Abstract
In the state of Uttar Pradesh in India, enteroviruses are a significant cause of infection presenting in endemic or epidemic forms. The present study aimed to use molecular methods to identify enterovirus serotypes in clinical specimens to determine their circulation in the community. A total of 320 clinical specimens were collected between January 2009 and December 2010 from children younger than 15 year of age in northern India. Reverse- transcription (RT) real time PCR and semi-nested RT PCR targeting the 5'untranslated region and VP1 region was used for the detection and identification of enterovirus serotypes. The enterovirus genome was detected in 79 (24.7%) of 320 clinical specimens by real time PCR. Central nervous system syndrome (CNS) was the most common clinical manifestation (n=32, 62.74%), followed by respiratory tract infection (n=8, 15.69%), acute febrile illness (n=7, 13.73%), and gastrointestinal disease (n=4, 7.84%). A total of 32 different serotypes were identified with the predominance of coxsackievirus B5 and echovirus 6. Phylogenetic analysis of partial VP1 gene sequences from this study showed that many enterovirus serotypes showed good similarity with strains from America and Europe in comparison to neighbouring Asian countries. To our knowledge this is the first study of enterovirus prevalence from northern India based on unbiased molecular methods which leads to the identification of fifteen different enterovirus serotypes. The high frequency of enterovirus B species serotypes circulation may be an important cause of CNS infection in the children of this region.
Highlights
In the state of Uttar Pradesh in India, enteroviruses are a significant cause of infection presenting in endemic or epidemic forms
The Human enteroviruses (HEVs) genome was detected in 79 (24.7%; 95% CI, 20 - 29.4%) of 320 clinical specimens from 320 children
This finding is consistent with the observations of Sawyer et al [20] who found that age is significantly associated with clinical manifestations and diseases caused by HEV
Summary
In the state of Uttar Pradesh in India, enteroviruses are a significant cause of infection presenting in endemic or epidemic forms. The conventional method for typing of HEV serotypes is isolation of the virus in cell culture, followed by neutralization with mixed hyperimmune equine serum pools and specific monovalent polyclonal antisera. The problems with this method are that i) some HEV serotypes do not grow in culture,and ii) that the antigenic variants emerge quite often [5,7,10]. In recent years, these methods have been replaced by molecular methods based on reverse transcription-PCR and sequencing. Molecular diagnosis of HEVs is based on the amplification of the highly conserved 5′
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