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. 2021 May 1;21(1):405.
doi: 10.1186/s12879-021-06112-9.

Analysis of enterovirus genotypes in the cerebrospinal fluid of children associated with aseptic meningitis in Liaocheng, China, from 2018 to 2019

Jing Wang #  1 , Min Meng #  1 , Huan Xu  1 , Ting Wang  2 , Ying Liu  1 , Han Yan  1 , Peiman Liu  1 , Daogang Qin  1 , Qiaozhi Yang  1
Affiliations

Analysis of enterovirus genotypes in the cerebrospinal fluid of children associated with aseptic meningitis in Liaocheng, China, from 2018 to 2019

Jing Wang et al. BMC Infect Dis. .

Abstract

Background: Aseptic meningitis is most often caused by enteroviruses (EVs), but EVs associated with aseptic meningitis have not yet been reported in Liaocheng. The aim of this study was to determine the prevalence and genetic characteristics of EVs causing aseptic meningitis in children in Liaocheng.

Methods: We reviewed the epidemiological and clinical characteristics of 504 paediatric cases of aseptic meningitis in Liaocheng from 2018 to 2019 and analysed the phylogeny of the predominant EV types causing this disease.

Results: A total of 107 children were positive for EV in cerebrospinal fluid samples by nested PCR. Most of the positive patients were children 13 years old or younger and had symptoms such as fever, headache and vomiting (P < 0.05). The seasons with the highest prevalence of EV-positive cases were summer and autumn. The 107 EV sequences belonged to 8 serotypes, and echovirus types 18, 6 and 11 were the three dominant serotypes in Liaocheng during the 2-year study period. Phylogenetic analyses demonstrated that the E18 and E6 isolates belonged to subgenotype C2, while the E11 isolates belonged to subgenotype D5. VP1 analysis suggested that only one lineage of these three types was cocirculating in the Liaocheng region.

Conclusions: This study demonstrated the diverse EV genotypes contributing to a large outbreak of aseptic meningitis in Liaocheng. Therefore, large-scale surveillance is required to assess the epidemiology of EVs associated with aseptic meningitis and is important for the diagnosis and treatment of aseptic meningitis in Liaocheng.

Keywords: Aseptic meningitis; Children; Enterovirus (EV); Liaocheng; Phylogenetic analysis.

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Conflict of interest statement

All authors declare that they have no competing financial interests.

Figures

Fig. 1
Fig. 1
Age distribution of aseptic meningitis patients in Liaocheng (n = 504)
Fig. 2
Fig. 2
Monthly distribution of enterovirus genotypes identified in aseptic meningitis patients from 2018 to 2019, Liaocheng, China
Fig. 3
Fig. 3
Phylogenetic analyses based on VP1 sequences of E18 (panel a), E6 (panel b) and E11 (panel c) causing aseptic meningitis in Liaocheng. Phylogenetic trees were constructed on the basis of partial VP1 gene sequences using neighbour-joining methods. Red diamonds and blue circles indicate isolates obtained in this study. The prototype E29-USA strain was used as an outgroup
See this image and copyright information in PMC

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