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Published Date: 2013-05-26 15:30:39
Subject: PRO/EDR> Human enterovirus 71 - Australia: sub-genogroup C4a, acute flaccid paralysis
Archive Number: 20130526.1738087
HUMAN ENTEROVIRUS 71 - AUSTRALIA: SUB-GENOGROUP C4A, ACUTE FLACCID PARALYSIS
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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Sun 26 May 2013
From: Bruce Thorley <bruce.thorley@mh.org.au> [edited]
Detection of enterovirus 71 sub-genogroup C4a in specimens from cases of acute flaccid paralysis, Australia
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Australia conducts surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age as part of the national polio surveillance program funded by the Australian government. From January to early May 2013, human enterovirus 71 (EV71) was detected in stool specimens from 5 of 14 (36 percent) AFP cases in children. EV71 was also detected in specimens from cases of hand-foot-mouth disease (HFMD) and non-paralytic neurological illness by members of the Enterovirus Reference Laboratory Network of Australia. A phylogenetic analysis of the VP1 genomic region identified homology with the EV71 C4a sub-genogroup circulating in China and South East Asia, which has been associated with more severe neurological complications than other sub-genogroups in recent years.
The identification of a more virulent strain of EV71 highlights the importance of referring stool specimens from patients suffering from AFP (including transverse myelitis and Guillain-Barre syndrome) to a WHO accredited polio reference laboratory not only to exclude poliovirus infection but also to identify non-polio enteroviruses of public health significance.
The Enterovirus Reference Laboratory Network of Australia was established in mid-2009 to broaden surveillance for poliovirus and now includes 10 public diagnostic virology laboratories. The network has accumulated more than 1100 enterovirus typing results nationally and of the EV71 detections, sub-genogroup B5 was the predominant strain detected from 2009-2011, with sporadic identifications of EV71 sub-genogroups C2 and C4a in 2012, none of which were associated with cases of AFP. It is also noteworthy that so far in 2013, echovirus 6 constituted the major enterovirus serotype associated with meningitis Australia-wide, with 74 of 311 (24 percent) identifications overall reported to the Enterovirus Reference Laboratory Network. This emphasizes the value of enterovirus typing to differentiate pathogens and their clinical manifestations.
--
Jason Roberts & A/Prof. Bruce Thorley
National Enterovirus Reference Laboratory
WHO Poliomyelitis Regional Reference Laboratory
The Enterovirus Reference Laboratory Network of Australia
<bruce.thorley@mh.org.au>
[AFP surveillance in Australia is coordinated by the National Enterovirus Reference Laboratory in collaboration with the Australian Paediatric Surveillance Unit and the National Centre for Immunisation Research and Surveillance.
ProMED-mail thanks Bruce Thorley for making this significant information available promptly to the general community. Enterovirus 71 for some years now has been the predominant virus in South and East Asia associated with the childhood disease hand-foot-mouth disease (HFMD). In particular, in contrast to other enteroviruses responsible for HFMD, enterovirus 71 has been associated with non-paralytic neurological illness.
The association of a particular strain of enterovirus 71 (a member of sub-genogroup C4a) with cases of acute flaccid paralysis in Australia is a warning that this virus may be evolving into a more dangerous pathogen and that it merits increased surveillance. - Mod.CP
Subject: PRO/EDR> Human enterovirus 71 - Australia: sub-genogroup C4a, acute flaccid paralysis
Archive Number: 20130526.1738087
HUMAN ENTEROVIRUS 71 - AUSTRALIA: SUB-GENOGROUP C4A, ACUTE FLACCID PARALYSIS
************************************************** **************************
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Sun 26 May 2013
From: Bruce Thorley <bruce.thorley@mh.org.au> [edited]
Detection of enterovirus 71 sub-genogroup C4a in specimens from cases of acute flaccid paralysis, Australia
----------------------------------------------------------------------
Australia conducts surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age as part of the national polio surveillance program funded by the Australian government. From January to early May 2013, human enterovirus 71 (EV71) was detected in stool specimens from 5 of 14 (36 percent) AFP cases in children. EV71 was also detected in specimens from cases of hand-foot-mouth disease (HFMD) and non-paralytic neurological illness by members of the Enterovirus Reference Laboratory Network of Australia. A phylogenetic analysis of the VP1 genomic region identified homology with the EV71 C4a sub-genogroup circulating in China and South East Asia, which has been associated with more severe neurological complications than other sub-genogroups in recent years.
The identification of a more virulent strain of EV71 highlights the importance of referring stool specimens from patients suffering from AFP (including transverse myelitis and Guillain-Barre syndrome) to a WHO accredited polio reference laboratory not only to exclude poliovirus infection but also to identify non-polio enteroviruses of public health significance.
The Enterovirus Reference Laboratory Network of Australia was established in mid-2009 to broaden surveillance for poliovirus and now includes 10 public diagnostic virology laboratories. The network has accumulated more than 1100 enterovirus typing results nationally and of the EV71 detections, sub-genogroup B5 was the predominant strain detected from 2009-2011, with sporadic identifications of EV71 sub-genogroups C2 and C4a in 2012, none of which were associated with cases of AFP. It is also noteworthy that so far in 2013, echovirus 6 constituted the major enterovirus serotype associated with meningitis Australia-wide, with 74 of 311 (24 percent) identifications overall reported to the Enterovirus Reference Laboratory Network. This emphasizes the value of enterovirus typing to differentiate pathogens and their clinical manifestations.
--
Jason Roberts & A/Prof. Bruce Thorley
National Enterovirus Reference Laboratory
WHO Poliomyelitis Regional Reference Laboratory
The Enterovirus Reference Laboratory Network of Australia
<bruce.thorley@mh.org.au>
[AFP surveillance in Australia is coordinated by the National Enterovirus Reference Laboratory in collaboration with the Australian Paediatric Surveillance Unit and the National Centre for Immunisation Research and Surveillance.
ProMED-mail thanks Bruce Thorley for making this significant information available promptly to the general community. Enterovirus 71 for some years now has been the predominant virus in South and East Asia associated with the childhood disease hand-foot-mouth disease (HFMD). In particular, in contrast to other enteroviruses responsible for HFMD, enterovirus 71 has been associated with non-paralytic neurological illness.
The association of a particular strain of enterovirus 71 (a member of sub-genogroup C4a) with cases of acute flaccid paralysis in Australia is a warning that this virus may be evolving into a more dangerous pathogen and that it merits increased surveillance. - Mod.CP