0.9% of 941 specimens positive for EV submitted to the Public Health Ontario Laboratory were positive for EV-A71 according to viral culture ( 3 ). Another 20 cases of EV-A71 in one tertiary care pediatric centre were reported in 1998 ( 4 ).…”

Section: Discussionmentioning

confidence: 99%