Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016.

Autor:	González-Sanz R; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain., Casas-Alba D; Institut de Recerca Sant Joan de Déu, Barcelona, Spain., Launes C; Institut de Recerca Sant Joan de Déu, Barcelona, Spain.; CIBER de epidemiología y Salud Pública, CIBERESP, Madrid, Spain., Muñoz-Almagro C; Universitat Internacional de Catalunya, Barcelona, Spain.; Institut de Recerca Sant Joan de Déu, Barcelona, Spain.; CIBER de epidemiología y Salud Pública, CIBERESP, Madrid, Spain., Ruiz-García MM; Hospital General de Elche, Alicante, Spain., Alonso M; Hospital Infantil Universitario Niño Jesús, Madrid, Spain., González-Abad MJ; Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Megías G; Complejo Hospitalario de Burgos, Burgos, Spain., Rabella N; Hospital Santa Creu i Sant Pau, Barcelona, Spain., Del Cuerpo M; Hospital Santa Creu i Sant Pau, Barcelona, Spain., Gozalo-Margüello M; Hospital Universitario Marqués de Valdecilla, Santander, Spain., González-Praetorius A; Hospital Universitario de Guadalajara, Guadalajara, Spain., Martínez-Sapiña A; Hospital Miguel Servet, Zaragoza, Spain., Goyanes-Galán MJ; Hospital Gregorio Marañón, Madrid, Spain., Romero MP; Hospital Universitario La Paz, Fundación IdiPaz, Madrid, Spain.; Translational Research Network in Paediatric Infectious Diseases (RITIP), IdiPaz, Madrid, Spain., Calvo C; Hospital Universitario La Paz, Fundación IdiPaz, Madrid, Spain.; Translational Research Network in Paediatric Infectious Diseases (RITIP), IdiPaz, Madrid, Spain., Antón A; Hospital Universitari Vall d´Hebron, Barcelona, Spain., Imaz M; Hospital de Basurto, Bilbao, Spain., Aranzamendi M; Hospital de Cruces, Bilbao, Spain., Hernández-Rodríguez Á; Microbiology Service, University Hospital 'Germans Trias i Pujol', Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain., Moreno-Docón A; Hospital Universitario Virgen de la Arrixaca, Murcia, Spain., Rey-Cao S; Hospital General de Vigo, Vigo, Spain., Navascués A; Complejo Hospitalario de Navarra, Pamplona, Spain., Otero A; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.; Translational Research Network in Paediatric Infectious Diseases (RITIP), IdiPaz, Madrid, Spain., Cabrerizo M; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.; CIBER de epidemiología y Salud Pública, CIBERESP, Madrid, Spain.; Translational Research Network in Paediatric Infectious Diseases (RITIP), IdiPaz, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin [Euro Surveill] 2019 Feb; Vol. 24 (7).
DOI:	10.2807/1560-7917.ES.2019.24.7.1800089
Abstrakt:	IntroductionEnterovirus A71 (EV-A71) is an emerging pathogen that causes a wide range of disorders including severe neurological manifestations. In the past 20 years, this virus has been associated with large outbreaks of hand, foot and mouth disease with neurological complications in the Asia-Pacific region, while in Europe mainly sporadic cases have been reported. In spring 2016, however, an EV-A71 outbreak associated with severe neurological cases was reported in Catalonia and spread further to other Spanish regions.AimOur objective was to investigate the epidemiology and clinical characteristics of the outbreak.MethodsWe carried out a retrospective study which included 233 EV-A71-positive samples collected during 2016 from hospitalised patients. We analysed the clinical manifestations associated with EV-A71 infections and performed phylogenetic analyses of the 3'-VP1 and 3Dpol regions from all Spanish strains and a set of EV-A71 from other countries.ResultsMost EV-A71 infections were reported in children (mean age: 2.6 years) and the highest incidence was between May and July 2016 (83%). Most isolates (218/233) were classified as subgenogroup C1 and 217 of them were grouped in one cluster phylogenetically related to a new recombinant variant strain associated with severe neurological diseases in Germany and France in 2015 and 2016. Moreover, we found a clear association of EV-A71-C1 infection with severe neurological disorders, brainstem encephalitis being the most commonly reported.ConclusionAn emerging recombinant variant of EV-A71-C1 was responsible for the large outbreak in 2016 in Spain that was associated with many severe neurological cases.
Databáze:	MEDLINE
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