The folling results were obtained through the clinical review and Virology Laboratory of 100 cases of meningitis seen at ward of the pediatric department of Has Sung Hospital during the period from May to June, 1993. 1) Early childhood period was the most frequent age group and male was predominant in aseptic meningitis. 2) The common chief complaints were fever, vomiting, headache in order. 3) On physical examination meningeal irritation signs were not prominent. 4) On admission, leukocytosis (WBC count>10.000/mm(3)) on peripheral blood was showed in 36%. 5) The findings of cerebrospinal fluid showed that cells (Mean WBC count 671.8/mm(3)) were increased in all cases, and protein and sugar were mostly within normal limit. 6) Echovirus 9 was thought to be main causative agent according to the cerebrospinal fluid culture and antibody test. 7) On follow up study 2 months after discharge, 14 cases showed minimal abnormalities of EEG but no abnormal finding in BERA.
Cerebrospinal Fluid ; Echovirus 9 ; Electroencephalography ; Fever ; Follow-Up Studies ; Headache ; Humans ; Leukocytosis ; Male ; Meningitis ; Meningitis, Aseptic* ; Physical Examination ; Virology ; Vomiting

Group B coxsackieviruses (CVBs) are a group of common human pathogens producing various clinical symptoms. Although the virology of CVB is well known, there is limited information on viral pathogenesis and the relationship between clinical symptoms and viral phenotype, particularly for CVB type 2 (CVB2). In 2004 in Korea, two CVB2 strains were isolated: CB2/04/279 from stool of an acute myocarditis patient with heart failure and CB2/04/243 from an aseptic meningitis patient. In this study, a high degree of homology was observed between the CB2/04/279 and CB2/04/243 full genome sequences. The two Korean CVB2 isolates had 93.1% homology compared to 82.1%–82.5% nucleotide sequence identity with the cardiovirulence-associated reference CVB strain Ohio-1 (CVB/O). CVB2-induced pathogenesis was analyzed, focusing on virus-induced pathology of various tissues in 4-week-old BALB/c inbred male mice. Myocarditis developed and extensive pancreatic inflammation was observed in all mice infected with CB2/04/279 or CVB/O, but not in animals infected with CB2/04/243. This is the first report of the full-genomic sequence and pathogenesis of the CVB2 strain isolated from an acute myocarditis patient in Korea.
Animals ; Base Sequence ; Enterovirus ; Genome ; Heart Failure ; Humans ; Inflammation ; Korea* ; Male ; Meningitis, Aseptic* ; Mice* ; Myocarditis* ; Pathology ; Phenotype ; Virology

BACKGROUND: Molecular methods have enabled rapid diagnosis of aseptic meningitis and have reduced both unnecessary therapeutic interventions and medical costs. In this study, we evaluated the analytical performance of the recently developed Real-Q Enterovirus Quantification kit (BioSewoom Inc., Korea). METHODS: We evaluated the detection limit, precision, linearity, and cross-reactivity of the Real-Q Enterovirus Quantification kit and compared it with the conventional PCR method. From March to September 2009, we tested 91 CSF specimens from patients who visited the pediatrics department of the university hospital with symptoms of aseptic meningitis or infantile sepsis, and we also tested 48 CSF specimens from patients with febrile convulsion for differential diagnosis. RESULTS: The Real-Q Enterovirus Quantification kit showed good linearity (r=0.997) within a range from 3x10(2) to 3x10(10) copies/mL, and the detection limit of the kit was 83 copies/mL. The within-run, between-run, and between-day CVs were 5.3-7.6%, 9.5-12.3%, and 11.4-13.4%, respectively. There was no cross reactivity between enteroviruses and various microorganisms. Positive results were obtained for 39.1% (25/64) of the patients suspected of aseptic meningitis and 44.4% (12/27) of the patients suspected of infantile sepsis. However, among the 48 children with febrile conversion, only 4 were positive for enterovirus. Further, the concordance with conventional PCR was high (73/74). CONCLUSIONS: The Real-Q Enterovirus Quantification kit showed excellent linearity and high reliability with a broad reportable range. It showed good detection rate when used with clinical specimens and also showed a high concordance with the conventional method. Therefore, this assay would be clinically useful not only in diagnosis of aseptic meningitis but also in differential diagnosis of infantile sepsis.
Child ; Child, Preschool ; Cross Reactions ; DNA, Viral/*analysis ; Enterovirus/genetics/*isolation & purification ; Humans ; Infant ; Meningitis, Aseptic/diagnosis/virology ; Polymerase Chain Reaction/*methods ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

OBJECTIVETo determine the partial sequence of virus strains causing an aseptic meningitis outbreak in northern part of Jiangsu province in 2003 and to compare them with the same serotype strains isolated in other countries to better understand its genetic characteristics and hereditary trend of development.

METHODSVirus RNA was amplified using two sets of specific enteroviral 3' half of VP1 primers 012/011 and 040/011. Polymerase chain reaction (PCR) products were purified and sequenced. BLAST program was then used to perform on nucleotide and amino acid pairwise-alignment with all available sequences in NCBI database. Phylogenetic trees were drawed to compare with other enteroviral sequences using PHYLIP software.

RESULTSUnder BLAST program, three sequences we submitted to GenBank were identically inferred as echovirus type 30, which had been identified by neutralization test in previous study. Phylogenetic analysis demonstrated that strains isolated from this outbreak were aggregated into a cluster, and the closest relationships with them were those isolated in 1999 and 2000. This phenomenon indicated that Echo30 from this outbreak was different from other strains in different epidemic area.

CONCLUSION3' half of VP1 sequence could be used to quickly identify the serotype of isolated enterovirus. Strains isolated from this outbreak had the similar hereditary developing trend comparing with Echo30 strains isolated from other countries.

Base Sequence ; China ; epidemiology ; DNA, Viral ; genetics ; Disease Outbreaks ; Enterovirus B, Human ; genetics ; isolation & purification ; Female ; Humans ; Male ; Meningitis, Aseptic ; epidemiology ; virology ; Molecular Sequence Data ; Sequence Analysis, DNA

BACKGROUNDTo provide a simple, specific and early serodiagnostic technique for the patients with aseptic meningitis caused by echovirus.

METHODSAn indirect enzyme-linked immunosorbent assay (ELISA) has been developed to detect echovirus-IgM and the specificity and availability of the assay were also examined.

RESULTSIn 78 cerebrospinal fluid (CSF) specimens which came from the children with aseptic meningitis, the positive rate was 17.9(14/78). In 64 CSF collected from non-aseptic meningitis (bacterial meningitis and cerebral trauma), the positive rate was 1.56(1/64). In 5 CSF specimens which were ELISA positive, the positive rate of neutralization test (NT) was 4/5, all the specimens which were ELISA negative were NT negative. In this assay there was no cross-reaction with poliovirus, Coxsackie virus B type 1-6 and A type 7. By blocking and destructive test of specific IgM, all CSF specimens with ELISA positive became negative.

CONCLUSIONSThe established indirect ELISA was specific and reliable. The te st was quick, simple and available, which is suitable for early and specific clinical diagnosis, and will be greatly significant to clinical treatment.

Adult ; Antibodies, Viral ; cerebrospinal fluid ; Child ; Child, Preschool ; Echovirus Infections ; diagnosis ; Enzyme-Linked Immunosorbent Assay ; methods ; Humans ; Immunoglobulin M ; cerebrospinal fluid ; Infant ; Infant, Newborn ; Meningitis, Aseptic ; diagnosis ; virology

In order to confirm the cause of the outbreak of aseptic meningitis in Zhejiang Province in 2002-2004, trace the pathogen and analyze the molecular characteristics, 271 cerebrospinal fluid (CSF) and faeces specimens were collected from suspected patients. The virus strains from the specimens were isolated with RD and Hep-2 cell lines. The VP1 and VP4/VP2 genes of the isolated viruses were sequenced, and their phylogenetic and homology trees were also constructed. Of the total 271 samples, 78 Echovirus type 30 (E30) strains were isolated. All of the complete VP1 genes in 31 sequenced virus isolates of E30 were composed of 876 nt without any insertion or deletion, encoding 292 amino acids (aa). The identity of nucleotide and amino acid in VP1 gene were 84.7%-86.3% and 92.1%-94.2% between the 31 Zhejiang strains and the prototype strain Bastianni of E30, and 87.1%-99.4% and 96.2%-100% among the 31 Zhejiang strains, respectively. The Zhejiang strains of E30 in the phylogenetic tree of the VP1 gene were attributed into two branches of the G and H genotype, respectively. In G genotype, the Shangdong and Jiangsu E30 strains in 2003 among domestic strains and Ukraine E30 strain in 1999 among overseas strains had maximum similarity with the Zhejiang strains, while H genotype had maximum similarity with the Korea E30 strains in 2008. The phylogenetic tree of the VP4/VP2 genes was similar to that of VP1 gene. The results indicated that the outbreak of aseptic meningitis in Zhejiang Provinec in 2002-2004 was caused by the G and H genotypes of E30 strains existing simultaneously. The H genotype was a new variant strain, which was first isolated in Zhejiang Province in 2002.
Amino Acid Sequence ; Capsid Proteins ; genetics ; Cell Line ; Cerebrospinal Fluid ; virology ; China ; epidemiology ; Disease Outbreaks ; Enterovirus B, Human ; classification ; genetics ; isolation & purification ; Evolution, Molecular ; Feces ; virology ; Genotype ; Humans ; Meningitis, Aseptic ; epidemiology ; virology ; Molecular Sequence Data ; Phylogeny ; Sequence Alignment

In Korea, there was a big outbreak of aseptic meningitis in 1993. Six clinical isolates of enterovirus were obtained from patients with aseptic meningitis and were identified as echovirus type 9 by serotyping with a pool of neutralizing antisera. For molecular characterization of the isolates, the nucleotide sequences of 5'-noncoding region (NCR), VP4, VP2, VP1, 2A and 2C regions of the isolates were compared with the corresponding regions of echovirus type 9 Hill and Barty strains. Unlike Hill strain, Barty strain contained a C-terminal extension to the capsid protein VP1 with an RGD (argnine-glycine-aspartic acid) motif. To determine whether similar structural features were present in our isolates, their nucleotide sequences including the VP1 region were analyzed. All isolates exhibited the VP1 extension with the RGD motif. We concluded the Korean isolates in the year of 1993 as the echovirus type 9 Barty strain although the isolates showed 15-20% nucleotide sequence differences in the several genomic regions.
5' Untranslated Regions ; Base Sequence ; Capsid/genetics ; Comparative Study ; Cysteine Endopeptidases/genetics ; Echovirus 9/genetics* ; Genome, Viral ; Human ; Meningitis, Aseptic/virology* ; Molecular Sequence Data ; RNA Helicases/genetics ; Variation (Genetics)*

BACKGROUNDTo find the pathogenic agents of aseptic meningitis prevalent in Xuzhou of Jiangsu province in 2001.

METHODSThe enterovirus (EV) was cultured from CSF of the patients and identified with anti-serum by neutralization test. Neutralization titer of antibody in paired sera from meningitis children was determined. EV RNA was detected by RT-PCR.

RESULTSFour strains of Coxsackievirus B5, 2 strains of Coxsackievirus B3 and 1 strain of Echovirus 7 were isolated from 22 CSF specimens. The isolation rate of virus was 31.8% (7/22), 21 CSF were tested by RT-PCR, the positive rate of EV RNA was 52.4% (11/21); 57.9% (11/19) of patients paired-sera had over 4 folds antibody rise or became seroconverted.

CONCLUSIONEnterovirus was the pathogenic agent of aseptic meningitis prevalent in Xuzhou of Jiangsu province, the main serotype of the virus was Coxsackievirus B5.

Antibodies, Viral ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Coxsackievirus Infections ; cerebrospinal fluid ; epidemiology ; virology ; Echovirus Infections ; cerebrospinal fluid ; epidemiology ; virology ; Enterovirus ; genetics ; immunology ; isolation & purification ; Humans ; Infant ; Meningitis, Aseptic ; cerebrospinal fluid ; epidemiology ; virology ; Microscopy, Electron ; Neutralization Tests ; Prevalence ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Virion ; isolation & purification ; ultrastructure