Abstract
BackgroundEnteroviruses are the most common causative agents of human illness. Enteroviruses have been associated with regional and global epidemics, recently, including with severe disease (Enterovirus A71 and D68), and are of interest as emerging viruses. Here, we typed Enterovirus A-D (EV) from central nervous system (CNS) and respiratory infections in Viet Nam.MethodsData and specimens from prospective observational clinical studies conducted between 1997 and 2010 were used. Species and serotypes were determined using type-specific RT-PCR and viral protein 1 or 4 (VP1, VP4) sequencing.ResultsSamples from patients with CNS infection (51 children – 10 CSF and 41 respiratory/rectal swabs) and 28 adults (28 CSF) and respiratory infection (124 children – 124 respiratory swabs) were analysed. Twenty-six different serotypes of the four Enterovirus species (A-D) were identified, including EV-A71 and EV-D68. Enterovirus B was associated with viral meningitis in children and adults. Hand, foot and mouth disease associated Enteroviruses A (EV-A71 and Coxsackievirus [CV] A10) were detected in children with encephalitis. Diverse serotypes of all four Enterovirus species were found in respiratory samples, including 2 polio-vaccine viruses, but also 8 CV-A24 and 8 EV-D68. With the exception of EV-D68, the relevance of these viruses in respiratory infection remains unknown.ConclusionWe describe the diverse spectrum of enteroviruses from patients with CNS and respiratory infections in Viet Nam between 1997 and 2010. These data confirm the global circulation of Enterovirus genera and their associations and are important for clinical diagnostics, patient management, and outbreak response.
Highlights
Enteroviruses are the most common causative agents of human illness
All were children with Enterovirus A-D (EV) detected in swabs only (Table 1)
Our study revealed diverse enterovirus serotypes have been circulating in Viet Nam in association with respiratory and central nervous system (CNS) infections
Summary
Enteroviruses are the most common causative agents of human illness. Enteroviruses have been associated with regional and global epidemics, recently, including with severe disease (Enterovirus A71 and D68), and are of interest as emerging viruses. We typed Enterovirus A-D (EV) from central nervous system (CNS) and respiratory infections in Viet Nam. Enteroviruses are non-enveloped single stranded RNA viruses of the genus Enterovirus within the family of Picornaviridae. While rhinoviruses commonly cause mild respiratory illness, enteroviruses A-D (EVs) are a significant cause of morbidity and mortality worldwide. Surveillance activities have been enhanced in response to the emergence of hand, foot, and mouth disease (HFMD) causing enteroviruses in the Asia-Pacific region [4] and the global spread of EV-D68 causing respiratory infections [5, 6]
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