Increased Activity of Coxsackievirus B1 Strains Associated with Severe Disease among Young Infants in the United States, 2007-2008
Increased Activity of Coxsackievirus B1 Strains Associated with Severe Disease among Young Infants in the United States, 2007-2008
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DOI：
10.1086/605090
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发表时间：
2009-09-01
影响因子：
11.8
通讯作者：
Oberste, M. Steven
中科院分区：
文献类型：
--
作者：
Wikswo, Mary E.;Khetsuriani, Nino;Oberste, M. Steven
背景肠病毒感染非常常见，通常引起轻度疾病，尽管新生儿患严重疾病的风险较高。2007年，疾病控制和预防中心（CDC）收到多份与柯萨奇病毒B1（CVB 1）相关的严重新生儿疾病和死亡报告，CVB 1是一种不太常见的肠道病毒血清型，以前在CDC的监测报告中与死亡无关。本报告包括2007年至2008年期间向国家肠道病毒监测系统（NESS）报告的与CVB 1相关的严重新生儿疾病病例的临床、流行病学和病毒学数据，NESS是一个自愿的被动监测系统。还包括在NESS之外向CDC报告的其他病例的数据。从25个州的患者中获得的病毒分离株或原始标本被转交给CDC小核糖核酸病毒实验室进行分子分型或表征。在2007-2008年期间，国家卫生服务中心共收到1079宗肠病毒感染报告。在775例已知血清型的报告病例中，CVB 1占176例（23%），使其首次成为NESS中最常见的血清型。在此期间，还向CDC报告了6例因CVB 1感染导致的新生儿死亡。对2007年和2008年CVB 1毒株的系统发育分析表明，病例的增加是由于至少自2001年以来在美国存在的单一遗传谱系的广泛传播。医疗服务提供者和公共卫生部门应警惕持续CVB 1相关新生儿疾病的可能性，并应鼓励检测和继续报告肠道病毒感染。
Background. Enterovirus infections are very common and typically cause mild illness, although neonates are at higher risk for severe illness. In 2007, the Centers for Disease Control and Prevention (CDC) received multiple reports of severe neonatal illness and death associated with coxsackievirus B1 (CVB1), a less common enterovirus serotype not previously associated with death in surveillance reports to the CDC.Methods. This report includes clinical, epidemiologic, and virologic data from cases of severe neonatal illness associated with CVB1 reported during the period from 2007 through 2008 to the National Enterovirus Surveillance System (NESS), a voluntary, passive surveillance system. Also included are data on additional cases reported to the CDC outside of the NESS. Virus isolates or original specimens obtained from patients from 25 states were referred to the CDC picornavirus laboratory for molecular typing or characterization.Results. During 2007-2008, the NESS received 1079 reports of enterovirus infection. CVB1 accounted for 176 (23%) of 775 reported cases with known serotype, making it the most commonly reported serotype for the first time ever in the NESS. Six neonatal deaths due to CVB1 infection were also reported to the CDC during that time. Phylogenetic analysis of the 2007 and 2008 CVB1 strains indicated that the increase in cases resulted from widespread circulation of a single genetic lineage that had been present in the United States since at least 2001.Conclusions. Healthcare providers and public health departments should be vigilant to the possibility of continuing CVB1-associated neonatal illness, and testing and continued reporting of enterovirus infections should be encouraged.