An echovirus 18-associated outbreak of aseptic meningitis in Taiwan: Epidemiology and diagnostic and genetic aspects
Date of Original Version
In 2006, an outbreak of aseptic meningitis was noted in Taiwan. From January to October 2006, a total of 3283 specimens collected from patients with viral infection, including 173 cerebrospinal fluid (CSF) samples, were examined for virus isolation and identification. Overall, 339 enterovirus (EV)-positive cases were identified by virus culture: echovirus 18 (E18) formed the majority (27.4%, 93 cases), followed by coxsackievirus B2 (13.8%, 47 cases) and coxsackievirus A2 (10.8%, 37 cases). The manifestations of the 93 E18 cases were aseptic meningitis (44.1%), viral exanthema (23.6%), acute tonsillitis (15.1%), acute pharyngitis (14.0%), acute gastritis (11.8%), herpangina (7.5%) and bronchopneumonia (5.3%). Of 107 E18 isolates identified, 100, 62.5 and 19% were obtained following culture in RD, MRC-5 and A549 cells, respectively. E18 was identified most frequently from throat swabs (67.2%) and less frequently from stool samples (15.9%) and CSF (16.8%). The detection rate of E18 was 78.2% from CSF, 50% from stool samples and 22.9% from throat swabs. Phylogenetic relationships among the E18 strains were examined. Analysis of the partial VP1 gene showed 3.7-23.8% variation in sequence compared with sequences from GenBank and, notably, the amino acid change V152S was detected in a protruding loop within the VP1 protein. These results indicate that a genetic variant of E18 was circulating and caused an outbreak of aseptic meningitis in Taiwan in 2006. © 2011 SGM.
Publication Title, e.g., Journal
Journal of Medical Microbiology
Tsai, Huey Pin, Sheng Wen Huang, Feng Ling Wu, Pin Hwa Kuo, Shih Min Wang, Ching Chuan Liu, Ih Jen Su, and Jen Ren Wang. "An echovirus 18-associated outbreak of aseptic meningitis in Taiwan: Epidemiology and diagnostic and genetic aspects." Journal of Medical Microbiology 60, 9 (2011): 1360-1365. doi: 10.1099/jmm.0.027698-0.