Abstract
Background Enteroviruses (EVs) can cause infections and outbreaks of mild to severe diseases, such as central nervous system (CNS) and systemic infections. The contribution of EVs to acute CNS/systemic infections requiring hospitalization was assessed by analysing data extracted from virology laboratory database. Methods Real-life data obtained from two molecular virology laboratories located in Northern Italy were retrieved from databases and analysed retrospectively. The queries used to extract the data were (i) requests for EV-RNA detection in clear cerebrospinal fluid (CSF) specimens collected from hospitalized patients with suspected acute CNS (including aseptic meningitis, encephalitis, and acute flaccid myelitis/paralysis) or systemic infections (sepsis-like illness or fever (≥ 38°C) of unknown origin), (ii) CSF samples collected from January 1st, 2015, to December 31st, 2017. Results 582 requests of EV-RNA detection in CSF samples collected from as many patients of any age were recorded. EV-RNA was detected in 4.5% of the CSF samples; 92.3% of EV-positive cases were patients < 15 years, 58.3% of whom were < 3 months. EVs circulated all-year-round, and the highest EV-positive rates were observed from May to August. The risk of EV infection and the relative illness ratio value among children < 1 − year − old were significantly higher than those observed for older patients. Conclusions EV surveillance should be carried out for all pediatric patients < 15 years and especially children less than 1 year of age with clinically suspected CNS infection/systemic infections. The implementation of a laboratory-based surveillance established for analysing the virological data provided by laboratories that routinely perform EV molecular testing may enable us to determine the impact of EVs that can cause infections requiring hospitalization.
Highlights
Human Enteroviruses (EVs) belong to the Enterovirus genus of the Picornaviridae family and are widespread viruses transmitted through faecal-oral and respiratory routes or through contact with contaminated fluids and surfaces [1]
The queries used to extract the data from the databases were (a) requests for EV-RNA detection, in clear cerebrospinal fluid (CSF) specimens collected from hospitalized patients in the case of suspicion of acute central nervous system (CNS) infection, or sepsis-like illness or fever (≥38°C) of unknown origin and (b) requests submitted from January 1st, 2015, to December 31st, 2017
This finding is confirmed by our results: approximately two-thirds of the CSF samples analysed were collected from adult patients, almost all (92.3%) of the EV-positive cases were identified in pediatric patients aged
Summary
Human Enteroviruses (EVs) belong to the Enterovirus genus of the Picornaviridae family and are widespread viruses transmitted through faecal-oral and respiratory routes or through contact with contaminated fluids and surfaces [1]. EVs can cause severe central nervous system (CNS) infections, including aseptic meningitis, encephalitis, and acute flaccid myelitis/paralysis, especially among children under 15 years of age [1]. The queries used to extract the data were (i) requests for EV-RNA detection in clear cerebrospinal fluid (CSF) specimens collected from hospitalized patients with suspected acute CNS (including aseptic meningitis, encephalitis, and acute flaccid myelitis/paralysis) or systemic infections (sepsis-like illness or fever (≥ 38°C) of unknown origin), (ii) CSF samples collected from January 1st, 2015, to December 31st, 2017. The implementation of a laboratory-based surveillance established for analysing the virological data provided by laboratories that routinely perform EV molecular testing may enable us to determine the impact of EVs that can cause infections requiring hospitalization
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