Prevalence of human parechoviruses in central nervous system infections in children: A retrospective study in Shanghai,China

Human parechoviruses (HPeV) are associated with central nervous system (CNS) infections and sepsis‐like illnesses. However, data from China are not available. The aim of this study was to determine the prevalence, age, and seasonal distributions and genotypes of HPeV infections in children with CNS related disease in Shanghai, China. Of 776 cerebrospinal fluid (CSF) samples collected from children with CNS‐related diseases under the age of 16 years during the years 2008–2011, 68 (9%) were identified to be HPeV positive. The annual prevalence varied remarkably: 1% (2/153) in 2008, 7% (12/177) in 2009, 15% (23/153) in 2010, and 11% (31/293) in 2011. The virus was detected in all age groups of children ranging from 2 days to 13 years and the median age was 14 months. Of the 31 positive samples that were genotyped successfully, 28 were HPeV1 and 3 were HPeV3. This study provided data on the molecular epidemiology of HPeV infections in CNS‐related diseases in Shanghai, China and suggest that the screening for HPeV by PCR should be included in the routine viral testing of CSF. J. Med. Virol. 85:320–326, 2013. © 2012 Wiley Periodicals, Inc.     

Molecular detection of human parechovirus in children with acute gastroenteritis in Guangzhou,China

Human parechoviruses (HPeVs) are widespread pathogens causing a wide spectrum of diseases. The prevalence and genetic diversity of HPeV in children with acute diarrhea in China is not well known. The purpose of this study was to investigate the epidemiological characteristics of HPeV in Guangzhou, China. A total of 328 stool specimens collected from children under the age of 5 years with acute diarrhea were tested for the presence of HPeV. Of these, 44 (13.4 %, 44/328) were HPeV positive, with the majority of the infected children (97.7 %, 43/44) being younger than two years of age. HPeV was more frequently detected during July and August. The epidemiological profile of co-infections was similar to that observed in a previous study. Six different HPeV genotypes, including HPeV1, -3, -4, -5, -6, and -14, were identified, and of these, HPeV14, a rarely reported genotype, was reported for the first time in children with acute gastroenteritis in China. In summary, this study clearly demonstrated that HPeV circulating in Guangzhou, China, is genetically diverse, including six genotypes, and it provides useful epidemiological data on the features of HPeV infection in this area.     

Molecular detection and phylogenetic analysis of human parechovirus in individuals with acute diarrhea and healthy controls in Guangzhou,China

Human parechoviruses (HPeVs) are prevalent in young children; however, their effects are incompletely understood. We investigated the prevalence, genotype distribution, and phylogeny of HPeVs in individuals with diarrhea (n = 430) and healthy controls (n = 93) by the analysis of stool specimens collected from July 2013 to December 2014; 51 (11.86%) and 6 (6.45%) specimens were HPeV positive, respectively. HPeV1A occurred in 28 (6.51%) and 6 (6.45%) individuals with diarrhea and controls, respectively, whereas HPeV1B (3.95%), HPeV3 (0.23%), HPeV4 (0.70%), and HPeV14 (a rare genotype, 0.47%) were only detected in individuals with diarrhea. There was no significant difference in the rate of HPeV detection between the 2 groups; however, the mean age of HPeV infection was significantly lower in males. We conclude that HPeVs may be opportunistic pathogens associated with acute diarrhea. Immunocompromised individuals, such as children aged under 2 years and the elderly, could be vulnerable to HPeV infections.     

Prospective assessment of clinical symptoms associated with enterovirus and parechovirus genotypes in a multicenter study in Dutch children

BackgroundHuman non-polio enterovirus (EV) and human parechovirus (HPeV) are important pathogens of viral infection and aseptic meningitis in children. The aim of this study is to prospectively compare the incidence, clinical signs, blood and cerebrospinal fluid in EV and HPeV infected children.ObjectivesTo compare the clinical symptoms and laboratory data of children with different EV and HPeV genotypes.Study designThis study is part of a multicenter prospective cohort study. Children were included in 3 different hospitals in The Netherlands from 2008 to 2011.ResultsOf 285 included patients, 140 (49%) had EV and 44 (15%) HPeV infection. Of children with EV infection 9 (6%) had EV-A, 109 (78%) EV-B, 12 (9%) had a non-type able EV and in 10 (7%) no genotyping was performed. Of children with HPeV infection, 24 (55%) had HPeV-3, 6 (14%) HPeV-1, 2 (5%) HPeV-4 and 1 (2%) HPeV-6. Meningitis was more frequent in EV than in HPeV infected children (54% vs. 36%, p = 0.046), and in EV-B than EV-A infected children (60 vs. 33%). In contrast gastroenteritis was more frequent in HPeV than EV infected children (30% vs. 15%, p = 0.030), and significantly more in HPeV-1 than HPeV-3 infected children (p < 0.001).ConclusionsEV infection is more often associated with meningitis and HPeV infection more often with a gastro-enteritis. EV genotype B infection is more often associated with meningitis than EV genotype A infection. HPeV-1 infection was more often associated with gastroenteritis than HPeV-3 infection.     

Molecular epidemiology of norovirus infection among children with acute gastroenteritis in Shanghai,China, 2001–2005

Norovirus is one of the major causes of outbreaks and sporadic cases of acute gastroenteritis in young children worldwide. Obtaining local baseline information regarding this virus is important for developing and evaluating prevention strategies of norovirus transmission in children. The age, seasonal distribution and circulating genotypes of norovirus in Shanghai, China, between 2001 and 2005 were determined. Of 5411 stool specimens collected from children under 5 years of age who were hospitalized with acute gastroenteritis 3,975 were rotavirus‐negative, indicating the presence of another causative agent. From these specimens, 484 were selected at random for genotyping, and 45 were norovirus‐positive. Norovirus infection was detected in all age groups, but infants less than 6 months old showed the lowest prevalence (5.4%). Norovirus infections peaked from August to November. Among the 37 identified norovirus strains, 2 were GII‐3, 2 were GII‐7, and 33 were GII‐4 genotypes. This study demonstrated the impact of norovirus infection causing acute gastroenteritis in hospitalized children and the importance of vaccination against norovirus diarrhea in Shanghai, China. J. Med. Virol. 81:1826–1830, 2009. © 2009 Wiley‐Liss, Inc.     

High prevalence of human Parechovirus (HPeV) genotypes in the Amsterdam region and identification of specific HPeV variants by direct genotyping of stool samples

Human parechoviruses (HPeV) are widespread pathogens belonging to the Picornavirus family. Six genotypes, which have predominantly been isolated from children, are known. Data on prevalence of HPeV genotypes are generally based on cell culture, which may underestimate the prevalence of certain HPeV strains that are difficult to grow. We studied 1,824 stool samples from 1,379 children (<5 years old) sent to the Academic Medical Center, Amsterdam, The Netherlands, between 2004 and 2006. Samples were screened using specific human enterovirus (HEV) and HPeV real-time PCRs based on the 5′ untranslated region. A high percentage of HPeV infections (16.3%), comparable to the percentage of HEV infections (18.4%), were found by PCR in stool samples. HPeV-positive stool samples were directly genotyped based on the VP1 region for the first time to avoid a culture bias. HPeV1 was found to be the most prevalent type. The majority of the HPeV1 strains clustered separately from the prototype strain, Harris, which has not been reported to circulate lately. However, we could identify three strains as HPeV1 Harris. HPeV3 was identified as the second most predominant type during 2004 and 2006 but was not found in 2005. HPeV4 to -6 were found in smaller numbers. One strain could not be associated with a known HPeV type (VP1 gene nucleotide similarity: 71%), possibly indicating a new genotype. Also, we report the first identification of three HPeV5 strains and one HPeV1 strain with a different motif at the C-terminal end of VP1, where the arginine-glycine-aspartic acid (RGD) motif is normally located.     

Molecular epidemiology, genome characterization, and recombination event of human parechovirus

Human Parechovirus (HPeV), a member of the Picornaviridae family, is an infectious agent mostly affecting children. There are 16 recognized genotypes which have globally spread. This study incorporated a total of 2957 nasopharyngeal (NP) swab and 759 fecal samples that were collected from different parts of Thailand. The NP of HPeV was detected in 0.4% of NP swab and 6.1% of fecal samples. The majority of HPeV infections occur in infants below the age of 2 years, while infections were detected in children above the age of 10 years as well. Various genotypes comprising 1A, 1B, 2, 3, 4, 5, 6, 10 and 14 have been characterized. This study revealed recombination events in 16 samples in which HPeV1B was shown as the highest frequency. In conclusion, HPeV can be detected in both the respiratory and GI tract. Moreover, HPeV which circulates in Thailand is highly diverse and subject to recombination.     

Comparison of human parechovirus and enterovirus detection frequencies in cerebrospinal fluid samples collected over a 5-year period in edinburgh: HPeV type 3 identified as the most common picornavirus type

Human enteroviruses (EVs) and more recently parechoviruses (HPeVs) have been identified as the principal viral causes of neonatal sepsis-like disease and meningitis. The relative frequencies of specific EV and HPeV types were determined over a 5-year surveillance period using highly sensitive EV and HPeV PCR assays for screening 4,168 cerebrospinal fluid (CSF) specimens collected from hospitalized individuals between 2005 and 2010 in Edinburgh. Positive CSF samples were typed by sequencing of VP1. From the 201 EV and 31 HPeV positive (uncultured) CSF samples on screening, a high proportion of available samples could be directly typed (176/182, 97%). Highest frequencies of EV infections occurred in young adults (n = 43; 8.6%) although a remarkably high proportion of positive samples (n = 98; 46%) were obtained from young infants (<3 months). HPeV infections were seen exclusively in children under the age of 3 months (31/1,105; 2.8%), and confined to spring on even-numbered years (22% in March 2006, 25% in April 2008, and 22% in March 2010). In contrast, EV infections were distributed widely across the years. Twenty different EV serotypes were detected; E9, E6, and CAV9 being found most frequently, whereas all but one HPeVs were type 3. Over this period, HPeV3 was identified as the most prevalent picornavirus type in CNS-related infections with similarly high incidences of EV infection frequencies in very young children. The highly sensitive virus typing methods applied in this study will assist further EV and HPeV screening of sepsis and meningitis cases as well as in future molecular epidemiological studies and population surveillance.     

人双埃柯病毒在腹泻患儿中的流行及其分子特征研究

目的研究吉林地区腹泻患儿中人双埃柯病毒（HPeV）的流行特点和分子特征。方法采用Real-time PCR方法直接检测筛查〈5岁腹泻患儿粪便标本,应用巢氏RT—PCR扩增VP1区进行分型。结果306例标本中,检出HPeV阳性27例（8．82％）,成功分型11例,包括9例HPeV1,HPeV2和HPeV4各1例。HPeV检出集中在7月、9月和10月,7月检出率最高（28．57％）。HPeV感染似乎与大于2岁患儿关系密切。VP1区基因片段与参考株核苷酸同源性为79％～92％。结论多种HPeV在我国吉林地区检出,但HPeV3未能检出,该地区HPeV的流行特征与国内外的报道基本一致,开展长期的HPeV监测对于阐明HPeV与婴幼儿腹泻及其他疾病的病因相关性有重要意义。     

Human parechoviruses in infants with systemic infection

Human parechoviruses (HPeVs) are RNA viruses related to neonatal sepsis, meningoencephalitis and other infections in young children. Little clinical and epidemiological information is available on these viruses. HPeVs were sought in cerebrospinal fluid from 397 infants aged less than 12 months from whom a sample was obtained to exclude meningitis or encephalitis from 2006 to 2009. HPeV infections were also tested in stool samples from 271 children aged less than 3 years old with gastroenteritis from November 2008 to March 2009. HPeV detection was by real‐time polymerase chain reaction assay (region 5′UTR), followed by genotyping (region VP3/VP1). HPeVs were detected in the cerebrospinal fluid of nine infants (2.3%), one aged 6 months and eight aged 14–55 days old. All were admitted to hospital for febrile syndrome with abrupt clinical deterioration and suspected systemic infection without clear laboratory signs of meningeal inflammation. The same virus was detected in all the available nasopharyngeal aspirates, stool, and/or serum samples from each patient. At least eight of the nine cases were caused by HPeV3. HPeVs were detected in stool samples from 17 children (6.3%), the most prevalent types being types 1 and 3. In conclusion, HPeV infection is common in the Basque Country (Spain) and HPeV3 is a significant cause of hospital admission due to systemic infection in the first few months of life. In these patients, HPeVs should be investigated as part of routine tests for enterovirus. J. Med. Virol. 82:1790–1796, 2010. © 2010 Wiley‐Liss, Inc.     

2008-2011年新疆维吾尔自治区5岁以下腹泻儿童人杯状病毒感染分析

目的 了解新疆5岁以下腹泻儿童人杯状病毒感染的流行特征.方法 收集2008-2011年新疆782份5岁以下腹泻儿童粪便标本,利用RT-PCR方法进行杯状病毒检测.结果 杯状病毒阳性率为12.7％,其中男性儿童中为12.4％,女性为13.1％;2008-2011四年阳性率分别为11.3％、16.0％、11.9％和11.5％;城镇地区为12.1％,农村地区为16.0％;不同年度、地区和性别之间差异均无统计学意义.5岁以下儿童中,6月以下、6-12月、1-2岁、＞2岁年龄组阳性率分别为10.2％、15.6％、13.8％、3.0％,差异有统计学意义(x2=8.149,P＜0.05).结论 杯状病毒感染是引起新疆5岁以下儿童腹泻的主要病原之一,2008-2011年间的阳性率为12.7％,2岁以下儿童感染风险最高.     

Detection of human parechovirus in stool samples collected from children with acute gastroenteritis in Japan during 2007-2008

Of 477 stool specimens, which had been screened for rotavirus, adenovirus, norovirus, sapovirus and astrovirus, collected from infants and children with acute gastroenteritis in pediatric clinics encompassing five localities (Sapporo, Tokyo, Maizuru, Osaka, and Saga) in Japan from July 2007 to June 2008, 247 negative samples (51.7%) were subjected to screening for human parechovirus. Human parechovirus (HPeV) was detected by RT‐PCR using a primer pair to amplify 5′UTR region of its genome and was genotyped by sequencing of the VP1 gene. HPeV was detected in 20 of 247 specimens tested, and the detection rate was found to be 8.1%. Seventeen of the 20 strains that tested positive for HPeV were sequenced successfully the VP1 gene. The majority of the HPeV strains (n = 15) could be identified as HPeV1, and the remaining 2 strains could be typed as HPeV3. By phylogenetic and identical matrix analyses of HPeV VP1 sequences, HPeV1 should be divided into two lineages, and all of the Japanese studied HPeV1 strains belong to the lineage 2 accordingly. This is the first report of the circulation of HPeV, especially HPeV1 in Japan. J. Med. Virol. 83:331–336, 2011. © 2010 Wiley‐Liss, Inc.     

Epidemiological and molecular investigation of norovirus and astrovirus infections in Rio Branco,Acre, Northern Brazil: A retrospective study

Norovirus (NoV) is a major cause of nonbacterial acute gastroenteritis (AGE) outbreaks worldwide, with infections reported in semiclosed environments, particularly in hospitals and nursing homes. Astrovirus (HAstV) is prevalent worldwide, especially in developing countries. We aimed to determine the prevalence, spatial distribution, and genetic diversity of NoV and HAstV in children under 5 years of age in Rio Branco city, Acre State, Amazon Region, Brazil. Stool samples from children with (n = 240) and without (n = 248) AGE were collected from January to December 2012 from seven neighborhoods. The overall NoV prevalence was 12.3% (60 of 488); representing 15.8% (38 of 240) of the symptomatic samples and 8.9% (22 of 248) of the controls. HAstVs infection was observed in 4.7% (23 of 488) of the samples tested, 6.2% (15 of 240) of AGE cases, and 2.4% (6 of 248) of the controls (plus two without information about feces consistency). Infections were found in all age groups with higher frequency in children less than two years of age, for both viruses. NoV was detected in all neighborhoods, with a higher concentration in the fourth (30%; 18 of 60). NoV nucleotide sequencing performed in 86.7% (52 of 60) of the positive samples showed the circulation of the strains GII.4 (57.7%; 30 of 52), GIIPe/GII.4 (19.2%; 10 of 52), GII.7, GII.Pg/GII.1, and GII.Pc (3.8%; 2 of 52 for each), GII.6 and GII.Pg (1.9%; 1 of 52 for each), and GI.3 (7.7%; 4 of 52). Three GII.4 variants were detected: Den Haag_2006b (n = 1), New Orleans_2009 (n = 1), and Sydney_2012 (n = 14). HAstV types HAstV-1a (81.8%; 9 of 11) and HAstV-2c (18.2%; 2 of 11) were observed in the 47.8% (11 of 23) of characterized samples. This is the first data obtained in Acre State regarding the prevalence of these viruses and provides epidemiological and molecular information for a better understanding of their role among children with and without AGE.     

Age-related prevalence and distribution of nontuberculous mycobacterial species among patients with cystic fibrosis

We studied the prevalence and species distribution of nontuberculous mycobacteria (NTM) in relation to age in 385 patients with cystic fibrosis (CF) (mean age +/- standard deviation [range], 12.0 +/- 6.1 [1 to 24] years; sex ratio, 0.53) attending three Parisian centers. The overall prevalence of NTM in sputum was 8.1% (31 out of 385). The following NTM were isolated (n = 33): Mycobacterium abscessus (n = 13, 39.4%), Mycobacterium avium complex (MAC) (n = 7, 21.2%), Mycobacterium gordonae (n = 6, 18.2%), and other (n = 7, 21.2%). Sixteen patients met the American Thoracic Society microbiological criteria for NTM infection, including 11 patients positive for M. abscessus, 4 for MAC, and 1 for MAC and Mycobacterium kansasii. The overall prevalence of NTM was significantly lower in patients under 15 years old than for patients equal to or more than 15 years old (4.8 versus 14.9%, respectively; P = 0.001). M. abscessus was isolated at all ages, while MAC was not recovered before 15 years (prevalence of 0.0 and 5.2% in patients aged 1 to 14 and 15 to 24, respectively; P = 0.001).     

Dermatophytosis in Tulugudu Island, Ethiopia.

The objective of this investigation was to assess the prevalence of dermatophytoses in children in a geographically restricted area in the Ethiopian countryside, and to determine the aetiological agents of these infections. Demographical and clinical-dermatological data were collected from all children 4-15 years of age on Tulugudu Island, Southern Ethiopia. Mycological specimens were taken and species identification determined through morphological observations and biochemical tests, complemented with sequencing of rDNA ITS2 region when necessary. Of 171 children, 96% shared combs, 85% shared beds and 97% had animal contact. Family size was > 5 persons in 50% of the test subjects and prevalence of tinea capitis was elevated in this group (P < 0.005). Dermatophytoses were clinically diagnosed in 136 cases (79.5%). Tinea capitis (T. capitis) was the most common manifestation with 104 cases (76.5%). T. capitis was combined with dermatophytic infections at other sites in 19 cases. Tinea faciae and Tinea corporis were found in four and two cases, respectively, and pediculosis capitis was diagnosed in 2.9% of the test subjects. Of 135 samples from hair (n = 112), skin (n = 19) and finger-nail (n = 4), 74.1% were microscopy-positive for dermatophytes, 73% were positive in culture, giving an overall prevalence of dermatophytoses in 57.3% of all children examined. Trichophyton violaceum was identified in 80.6% of cultures, Trichophyton verrucosum in 16.3% and Trichophyton tonsurans in 2.0%. One isolate was identified as a white variant of T. violaceum. Tinea capitis was highly prevalent in children on Tulugudu Island, Southern Ethiopia. The anthropophilic species T. violaceum dominated as an aetiological agent. Zoophilic dermatophytes were relatively rarely isolated from clinical specimens, despite the children's frequent contact with animals.     

Clinical features and molecular epidemiology of rotavirus and norovirus infections in Libyan children

Rotaviruses and noroviruses are leading viral causes of diarrhoea in children. A cross‐sectional study was undertaken among children aged <5 years with acute gastroenteritis at Al‐Jala Children's Hospital, Tripoli, Libya, from October 2007 to September 2008. Of 1,090 fecal samples collected, 260 from inpatients and 830 from outpatients, all inpatients and approximately a third of outpatients, selected systematically, were investigated for rotavirus and norovirus infection by ELISA and real‐time RT‐PCR, respectively. Of 520 fecal samples examined (inpatients = 260, outpatients = 260), 164 (31.5%) had rotavirus and 91 (17.5%) had norovirus detected. Rotavirus was identified more often among inpatients than outpatients (35.8% vs. 27.3% respectively, P = 0.038). Norovirus was detected more commonly among outpatients than inpatients (21.2% vs. 13.8% respectively, P = 0.028). The peak incidence of infection with both viruses was among children aged between 6 and 11 months. The number of rotavirus cases was highest between November and June with a peak detection rate of 50% in January. Norovirus occurred most commonly from May through August with a peak detection rate of 47% in August. The most prevalent rotavirus genotypes were P[8], G9 (n = 116, 65.9%), followed by P[8],G1 (n = 49, 27.8%); a single P[9], G3 strain was detected. There were seven distinct electropherotypes among the G9 strains and all belonged to VP7 Lineage III. Among 91 noroviruses identified, 90 were genogroup II. Of 26 genogroup II noroviruses examined, all were genotype GII.4. Rotaviruses and noroviruses are both important causes of gastrointestinal infection among young children in Libya. J. Med. Virol. 83:1849–1856, 2011. © 2011 Wiley‐Liss, Inc.