2018-2019 年南非西开普省和东开普省与肠病毒相关的无菌性脑膜炎的分子特征和流行病学。

Molecular characterisation and epidemiology of enterovirus-associated aseptic meningitis in the Western and Eastern Cape Provinces, South Africa 2018-2019.

机构信息

Division of Medical Virology, Department of Pathology, Stellenbosch University and the National Health Laboratory Service Tygerberg, Cape Town, South Africa.

出版信息

J Clin Virol. 2021 Jun;139:104845. doi: 10.1016/j.jcv.2021.104845. Epub 2021 Apr 24.

DOI:10.1016/j.jcv.2021.104845

PMID:33962182

Abstract

BACKGROUND

Enteroviruses are amongst the most common causes of aseptic meningitis. Between November 2018 and May 2019, an outbreak of enterovirus-associated aseptic meningitis cases was noted in the Western and Eastern Cape Provinces, South Africa.

OBJECTIVES

To describe the epidemiology and phylogeography of enterovirus infections during an aseptic meningitis outbreak in the Western and Eastern Cape Provinces of South Africa.

METHODS

Cerebrospinal fluid samples from suspected cases were screened using a polymerase chain reaction targeting the 5'UTR. Confirmed enterovirus-associated meningitis samples underwent molecular typing through species-specific VP1/VP2 primers and pan-species VP1 primers.

RESULTS

Between November 2018 and May 2019, 3497 suspected cases of aseptic meningitis were documented in the Western and Eastern Cape Provinces. Median age was 8 years (range 0-61), interquartile range (IQR=4-13 years), 405/735 (55%) male. 742/3497 (21%) cases were laboratory - confirmed enterovirus positive by routine diagnostic PCR targeting the 5'UTR. 128/742 (17%) underwent molecular typing by VP1 gene sequencing. Echovirus 4 (E4) was detected in 102/128 (80%) cases. Echovirus 9 was found in 7%, Coxsackievirus A13 in 3%. 10 genotypes contributed to the remaining 10% of cases. Synonymous mutations were found in most cases, with sporadic amino acid changes in 13 (12.7%) cases.

CONCLUSION

The aseptic meningitis outbreak was associated with echovirus 4. Stool samples are valuable for molecular typing in CSF confirmed EV-associated aseptic meningitis.

摘要

背景

肠道病毒是无菌性脑膜炎的最常见病因之一。2018 年 11 月至 2019 年 5 月期间，南非西开普省和东开普省发生了一起肠道病毒相关无菌性脑膜炎暴发。

目的

描述南非西开普省和东开普省无菌性脑膜炎暴发期间肠道病毒感染的流行病学和系统发育地理学。

方法

采用针对 5'UTR 的聚合酶链反应对疑似病例的脑脊液样本进行筛查。通过种特异性 VP1/VP2 引物和泛种 VP1 引物对确认的肠道病毒相关脑膜炎样本进行分子分型。

结果

2018 年 11 月至 2019 年 5 月期间，西开普省和东开普省共记录了 3497 例疑似无菌性脑膜炎病例。中位年龄为 8 岁（范围 0-61），四分位距（IQR=4-13 岁），405/735（55%）为男性。742/3497（21%）例通过针对 5'UTR 的常规诊断 PCR 确认为肠道病毒阳性。128/742（17%）例通过 VP1 基因测序进行了分子分型。在 102/128（80%）例中检测到埃可病毒 4（E4）。在 7%的病例中发现了柯萨奇病毒 A13，3%的病例中发现了埃可病毒 9。10 种基因型导致了其余 10%的病例。大多数病例发现同义突变，13 例（12.7%）有散在的氨基酸变化。