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. 2010 Apr 6:7:72.
doi: 10.1186/1743-422X-7-72.

An outbreak of aseptic meningitis caused by coxsackievirus A9 in Gansu, the People's Republic of China

Aili Cui  1 , Deshan Yu, Zhen Zhu, Lei Meng, Hui Li, Jianfeng Liu, Guiyan Liu, Naiying Mao, Wenbo Xu
Affiliations

An outbreak of aseptic meningitis caused by coxsackievirus A9 in Gansu, the People's Republic of China

Aili Cui et al. Virol J. .

Abstract

Background: An outbreak of aseptic meningitis occurred in Tianshui city of Gansu Province, the People's Republic of China, from March to June 2005. A total of 85 patients were clinical confirmed as aseptic meningitis in this outbreak.

Results: CVA9 was mainly responsible for this outbreak supported by the clinical manifestations of the patients, epidemiological data of the outbreak, the results of RT-PCR and complete VP1 sequence determination, conventional neutralization assays, IgM serological assays, viral isolation and phylogenetics analysis. Through phylogenetic analysis and homogeneity analysis for partial VP1 gene, the nucleotide and amino acid homologies between Gansu isolates and former Chinese CVA9 strains were 88.2%-96.1% and 97.2%-99.2%, respectively. Multiple transmission chains of CVA9 occurred in different provinces or years in China. Moreover, in order to clarify the genotype of CVA9, Gansu CVA9 strains isolated in this outbreak were compared with other CVA9 isolates based on VP1/2A junction regions (genotyping region) and they might belong to a new genotype of CVA9, which could be assigned for genotype XIII, CONCLUSIONS: CVA9 was confirmed as the pathogen responsible for this outbreak. The phylogenetic analysis indicated that the CVA9 strains isolated in this outbreak might belong to a new genotype.

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Figures

Figure 1
Figure 1
Distribution of aseptic meningitis cases in Tianshui city of Gansu Province by date. On March 4, 2005, the first case appeared. The number of similar cases had increased dramatically. By June 29, 2005, the outbreak had affected 85 children. The numbers above column indicated 22 out of 85 patients in this outbreak.
Figure 2
Figure 2
Dendrogram illustrating sequence relationships among the studied CVA9 isolates and the prototype strains of Human enterovirus. The phylogenetic tree constructed based on analysis of VP1 gene was drawn by bootstrap analysis (500 times) using the Neighbor-joining of MEGA 4.0 software. The triangle in the figure showed strain Gansu05-1/GS/CHN/2005 was sequenced in this study.
Figure 3
Figure 3
Dendrogram illustrating sequence relationships among the studied CVA9 isolates and the prototype Griggs strain based on VP1 gene. The triangle in the figure showed strain Gansu05-1/GS/CHN/2005 was sequenced in this study. The circle in the figure showed CVA9 strains isolated in China.
Figure 4
Figure 4
Dendrogram illustrating sequence relationships among the studied CVA9 isolates and the prototype Griggs strain based on VP1/2A junction region. The triangle in the figure showed strain Gansu05-1/GS/CHN/2005 was sequenced in this study.
See this image and copyright information in PMC

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