Abstract
To the Editor: Enterovirus A71 (EV-A71) strains circulate worldwide, and numerous outbreaks have been reported from Asia, Australia, Europe, and America (1). Symptomatic infections range from mild febrile illness or characteristic diseases such as hand, foot and mouth disease to severe neurologic disorders such as meningitis/encephalitis and acute flaccid paralysis. EV-A71 infections are usually asymptomatic and self-limiting but can also result in life-threatening complications such as pulmonary edema and cause death, predominantly in children <5 years of age. On the basis of viral protein 1 (VP1) sequences, 3 genogroups (A, B, C), including different subgenogroups (B0–B5, C1–C5), have been defined (2,3). Additional genogroups (D, E, F, G) have been proposed (4,5). In Europe, C1 and C2 strains have circulated predominantly within the past 2 decades, and recent introduction of C4 strains has been reported (6,7). Within subgenogroup C1, a lineage is replaced by the subsequent lineage over time (8).
Highlights
Recombinant Enterovirus A71 Subgenogroup C1 Strains, Germany, 2015
Phylogenetic tree based on complete viral protein 1 (VP1) nucleotide sequences of the strains identified within the German enterovirus surveillance and a representative set of enterovirus A71 strains available from GenBank (891 bases, corresponding to nucleotide positions 2439–3329 in the prototype BrCr ETU22521)
1 cerebrospinal fluid (CSF) specimen tested Enterovirus A71 (EV-A71) positive (11.2% of the typed enteroviruses); these samples were obtained from patients with signs of meningitis/encephalitis hospitalized in 25 secondary and tertiary care hospitals from 13 of 16 federal states of Germany
Summary
Recombinant Enterovirus A71 Subgenogroup C1 Strains, Germany, 2015 National enterovirus surveillance (EVSurv) in Germany monitors polio-free status by testing fecal or cerebrospinal fluid (CSF) samples from hospitalized patients with suspected meningitis/encephalitis or acute flaccid paralysis. Subgenogroups B5, C1, and C4 have been identified, but less frequently (online Technical Appendix Table 3, http://wwwnc.cdc.gov/EID/article/22/10/16-0357Techapp1.pdf).
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