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PLoS One. 2014 Feb 21;9(2):e89766. doi: 10.1371/journal.pone.0089766. eCollection 2014.

Molecular epidemiology of human enterovirus associated with aseptic meningitis in Shandong Province, China, 2006-2012.

Author information

1
Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China ; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China.
2
Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China ; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China ; School of Public Health, Shandong University, Jinan, People's Republic of China.
3
Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China.
4
Department of Preventive Medicine, College of Basic Medical Sciences, Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China.
5
School of Public Health, Shandong University, Jinan, People's Republic of China.

Abstract

BACKGROUND:

Human enteroviruses (HEVs) are common causes of acute meningitis. However, there is limited information about HEV associated with aseptic meningitis in mainland China because it has not been classified as a notifiable disease.

OBJECTIVES:

To characterize the HEVs associated with sporadic aseptic meningitis in China and to analyze their genetic features.

STUDY DESIGN:

Cerebrospinal fluid, throat swab and feces specimens were collected from patients with aseptic meningitis in 5 sentinel hospitals in Shandong Province, China between 2006 and 2012. Virological investigation (viral isolation and molecular identification) and phylogenetic analysis were performed.

RESULTS:

A total of 437 hospitalized patients were reported, and enteroviruses were detected in the specimens from 84 patients (19.2%) and were identified into 17 serotypes. The nine main serotypes were echovirus (E) 30 (27.4%), EV71 (13.1%), coxsackievirus (CV) B1 (9.5%), CVB3 (7.1%), CVB5 (7.1%), E6 (7.1%), E9 (7.1%), CVA9 (6.0%), and CVA10 (3.6%). Monthly distribution of isolated enteroviruses revealed a major peak in summer-fall season and a small second peak in winter constituted totally by EV71. Sequence analysis on VP1 coding region suggested Shandong strains had great genetic divergence with isolates from other countries.

CONCLUSIONS:

Multiple serotypes were responsible for enterovirus meningitis in mainland China. Aseptic meningitis caused by EV71 and coxsackie A viruses-the predominant pathogens for the hand, foot, and mouth disease-is currently an important concern in mainland China.

PMID:
24587020
PMCID:
PMC3931826
DOI:
10.1371/journal.pone.0089766
[Indexed for MEDLINE]
Free PMC Article

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