Outbreak of Acute Hemorrhagic Conjunctivitis Due to Coxsackie A24 Variant—taiwan

Abstract

Outbreaks of acute hemorrhagic conjunctivitis caused by enterovirus 70 and several serotypes of adenovirus have occurred in Taiwan since 1971. In 1980-1981, there was a pandemic of acute hemorrhagic conjunctivitis in southeast Asia caused by coxsackie A24 variant (CA24v); however, this virus did not affect Taiwan. In October 1985, CA24v was isolated for the first time from patients with acute hemorrhagic conjunctivitis in southern Taiwan. The following summer, a large epidemic of acute hemorrhagic conjunctivitis due to CA24v occurred. An epidemiologic investigation of patients seen at one ophthalmology clinic in Taipei City revealed that school-age children were the most likely group to introduce illness into households (p less than 0.001) and that males were more often household index cases than were females (p less than 0.01). Multiple case households tended to be more crowded (3.0 vs. 2.5 persons per bathroom; p less than 0.05) and had illness introduced by younger family members (median age of index case = 10 vs. 17 years; p less than 0.01). It is unknown whether this outbreak is an isolated occurrence or represents another resurgence of CA24v in the area.

Outbreak of enteroviruses and groundwater contamination in Taiwan: Concept of biomedical hydrogeology

“…Prior to this outbreak, very few deaths had occurred in Taiwan from enteroviruses; at most, 1000 cases per year had been reported, principally in 1982 and 1986 (Chou and Malison 1988). Shen (1998) reports that the enterovirus outbreak in Taiwan has become the world's worst ever; about 300,000 people have been infected, and 85 children have died.…”

Molecular and immunocytochemical identification of coxsackievirus A-24 variant from the acute haemorrhagic conjunctivitis outbreak in Taiwan in 2007

“…Thereafter, however, four major outbreaks of AHC reported in 1985-1986, 1988-1989, and in 1990-1994 were all caused by different strains of CA-24v, rather than EV-70. 7,19,20,23,24 This is supported by the serological evidence, from the serum of the Taiwanese population before the 1985-1986 outbreak, which indicates high titres of antibodies against EV-70 and very low titres of antibodies against CA-24v. 19 During September and October 2007, a major outbreak of AHC occurred again in Taiwan, with an estimate of more than 11 000 people affected.…”

“…Real-time RT-PCR assay revealed that the CA-24v isolates that were collected belonged to a distinct lineage within genotype III similar to the earlier Asian isolates. 7 The cell culture supernatants from all the swab inoculations were tested positive for the CA-24v by realtime RT-PCR assay. The range of C t values observed in the undiluted cell culture supernatants is from 29 to 32.…”

Sialic Acid Is a Cellular Receptor for Coxsackievirus A24 Variant, an Emerging Virus with Pandemic Potential

“…Replication of a virus in the cornea leads to destruction of cells and is followed by punctate epithelial keratitis, which is thought to be the cause of foreign body sensation (64). This symptom is reported as being predominant in most outbreaks of AHC (ϳ80% of all cases) (12,18,25). Thus, replication in corneal cells contributes considerably to the clinical picture of AHC, so the use of sialic acid as a cellular receptor by CVA24v in the cornea is likely to affect the severity of AHC.…”