ABSTRACT
Norovirus is one of the common causative agents of viral gastroenteritis in developed countries. A large outbreak of gastroenteritis occurred among girls' high school students in Cheongju city, Chungbuk province, who had attended a school trip to Cheju island from 19 to 21 May 2003. One hundred and ninety six students were consistent with case definition and attack rate was 54.9%. The epidemic curve was characteristic of a point-source outbreak. The frequency of diarrhea was 1 to 6 times (76.8%) and the duration of diarrhea was within two days (85.1%) in most cases. The most common symptom with diarrhea was abdominal pain followed by headache, tenesmus, febrile sense, chill and vomiting. The following bacterial organisms, Salmonella spp, Shigella spp, Vibrio spp, Staphylococcus aureus, and E coli O157 were examined in 196 stool specimens, but no suspicious organism was detected. In virological examinations, Norovirus was dectected in 3 out of 25 stool specimens from the sick students. Among the 22 stool specimens of the food handlers during the school trip, both bacterial and virological examinations were all negative. Among the 13 environmental specimens, the groundwater of the hotel, where the students had stayed during their school trip, was contaminated with general bacteria and E. Coli. However, we could not detect Norovirus in the groundwater of the hotel. We concluded that Norovirus might be a possible cause of this outbreak, and the water supply of the hotel might be a probable source of this outbreak.
Subject(s)
Humans , Abdominal Pain , Bacteria , Developed Countries , Diarrhea , Escherichia coli O157 , Gastroenteritis , Groundwater , Headache , Norovirus , Salmonella , Shigella , Staphylococcus aureus , Vibrio , Vomiting , Water SupplyABSTRACT
PURPOSE: There occurred an explosive outbreak of aseptic meningitis in Ulsan, in the year of 2002. In this study, we report clinical manifestations, laboratory data and causative viruses of the outbreak. METHODS: Were assessed 371 children with aseptic meningitis who were admitted to the Department of Pediatrics, Ulsan University Hospital in Ulsan between May and July, 2002. We reviewed the sex, age, clinical manifestations, peripheral blood examinations and CSF examinations of the patients. Virus isolation and serotype identification were performed by cell cultures of cerebrospinal fluid and stool. RESULTS: The ratio of males to females was 1.9:1. The majority of aseptic meningitis occurred in children between 1 and 5 years of age with a mean age of 6.8+/-5.1 years. The clinical manifestations was fever, headache, vomiting, and abdominal pain and 16.2% of the patients developed neck stiffness. The mean duration of fever was 3.2 days. The mean value of peripheral blood leukocytes was 10,355+/-4,800/mm3 and the mean value of CRP was 0.96+/-1.67 mg/dL. Initial CSF findings revealed leukocytes 212+/-385/mm3, protein 37.0+/-18.9 mg/dL and glucose 68.3+/-17.6 mg/dL. Viruses were isolated 67(18.1%) out of 371 patients and the serotypes were echovirus 6 in 10 cases, echovirus 9 in 15 cases, echovirus 11 in 4 cases, echovirus 13 in 18 cases, and unclassified enterovirus in 20 cases. CONCLUSION: Aseptic meningitis was prevalent in Ulsan, in the year of 2002. The clinical manifestations and the laboratory findings of the patients were compatible with those of previous reports. The causative viruses were echovirus 6, echovirus 9, echovirus 11, echovirus 13 and unclassified enterovirus.
Subject(s)
Child , Female , Humans , Male , Abdominal Pain , Cell Culture Techniques , Cerebrospinal Fluid , Echovirus 6, Human , Echovirus 9 , Enterovirus , Enterovirus B, Human , Fever , Glucose , Headache , Leukocytes , Meningitis, Aseptic , Neck , Pediatrics , VomitingABSTRACT
We have determined and analyzed the full-length cDNA sequence of a coxsackievirus B3 (CVB3) Korean isolate (CVB3-Korea/97) which has been known as a general human pathogen. The whole genome contains 7,400 nucleotides and has a single large open reading frame with 6,555 nucleotides that encodes a potential polyprotein precursor of 2,185 amino acids. The genome also contains a 5' non-coding region (NCR) of 741 bases and a 3' NCR of 104 bases followed by poly(A) tail. Sequence homologies of nucleotides and deduced amino acids between the CVB3-Korea/97 strain and the prototype (Nancy strain) were 81.7% and 91.5%, respectively. The genes encoding the functional proteins including viral protease and RNA dependent RNA polymerase showed higher homology than those encoding the structural proteins. We have further analyzed the sequences of 5' NCR, VP1 and VP2 of CVB3-Korea/97, which are known as cardiovirulent determining factors at the nucleotide and amino acid levels. Although the CVB 3-Korea/97 strain was isolated from an aseptic meningitis patient without cardiomyopathy, its 234th nucleotide and 165th amino acid were uracil and Asn as same as those of other cardiovirulent strains one. However, the 155th amino acid of VR1, which closely associated with cardiovirulence, was replaced with Arg155 by single nucleoptide substitution from A2916 to T2916. Moreover, additional amino acid substitutions were observed in the flanking region of Asp155. Taken together, aminoacid(s) substitution in VP1 may play a critical role in determining cardiovirulence of the CVB3-Korea/97 strain rather than individual nucleotide replacements in the 5' NCR and/or an amino acid substitution in VP2.
Subject(s)
Humans , Amino Acid Substitution , Amino Acids , Cardiomyopathies , Clone Cells , Cloning, Organism , DNA, Complementary , Genome , Korea , Meningitis, Aseptic , Nucleotides , Open Reading Frames , RNA-Dependent RNA Polymerase , RNA, Messenger , Sequence Analysis , Sequence Homology , UracilABSTRACT
BACKGROUND: To investigate the epidemiology of aseptic meningitis in Korea, we have isolated and characterized enteroviruses isolated from patients with acute meningitis from 1993 to 1998. METHODS: Stool and/or cerebrospinal fluid (CSF) samples from patients with aseptic meningitis were inoculated onto enterovirus-susceptible cell lines. The virus propagation was examined by the presence of cytopathic effects and each viral isolate was further characterized using a neutralization test. RESULTS: Out of 1,127 specimens, 197 enteroviral isolates were obtained mostly from stool samples (82.8 %) of children aged zero to ten years. At least 15 serotypes of enteroviruses, including echoviruses (EV) 3, 6, 7, 9, 25 and 30, coxsackieviruses (CV) B1~B6, and vaccine-derived polioviruses (PV) had circulated during the previous 6 years. The major serotypes that caused outbreaks of aseptic meningitis, were EV30 in 1997 and EV6 in 1998. Although the incidence of virus isolation peaked during summer, we had isolated enteroviruses all the year round in 1998. CONCLUSION: Since 1993, we had confirmed 197 cases of enteroviral meningitis. Outbreaks of aseptic meningitis were mainly caused by EVs, with peaks during the summer months. Our data emphasize that the nationwide surveillance of aseptic meningitis should be expanded and maintained throughout the year.
Subject(s)
Child , Humans , Cell Line , Cerebrospinal Fluid , Disease Outbreaks , Enterovirus B, Human , Enterovirus , Epidemiologic Studies , Epidemiology , Incidence , Korea , Meningitis , Meningitis, Aseptic , Neutralization Tests , PoliovirusABSTRACT
BACKGROUND: To investigate the epidemiology of aseptic meningitis in Korea, we have isolated and characterized enteroviruses isolated from patients with acute meningitis from 1993 to 1998. METHODS: Stool and/or cerebrospinal fluid (CSF) samples from patients with aseptic meningitis were inoculated onto enterovirus-susceptible cell lines. The virus propagation was examined by the presence of cytopathic effects and each viral isolate was further characterized using a neutralization test. RESULTS: Out of 1,127 specimens, 197 enteroviral isolates were obtained mostly from stool samples (82.8 %) of children aged zero to ten years. At least 15 serotypes of enteroviruses, including echoviruses (EV) 3, 6, 7, 9, 25 and 30, coxsackieviruses (CV) B1~B6, and vaccine-derived polioviruses (PV) had circulated during the previous 6 years. The major serotypes that caused outbreaks of aseptic meningitis, were EV30 in 1997 and EV6 in 1998. Although the incidence of virus isolation peaked during summer, we had isolated enteroviruses all the year round in 1998. CONCLUSION: Since 1993, we had confirmed 197 cases of enteroviral meningitis. Outbreaks of aseptic meningitis were mainly caused by EVs, with peaks during the summer months. Our data emphasize that the nationwide surveillance of aseptic meningitis should be expanded and maintained throughout the year.
Subject(s)
Child , Humans , Cell Line , Cerebrospinal Fluid , Disease Outbreaks , Enterovirus B, Human , Enterovirus , Epidemiologic Studies , Epidemiology , Incidence , Korea , Meningitis , Meningitis, Aseptic , Neutralization Tests , PoliovirusABSTRACT
In this study, the feasibility of identification and genotypic differentiation of enteroviruses was investigated by using nested reverse transcription-polymerase chain reaction (nested RT-PCR), single-stranded conformation polymorphism (SSCP), and restriction fragment length polymorphism (RFLP) techniques. Two hundred seventy-four clinical samples were assayed by both nested RT-PCR and tube culture method using MRC-5 and MK cells; 58 (86.6%) out of 67 enterovirus culture-positive samples contained enteroviral RNA. In addition, 114 (55.1%) of 207 samples from patients with suspected enteroviral CNS disease with negative viral cultures were positive by the nested RT-PCR. The nested RT-PCR products were genotyped by the SSCP method and the results were compared with serotypes. We could differentiate 6 subtypes, 3 of which are similar to coxsackievirus B3, B5, echovirus 11, plus 3 other subtypes. RFLP cleaved with Sty I, Bgl I, and Xmn I yielded characteristic patterns for each laboratory strains. This study demonstrates the usefulness of the RT-PCR for the rapid diagnosis of enterovirus infection and the potentials of the SSCP method for differentiation of enterovirus strains.
Subject(s)
Humans , Central Nervous System Diseases , Diagnosis , Enterovirus B, Human , Enterovirus Infections , Enterovirus , Genotype , Polymorphism, Restriction Fragment Length , Polymorphism, Single-Stranded Conformational , RNAABSTRACT
No abstract available.
Subject(s)
Hepacivirus , Hepatitis C , Hepatitis , Korea , PrevalenceABSTRACT
No abstract available.