Molecular epidemiology of enteroviruses and predominance of echovirus 30 in an Iranian population with aseptic meningitis

Abstract

Human enteroviruses are the most prevalent causes of aseptic meningitis worldwide. However, despite such predominancy, defining the enteroviral etiology of aseptic meningitis remains a diagnostic dilemma for the clinician in Iran. Therefore, this study was conducted to characterize the prevalence and clinical significance of enteroviral aseptic meningitis as well as the predominant enterovirus serotypes among patients with aseptic meningitis in the South of Iran. Cerebrospinal fluid (CSF) specimens were obtained from 73 patients with aseptic meningitis (52.1% males and 47.9% females), ages ranging from 1 month to 88 years. Following the extraction of nucleic acid, the detection of enteroviruses was performed by RT-PCR, targeting the 5′ untranslated region of the genome, and sequencing. Enteroviruses were found in 46.6% of samples (34/73). The most predominant serotype was echovirus 30, followed by coxsackievirus B5 and poliovirus type 1 Sabin strain. The enterovirus infections were more prevalent among female patients (58.8%) and those below 5 years of age (52.9%). Although enterovirus infections were observed throughout the year, the infections were more prevalent during autumn with fever as the predominant clinical symptom. The outcomes revealed that enteroviruses are significant causes of aseptic meningitis in the South of Iran, while suspected cases of aseptic meningitis are usually monitored by bacterial culture and biochemical testing of CSF samples. Therefore, the etiology remains unknown in most cases. Molecular detection of viral pathogens should be included as a common approach in the screening of patients with aseptic meningitis to prevent unnecessary treatment and to improve clinical management.

High Prevalence of Occult Hepatitis B Virus Infection among Iranian Hemodialysis Patients

“…Compared with the manual method, the nucleic acid extraction kit is able to remove PCR inhibitors effectively. 33 In this study, the prevalence of occult HBV infection among hemodialysis patients was not statistically associated with duration of hemodialysis, age, gender distribution, and level of education, although the prevalence of HBV infection was higher in patients with 1 to 2 years on regular hemodialysis, the hemodialysis patients aged 40 to 49 years, female hemodialysis patients, and upper diploma patients. Similarly, recent studies in Zanjan (West of Iran) and Qazvin (West-Center of Iran) demonstrated that the prevalence of occult HBV infection among hemodialysis patients is not associated with age, gender, or duration of hemodialysis.…”

Etiology, Clinical Phenotypes, Epidemiological Correlates, Laboratory Biomarkers and Diagnostic Challenges of Pediatric Viral Meningitis: Descriptive Review

“…Historically, EVs were firstly known as causative agents of PVM during the early sixties of the last Gregorian century (108). Later, they were confirmed in several epidemiological investigations to constitute the primary cause of VM in children (7,(32)(33)(34). In the Middle East region, most of the PVM cases were also attributed to the EVs group of viruses (10)(11)(12)(13)(14)(15)109).…”

Molecular characterization of a novel clade echovirus 3 isolated from patients with hand‐foot‐and‐mouth disease in southwest China

“…EV is the primary pathogen causing aseptic meningitis, 34 and the main EV serotypes of causative agents for HFMD often overlap with those of aseptic meningitis 35 . E30 is one of the most common pathogens causing aseptic meningitis outbreaks 36–38 . Since the 2008 HFMD outbreaks, E3 and E30 were often detected in HFMD cases 19,25,26,39,40 .…”