Enterovirus genotypes among patients with severe acute respiratory illness, influenza‐like illness, and asymptomatic individuals in South Africa, 2012‐2014

Abstract

Enteroviruses can cause outbreaks of severe acute respiratory illness (SARI) and EV-A, -B, -C, and -D species have different pathogenic profiles and circulation patterns. We aimed to characterize and determine the prevalence of enterovirus genotypes among South African patients with respiratory illness and controls during June 2012 to July 2014. Syndromic SARI and influenza-like illness (ILI) surveillance was performed at two sentinel sites. At each site nasopharyngeal/oropharyngeal specimens were collected from SARI and ILI patients as well as controls. Specimens were tested for enterovirus by real-time PCR. Positive specimenswere further genotyped by sequencing a region of theVP1 gene. The prevalence of enterovirus was 5.8% (87/1494), 3.4% (103/3079), and 3.4% (46/1367) among SARI, ILI, and controls, respectively (SARI/controls, P=0.002 and ILI/control, P = 0.973). Among the 101/236 (42.8%) enterovirus-positive specimens that could be genotyped, we observed a high diversity of circulating enterovirus genotypes (a total of 33 genotypes) from all four human enterovirus species with high prevalence of Enterovirus-B (60.4%; 61/101) and Enterovirus-A (21.8%; 22/101) compared to Enterovirus-C (10.9%; 11/101) and Enterovirus-D (6.9%; 7/101) (P = 0.477). Of the enterovirus genotypes identified, Echovirus 30 (9.9%, 10/101), Coxsackie virus B5 (7.9%, 8/101) and Enterovirus-D68 (6.9%, 7/101) were most prevalent. There was no difference in disease severity (SARI or ILI compared to controls) between the different enterovirus species (P = 0.167).We observed a high number of enterovirus genotypes in patients with respiratory illness and in controls from South Africa with no disease association of EV species with disease severity.

High frequency of Polio-like Enterovirus C strains with differential clustering of CVA-13 and EV-C99 subgenotypes in a cohort of Malawian children

“…In our study, 34% of the typed EV strains belonged to species EV-C. Although EV-C is a rather rare species in most of the world [ 3 , 7 , 8 , 49 – 51 ], it accounts for up to 76% of typed EV strains found in African populations [ 18 , 20 , 22 , 25 – 28 ]. The high proportion of EV-C subgroup C as found in our study is in accordance with findings in Cameroon and Madagascar.…”

A Novel Neutralizing Antibody Specific to the DE Loop of VP1 Can Inhibit EV-D68 Infection in Mice

“…E nterovirus D68 (EV-D68) is a major causative agent of mild to severe upper and lower respiratory illnesses and is prevalent in North America, Europe, and Asia in recent years (1)(2)(3). Patients infected with EV-D68 exhibit fever, sneezing, rhinorrhea, cough, sore throat, pneumonia, asthma exacerbation, and acute flaccid myelitis, with the possibility of death (2,(4)(5)(6)(7). No prophylactic vaccine or therapeutic drug against EV-D68 infection is yet available.…”

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

“…Tracking of circulating HEV serotypes in South Africa has only recently recommenced with the growing interest in understanding serotype prevalence over time and clinical association. Hellferscee et al [44] identified 33 different serotypes circulating over a 3-year period (2012–2014) in respiratory samples with echovirus 30, coxsackie virus B5 and enterovirus D68 most prevalent, and 3 cases of CVA9 detected. Unpublished data from Cape Town from 2014 to 2017 showed 38 different serotypes circulating in respiratory samples with different serotypes predominating in each year (Smuts, unpublished).…”