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Updates on Enterovirus Surveillance in Korea
Youngmee Jee1, Doosung Cheon1, Wooyoung Choi1, Jeongbae Ahn1, Kisoon Kim1, Yoonseok Chung1 Jiwon Lee1, Kangbum Lee1, Hyosong Noh1, Kwisung Park1, Sunhwa Lee1, Sunghan Kim1 Kyungsoon Cho2, Eunsun Kim3, Jaekeun Jung3, Jaedeuk Yoon1, Haewol Cho1
Division of Enteric and Hepatitis Viruses1, Department of Virology, Korea Center for Disease Control and Prevention, Seoul Division of Epidemiologic Investigation2, Institute of Public Health and Environment, Busan Division of Microbiology3, Institute of
Vol.36 Num.5 (p294~303)
Purpose:We identified the causative viruses from patients with aseptic meningitis, acute hemorrhagic conjunctivitis and other enterovirus-related diseases to understand the epidemiological patterns and prevailing strains of enterovirus infections each year.
Materials and Methods:During 1999-2003, we examined 3,260 specimens from 2,939 patients with aseptic meningitis or other clinical manifestations for the presence of enteroviruses by using both cell culture/ neutralisation test and reverse transcription-polymerse chain reaction-sequencing. To investigate the etiological agents which caused an epidemic of acute haemorrhagic conjunctivitis, conjunctival swab samples from acute haemorrhagic conjunctivitis patients showing cytopathic effects in HEp2 cells were tested by enteroviral specific PCR.
Results:We identified 603 isolates of enteroviruses (20.5%) among 2,939 cases and 22 serotypes of human enteroviruses were isolated during this 5 year period. Echovirus 13 and coxsackievirus A24 in 2002 and coxsackievirus A9 in 2003 were the first enterovirus to be indentified in Korea since we began the enterovirus surveillance in 1993. While an epidemic of echovirus 13 infection in Korea began in Gwangju and Jeolla province in 2002 and spread to Seoul, Gyunggi, Busan, Ulsan and other regions, echovirus 6 isolates in 2002 were mainly detected in Busan specimens and some Gwangju samples. From the nucleotide sequencing of enteroviral PCR products of conjunctival swab specimens, we found 85% nucleotide homology to coxsackievirus A24 (D90457).
Conclusions:We isolated 603 enteroviral isolates among 2939 cases during 1999-2003. Echovirus 13 and coxsackievirus A24 were the first enterovirus to be identified in Korea and caused nationwide epidemics in 2002.
Keywords : Enterovirus, Neutralization, RT-PCR, Echovirus 13, Coxsackievirus A24