Enterovirus 75 Encephalitis in Children, Southern India

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Abstract

Recent outbreaks of enterovirus in Southeast Asia emphasize difficulties in diagnosis of this infection. To address this issue, we report 5 (4.7%) children infected with enterovirus 75 among 106 children with acute encephalitis syndrome during 2005–2007 in southern India. Throat swab specimens may be useful for diagnosis of enterovirus 75 infection.

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Molecular evolution of the human enteroviruses: correlation of serotype with VP1 sequence and application to picornavirus classification.

M. Oberste, K Maher, D Kilpatrick … (1999)

Sixty-six human enterovirus serotypes have been identified by serum neutralization, but the molecular determinants of the serotypes are unknown. Since the picornavirus VP1 protein contains a number of neutralization domains, we hypothesized that the VP1 sequence should correspond with neutralization (serotype) and, hence, with phylogenetic lineage. To test this hypothesis and to analyze the phylogenetic relationships among the human enteroviruses, we determined the complete VP1 sequences of the prototype strains of 47 human enterovirus serotypes and 10 antigenic variants. Our sequences, together with those available from GenBank, comprise a database of complete VP1 sequences for all 66 human enterovirus serotypes plus additional strains of seven serotypes. Phylogenetic trees constructed from complete VP1 sequences produced the same four major clusters as published trees based on partial VP2 sequences; in contrast to the VP2 trees, however, in the VP1 trees strains of the same serotype were always monophyletic. In pairwise comparisons of complete VP1 sequences, enteroviruses of the same serotype were clearly distinguished from those of heterologous serotypes, and the limits of intraserotypic divergence appeared to be about 25% nucleotide sequence difference or 12% amino acid sequence difference. Pairwise comparisons suggested that coxsackie A11 and A15 viruses should be classified as strains of the same serotype, as should coxsackie A13 and A18 viruses. Pairwise identity scores also distinguished between enteroviruses of different clusters and enteroviruses from picornaviruses of different genera. The data suggest that VP1 sequence comparisons may be valuable in enterovirus typing and in picornavirus taxonomy by assisting in the genus assignment of unclassified picornaviruses.

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Typing of human enteroviruses by partial sequencing of VP1.

Mark Pallansch, Steven M. Oberste, Ryan Kilpatrick … (1999)

Human enteroviruses (family Picornaviridae) are the major cause of aseptic meningitis and also cause a wide range of other acute illnesses, including neonatal sepsis-like disease, acute flaccid paralysis, and acute hemorrhagic conjunctivitis. The neutralization assay is usually used for enterovirus typing, but it is labor-intensive and time-consuming and standardized antisera are in limited supply. We have developed a molecular typing system based on reverse transcription-PCR and nucleotide sequencing of the 3' half of the genomic region encoding VP1. The standard PCR primers amplify approximately 450 bp of VP1 for most known human enterovirus serotypes. The serotype of an "unknown" may be inferred by comparison of the partial VP1 sequence to those in a database containing VP1 sequences for the prototype strains of all 66 human enterovirus serotypes. Fifty-one clinical isolates of known serotypes from the years 1991 to 1998 were amplified and sequenced, and the antigenic and molecular typing results agreed for all isolates. With one exception, the nucleotide sequences of homologous strains were at least 75% identical to one another (>88% amino acid identity). Strains with homologous serotypes were easily discriminated from those with heterologous serotypes by using these criteria for identification. This method can greatly reduce the time required to type an enterovirus isolate and can be used to type isolates that are difficult or impossible to type with standard immunological reagents. The technique may also be useful for the rapid determination of whether viruses isolated during an outbreak are epidemiologically related.

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Antibodies against prM protein distinguish between previous infection with dengue and Japanese encephalitis viruses.

Mary Jane Cardosa, Seok Mui Wang, Magdline Sum … (2002)

Background In Southeast Asia, dengue viruses often co-circulate with other flaviviruses such as Japanese encephalitis virus, and due to the presence of shared antigenic epitopes it is often difficult to use serological methods to distinguish between previous infections by these flaviviruses. Results Convalescent sera from 69 individuals who were known to have had dengue or Japanese encephalitis virus infection were tested by western blotting against dengue, Japanese encephalitis and West Nile virus antigens. We determined that individuals who had been infected with dengue viruses had IgG responses against the premembrane protein of dengue viruses but not Japanese encephalitis, whereas individuals who had been infected with Japanese encephalitis had IgG specific for the premembrane protein of Japanese encephalitis virus but not the dengue viruses. None reacted with the premembrane protein of West Nile virus. Using the Pearson Chi Square test, it was determined that the difference between the two groups was highly significant with a p value of <0.001. Conclusion The use of flavivirus premembrane protein in seroepidemiological studies will be useful in determining what flaviviruses have circulated in a community.

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Author and article information

Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): November 2010

Volume: 16

Issue: 11

Pages: 1780-1782

Affiliations

[1]Author affiliations: University of Liverpool, Liverpool, UK (P. Lewthwaite, M.H. Ooi, A. Last, T. Solomon);

[2]Universiti Malaysia Sarawak, Sarawak, Malaysia (D. Perera, M.H. Ooi, P.H. Tio, M.J. Cardosa);

[3]Sibu Hospital, Sibu, Sarawak (M.H. Ooi);

[4]Vijayanagar Institute of Medical Sciences, Karnataka, India (R. Kumar, A. Begum, M. Veera Shankar);

[5]National Institute of Mental Health and Neurological Sciences, Bangalore, India (R. Kumar, A. Desai, V. Ravi)

Author notes

Address for correspondence: Penny Lewthwaite, Brain Infections Group, Divisions of Neurological Science and Medical Microbiology, University of Liverpool, 8th Floor, Duncan Bldg, Daulby St, Liverpool, L69 3GA, UK; email: pennylewthwaite@ 123456doctors.org.uk

Article

Publisher ID: 10-0672

DOI: 10.3201/eid1611.100672

PMC ID: 3294525

PubMed ID: 21029544

SO-VID: e8902da8-23e2-4ca1-a82c-34026771aee8

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Enterovirus 75 Encephalitis in Children, Southern India

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Most cited references 11

Molecular evolution of the human enteroviruses: correlation of serotype with VP1 sequence and application to picornavirus classification.

Typing of human enteroviruses by partial sequencing of VP1.

Antibodies against prM protein distinguish between previous infection with dengue and Japanese encephalitis viruses.

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