Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Ji-Yeon Hyeon ,Jong-Hyun Kim ,Wooyoung Choi ,Kisang Kim,Kisoon Kim,Jeongbae Ahn ,Cheon-Hyun Kim,Hye-Jin Kim ,Byunghak Kang,Youngmee Jee,Jae-Hyoung Song ,Kyungsoon Cho ,Minji Kim ,Jae Keun Chung ,Sun‐Hee Kim ,Sun-Mi Hwang ,Doo‐Sung Cheon

doi:10.3201/eid.1908.130496

Abstract

The epidemiology of enteroviral infection in South Korea during 1999–2011 chronicles nationwide outbreaks and changing detection and subtyping methods used over the 13-year period. Of 14,657 patients whose samples were tested, 4,762 (32.5%) samples were positive for human enterovirus (human EV); as diagnostic methods improved, the rate of positive results increased. A seasonal trend of outbreaks was documented. Genotypes enterovirus 71, echovirus 30, coxsackievirus B5, enterovirus 6, and coxsackievirus B2 were the most common genotypes identified. Accurate test results correlated clinical syndromes to enterovirus genotypes: aseptic meningitis to echovirus 30, enterovirus 6, and coxsackievirus B5; hand, foot and mouth disease to coxsackievirus A16; and hand, foot and mouth disease with neurologic complications to enterovirus 71. There are currently no treatments specific to human EV infections; surveillance of enterovirus infections such as this study provides may assist with evaluating the need to research and develop treatments for infections caused by virulent human EV genotypes.

Highlights

The epidemiology of enteroviral infection in South Korea during 1999–2011 chronicles nationwide outbreaks and changing detection and subtyping methods used over the 13year period
Laboratory diagnosis of EV infection is based on detection of the virus in clinical specimens such as fecal or rectal swab samples, cerebrospinal fluid (CSF), nasopharyngeal secretions collected by throat swab, and blood [11,13]
Surveillance System and Data Sources The Korea Centers for Disease Control and Prevention (KCDC) national enterovirus surveillance system consists of 180 clinics managed by pediatrics physicians (35 primary clinics, 105 secondary hospitals, and 40 tertiary hospitals nationwide), and the number of clinics participating in the surveillance system varied each year

Summary

Introduction

The epidemiology of enteroviral infection in South Korea during 1999–2011 chronicles nationwide outbreaks and changing detection and subtyping methods used over the 13year period. Laboratory diagnosis of EV infection is based on detection of the virus in clinical specimens such as fecal or rectal swab samples, cerebrospinal fluid (CSF), nasopharyngeal secretions collected by throat swab, and blood [11,13]. Since 1993, the national enterovirus surveillance system of the Korea Centers for Disease Control and Prevention (KCDC) has monitored and characterized human EV infection in patients with EV-related diseases.

Results

Conclusion