Genetic characterization of enterovirus A71 isolates from severe neurological cases in Poland

Wieczorek, Magdalena; Purzyńska, Mariola; Krzysztoszek, Arleta; Ciąćka, Agnieszka; Figas, Agnieszka; Szenborn, Leszek

doi:10.1002/jmv.24958

Cited by 14 publications

(9 citation statements)

References 20 publications

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“…The outbreak caused a 35-fold increase in hospitalization rates in comparison to the previous year [ 8 ]. Acute flaccid paralysis associated with enterovirus 71 was also previously reported in Poland [ 9 ]. Recently we have shown that enteroviruses are the most frequently detected pathogens in children with infection of the CNS hospitalized in Bialystok, Poland [ 10 ].…”

Section: Introductionsupporting

confidence: 62%

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Toczyłowski

Wieczorek

Bojkiewicz

et al. 2020

Viruses

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Enteroviruses are common causes of infections of the central nervous system (CNS) that in temperate climates tend to peak in the summer. The aim of the study was to describe epidemiology, drivers of seasonality, and types of enteroviruses causing infections of the CNS in children in Northeastern Poland. We prospectively collected data on children hospitalized with infection of the CNS attributed to enteroviruses in Bialystok, Poland, from January 2015 to December 2019. In total, 224 children were included. Nineteen different enterovirus types were identified in isolates collected from 188 children. Coxsackie B5 (32%), echovirus 30 (20%), and echovirus 6 (14%) were the three most common types. Enteroviruses were more prevalent during the summer–fall season. Infections caused by echovirus 30 peaked early in June and coxsackievirus B5 in July, whereas echovirus 6 peaked late in October. Phylogenetic analyses of these three enterovirus types showed multiple lineages co-circulating in this region. Mean air temperatures and precipitation rates were independently associated with monthly number of cases. Considering lack of effective treatment or vaccine, easy transmission of enteroviruses between susceptible individuals, their high mutation rate and prolonged time of viral shedding, continued monitoring and surveillance are imperative to recognize enteroviral infections of the CNS and the changes in circulation of enteroviruses in Poland.

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Section: Introductionsupporting

confidence: 62%

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Toczyłowski

Wieczorek

Bojkiewicz

et al. 2020

Viruses

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“…Reports of severe clinical presentation associated with detection of a EV-A71 C1-like strains [3,5-7], together with recent indications of long-term sequelae [13,14], should be a signal for physicians and public health authorities to include/intensify EV diagnostic in patients showing signs of aseptic meningitis, encephalitis or acute flaccid paralysis/myelitis.…”

Section: Discussionmentioning

confidence: 99%

Increased detection of enterovirus A71 infections, Germany, 2019

2019

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We report on the increased circulation of enterovirus A71 in Germany in 2019. Strains were mainly identified in hospitalised patients with suspected aseptic meningitis/encephalitis. Molecular analysis showed co-circulation of EV-A71 sub-genogroups C1 and C4, a signal for physicians and public health authorities to include/intensify EV diagnostic in patients showing signs of aseptic meningitis, encephalitis or acute flaccid paralysis/myelitis.

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“…2015 ). In particular, four cases of aseptic meningitis caused by viruses of the C2 sub-genogroup were identified in Poland in mid-late 2016 ( Wieczorek et al. 2018 ).…”

Section: Discussionmentioning

confidence: 99%

A complex mosaic of enteroviruses shapes community-acquired hand, foot and mouth disease transmission and evolution within a single hospital

et al. 2018

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Human enteroviruses (EV) pose a major risk to public health. This is especially so in the Asia-Pacific region where increasing numbers of hand, foot and mouth disease (HFMD) cases and large outbreaks of severe neurological disease associated with EV-A71 have occurred. Despite their importance, key aspects of the emergence, epidemiology and evolution of EVs remain unclear, and most studies of EV evolution have focused on a limited number of genes. Here, we describe the genomic-scale evolution of EV-A viruses sampled from pediatric patients with mild disease attending a single hospital in western Sydney, Australia, over an 18-month period. This analysis revealed the presence of eight viral serotypes—Coxsackievirus (CV) A2, A4, A5, A6, A8, A10, A16 and EV-A71—with up to four different serotypes circulating in any 1 month. Despite an absence of large-scale outbreaks, high levels of geographical and temporal mixing of serotypes were identified. Phylogenetic analysis revealed that multiple strains of the same serotype were present in the community, and that this diversity was shaped by multiple introductions into the Sydney population, with only a single lineage of CV-A6 exhibiting in situ transmission over the entire study period. Genomic-scale analyses also revealed the presence of novel and historical EV recombinants. Notably, our analysis revealed no association between viral phylogeny, including serotype, and patient age, sex, nor disease severity (for uncomplicated disease). This study emphasizes the contribution of EV-A viruses other than EV-A71 to mild EV disease including HFMD in Australia and highlights the need for greater surveillance of these viruses to improve strategies for outbreak preparedness and vaccine design.

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Genetic characterization of enterovirus A71 isolates from severe neurological cases in Poland

Cited by 14 publications

References 20 publications

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation

Increased detection of enterovirus A71 infections, Germany, 2019

A complex mosaic of enteroviruses shapes community-acquired hand, foot and mouth disease transmission and evolution within a single hospital

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