Molecular epidemiological study of enteroviruses associated with encephalitis in children from Hangzhou, China

Li, Wei; Zhang, Qiong; Xiao-ting, Shen; Liu, Yujie; Jian-hua, Mao; Shu, Qiang; Shang, Shuai

doi:10.1097/md.0000000000004870

Cited by 16 publications

(11 citation statements)

References 24 publications

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“…In this study, the major EV serotypes observed were E6 and E30, which were detected in 25.0% and 17.3% of cases in 2014, respectively. E18, which was detected at low prevalence in mainland China in previous studies, became the predominant EV serotype causing VE and VM in Hebei province in 2015 . The E18 serotype of EV‐B has caused many outbreaks of aseptic meningitis in the USA, Japan, Germany, and other regions .…”

Section: Discussionmentioning

confidence: 97%

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Serotypes of human enteroviruses causing pediatric viral encephalitis and meningitis in Hebei province, China, from 2013 to 2015

Chen

Guo

et al. 2018

Pediatric Investigation

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Importance: Viral encephalitis and meningitis are severe infectious diseases responsible for substantial morbidity and mortality in children. Enteroviruses are typically the most common causative agents of viral encephalitis and meningitis. Objective: This study aimed to investigate the etiology of viral encephalitis and meningitis among children in Hebei province, China. Methods: Cerebrospinal fluid samples from children with viral encephalitis (n=309) and meningitis (n=133) were collected between Nov 2013 and Dec 2015 and viral pathogens were identified by real-time and multiplex PCR. Amplification and sequencing of partial VP1 genes was used to type enteroviruses. Results: The causative pathogen was successfully detected in 176 (57%) patients with viral encephalitis and 82 (61.7%) patients with viral meningitis. The most common causative agents of both viral encephalitis and meningitis were enteroviruses (55.7% and 64.6% of cases, respectively). The most common enterovirus serotypes identified were echovirus 18, echovirus 6 and echovirus 30. Echovirus 18 accounted for 74.4% of all typed enteroviruses and caused a viral encephalitis and meningitis outbreak in Hebei province in 2015. By contrast, the major enterovirus serotypes circulating in 2014 were echovirus 6 and echovirus 30. Interpretation: Enteroviruses were the main causative agents of viral encephalitis and meningitis in children in Hebei province from Nov 2013 to Dec 2015. Echovirus 18 became the leading cause of viral encephalitis and meningitis for the first time in Hebei province in 2015.

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Section: Discussionmentioning

confidence: 97%

“…Infection by EVs was the leading cause of VM in many parts of the world . Outbreaks of VM and VE associated with EV infection are usually caused by EV‐B, most commonly by serotypes CV‐B5, E6, and E30 …”

Section: Discussionmentioning

confidence: 99%

Serotypes of human enteroviruses causing pediatric viral encephalitis and meningitis in Hebei province, China, from 2013 to 2015

Chen

Guo

et al. 2018

Pediatric Investigation

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“…Epidemiological data also suggest an important impact of NPEV on populations in Africa, Asia, and South America [ 3 – 6 ]. Disease course can range from mild clinical presentations to severe complications such as meningitis, encephalitis, or acute flaccid paralysis [ 6 , 7 ]. As a result of Enterovirus surveillance programs, and intensified molecular and genetic typing, knowledge on epidemiology and clinical courses of different serotypes and genotypes of NPEV is currently expanding [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Strain-dependent effects of clinical echovirus 30 outbreak isolates at the blood-CSF barrier

Dahm

Adams

Boettcher

et al. 2018

J Neuroinflammation

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BackgroundEchovirus (E) 30 (E-30) meningitis is characterized by neuroinflammation involving immune cell pleocytosis at the protective barriers of the central nervous system (CNS). In this context, infection of the blood-cerebrospinal fluid barrier (BCSFB), which has been demonstrated to be involved in enteroviral CNS pathogenesis, may affect the tight junction (TJ) and adherens junction (AJ) function and morphology.MethodsWe used an in vitro human choroid plexus epithelial (HIBCPP) cell model to investigate the effect of three clinical outbreak strains (13-311, 13-759, and 14-397) isolated in Germany in 2013, and compared them to E-30 Bastianni. Conducting transepithelial electrical resistance (TEER), paracellular dextran flux measurement, quantitative real-time polymerase chain reaction (qPCR), western blot, and immunofluorescence analysis, we investigated TJ and AJ function and morphology as well as strain-specific E-30 infection patterns. Additionally, transmission electron and focused ion beam microscopy electron microscopy (FIB-SEM) was used to evaluate the mode of leukocyte transmigration. Genome sequencing and phylogenetic analyses were performed to discriminate potential genetic differences among the outbreak strains.ResultsWe observed a significant strain-dependent decrease in TEER with strains E-30 Bastianni and 13-311, whereas paracellular dextran flux was only affected by E-30 Bastianni. Despite strong similarities among the outbreak strains in replication characteristics and particle distribution, strain 13-311 was the only outbreak isolate revealing comparable disruptive effects on TJ (Zonula Occludens (ZO) 1 and occludin) and AJ (E-cadherin) morphology to E-30 Bastianni. Notwithstanding significant junctional alterations upon E-30 infection, we observed both para- and transcellular leukocyte migration across HIBCPP cells. Complete genome sequencing revealed differences between the strains analyzed, but no explicit correlation with the observed strain-dependent effects on HIBCPP cells was possible.ConclusionThe findings revealed distinct E-30 strain-specific effects on barrier integrity and junctional morphology. Despite E-30-induced barrier alterations leukocyte trafficking did not exclusively occur via the paracellular route.Electronic supplementary materialThe online version of this article (10.1186/s12974-018-1061-4) contains supplementary material, which is available to authorized users.

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“…Echoviruses are the major cause of aseptic meningitis 4 – 6 . They share a similar genome structure to other EVs.…”

Section: Introductionmentioning

confidence: 99%

Molecular characterization of echovirus 12 strains isolated from healthy children in China

Liu

Zhang

Zhao

et al. 2018

Sci Rep

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Human echovirus 12 (E-12) belongs to the enterovirus B species. To date, only one full-length genome sequence of E-12 (prototype strain Travis) is available in the GenBank database. This study determined the complete sequence of three E-12 strains, which were isolated from the stools of three healthy children in Yunnan, China, in 2013. We revealed that the three Yunnan E-12 strains had only 80.8–80.9% nucleotide identity and 96.4–96.8% amino acid identity with the Travis strain based on pairwise comparisons of the complete genome nucleotide and amino acid sequences. The three Yunnan strains shared 99.7% nucleotide identity and 99.1–99.5% amino acid similarity. Phylogenetic and similarity plot analyses showed that intertypic recombination occurred in the non-structural regions of the three Yunnan E-12 strains. This is the first report of the complete genome sequence of E-12 in China and it enriches the complete genome sequences of E-12 in the GenBank database.

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Molecular epidemiological study of enteroviruses associated with encephalitis in children from Hangzhou, China

Cited by 16 publications

References 24 publications

Serotypes of human enteroviruses causing pediatric viral encephalitis and meningitis in Hebei province, China, from 2013 to 2015

Serotypes of human enteroviruses causing pediatric viral encephalitis and meningitis in Hebei province, China, from 2013 to 2015

Strain-dependent effects of clinical echovirus 30 outbreak isolates at the blood-CSF barrier

Molecular characterization of echovirus 12 strains isolated from healthy children in China

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