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A coxsackievirus B5‐associated aseptic meningitis outbreak in Shandong Province,China in 2009
Authors:Peng Chen  Zexin Tao  Yanyan Song  Guifang Liu  Haiyan Wang  Yao Liu  Lizhi Song  Yan Li  Xiaojuan Lin  Ning Cui  Aiqiang Xu
Institution:1. Department of Epidemiology, School of Public Health, Shandong University, Jinan, China;2. Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan, China;3. Shandong Center for Disease Control and Prevention, Jinan, China;4. Department of Preventive Medicine, College of Basic Medical Sciences, Shandong University of Traditional Chinese Medicine, Jinan, China
Abstract:In 2009, a major outbreak of aseptic meningitis was noted in Linyi city, Shandong province, China. From June to September 2009, a total of 2,104 cases were involved in this outbreak, and 98.6% of patients were <16 years of age. To determine the pathogen of the outbreak, 42 cerebrospinal fluid specimens collected from aseptic meningitis cases were tested for cell culture, and 17 (40.5%) enteroviruses were isolated and identified as Coxsackievirus B5 (CVB5). Homologous comparison indicated that these isolates had 0–7.7% nucleotide divergence with each other. Phylogenetic reconstruction showed global CVB5 could be separated into four genogroups, and all Linyi CVB5 isolates belonged to the genogroup C which had been circulating for recent 27 years in Asia and Europe. Interestingly, two distinct lineages were observed for the 17 isolates in the phylogenetic tree, indicating that at least two different transmission chains of CVB5 were responsible for this outbreak. This study showed that CVB5‐associated aseptic meningitis is an emerging concern in China. J. Med. Virol. 85:483–489, 2013. © 2012 Wiley Periodicals, Inc.
Keywords:aseptic meningitis  Coxsackievirus B5 (CVB5)  enterovirus  genetic characterization
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