Emergence of enterovirus 71 C4a in Denmark, 2009 to 2013
Emergence of enterovirus 71 C4a in Denmark, 2009 to 2013
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DOI：
10.2807/1560-7917.es2014.19.38.20911
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发表时间：
2014-09-25
期刊：
影响因子：
19
通讯作者：
Midgley, S. E.
中科院分区：
文献类型：
--
作者：
Fischer, T. K.;Nielsen, A. Y.;Midgley, S. E.
在全球根除脊髓灰质炎努力之后，肠病毒（EV） 71已成为严重神经系统肠病毒感染的主要原因。EV71存在11个亚基因型，其中C4亚基因型与亚洲高死亡率的大规模暴发有关。这种亚基因型在欧洲很少报道。在2009年1月1日至2013年12月31日期间，来自1 143人的1 447份EV阳性样本被送往Statens血清研究所（SSI），来自913名患者的938份样本在SSI的丹麦国家世界卫生组织脊髓灰质炎病毒参考实验室进行了基因分型。埃可病毒6型（E06）（141例）、埃可病毒30型（E30）（114例）、柯萨奇病毒A6型（CA06）（96例）和EV71型（63例）是最常见的基因型。在研究期间，我们观察到EV71病毒的亚基因型发生了变化，在2012年以C4亚基因型为主。共发现34例EV71患者感染C4亚基因型菌株，系统发育分析显示他们属于C4a谱系。在我们的研究中，C4a患者（19/34）和C1和C2患者（15/35）出现脑和/或败血症样症状的比例相似。34例EV71 C4病例中以儿童为主（n= 30）
Enterovirus (EV) 71 has emerged as a primary cause of severe neurologic enterovirus infection in the aftermath of the global polio eradication effort. Eleven subgenotypes of EV71 exist, the C4 subgenotype being associated with large outbreaks in Asia with high mortality rates. This subgenotype has rarely been reported in Europe. In the period between 1 January 2009 and 31 December 2013 a total of 1,447 EV positive samples from 1,143 individuals were sent to the Statens Serum Institute (SSI), and 938 samples from 913 patients were genotyped at the Danish National World Health Organization Reference laboratory for Poliovirus at SSI. Echovirus 6 (E06) (n= 141 patients), echovirus 30 (E30) (n= 114), coxsackievirus A6 (CA06) (n= 96) and EV71 (n= 63) were the most prevalent genotypes. We observed a shift in circulating EV71 subgenotypes during the study period, with subgenotype C4 dominating in 2012. A total of 34 EV71 patients were found to be infected with strains of the C4 subgenotype, and phylogenetic analysis revealed that they belonged to the C4a lineage. In our study, the proportions of cases with cerebral and/or sepsis-like symptoms were similar in those affected by C4a (19/34) and those with C1 and C2 (15/35). The majority (n= 30) of the 34 EV71 C4 cases were children