Impact of Human Enterovirus 71 Genotypes in Meningoencephalitis in Iran

Abstract

Background:Since the importance of poliovirus has diminished, as a result of its elimination in the majority of countries, non-polioviruses are emerging as causative agents of severe central nervous system (CNS) involvement. Outbreaks of enterovirus 71 (EV71)-associated CNS infections have recently been reported in Asia, Australia, and Europe.Objectives:This is the first study on genotyping of EV71 in children with meningoencephalitis to be carried out in Iran, and it was conducted in order to obtain an improved understanding of the disease burden of this virus, particularly with regard to CNS involvement.Patients and Methods:Viral RNA was extracted from 170 cerebrospinal fluid samples obtained from children aged under 8 years with a primary diagnosis of aseptic meningitis. Specific EV71 PCR was conducted to identify the genotype of the detected EV71 viruses.Results:Human enteroviruses (HEVs) were detected in 89 patients (52.3%). EV71 infection was detected in 19 (21.3%) of the 89 EV71-positive patients, and the C genotype was identified in 15 isolates.Conclusions:The C genotype should be considered as the prevalent EV71 circulating genotype in Iran, particularly in cases of aseptic meningitis.

First seroepidemiological investigation of human enterovirus 71 in Iran

“…In European and Mediterranean races (like Iran), the virus is mainly neurotropic, but in Asians, it is more likely to develop HFMD. Up until now, all reported EV-A71 cases in Iran have been Neurologic ( 13 , 14 , 16 ), and regarding the recent and only molecular study on HFMD cases documented in 2019 in Ahvaz, that no EV-A71 was isolated from 16 HFMD patients, there has been no reported case of HFMD in Iran so far ( 27 ).…”

“…Although EV-A71 seroepidemiological investigations have done in several countries, in Iran, limited information about EV-A71 is mainly based on virus detection by RT-PCR ( 13 , 14 , 16 , 18 ). Therefore, this study was designed as the first seroepidemiological investigation for EV-A71 in Iran.…”

Investigation of the Causative Agents of Meningitis By Real-Time PCR Method

“…PCR gibi amplifikasyon temelli yöntemlerle, viral nükleik asidin BOS'da saptanması, SSS enfeksiyonlarının tanısında önemli bir dönüm noktası olmuş ve böylece viral etkenleri belirlemedeki başarı %20-30'lardan, günümüzde %50-70'lere ulaşmıştır (8) . BOS'da PCR yöntemiyle etken arama, HSV, CMV ve enteroviral menenjit tanısı için önerilen tanı yöntemidir (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) . HSV menenjitleri, viral menenjitlerin %1-3'ünü oluşturur.…”

“…Enteroviruslar dünya genelinde yaz ve sonbaharda yaygın olarak görülürler, çocuklarda daha sık etkendirler. Enterovirusların oluşturduğu SSS enfeksiyonlarının, yetişkin şizofrenisi ve diğer psikozlarla ilişkili olabileceğini gösteren yayınlar vardır (10,11) . Ayrıca kardiyomiyopatilere ve diğer başka organ bozukluklarına neden olabilir.…”

Molecular Evaluation of Human Enterovirus-Related Aseptic Meningitis in Isfahan, Iran 2017

“…Additionally, antibody-deficient patients may develop chronic CNS infections, often with lethal outcomes (6). In a similar study in Iran, enterovirus serotype of EV71 was the major cause of the disease, especially in very young children (7). However, pleconaril, pocapavir, and vapendavir are three antiviral agents, which are being clinically evaluated for enteroviral infections (8,9).…”