ABSTRACT
Enteroviruses (EVs) are important human pathogens associated with various clinical syndromes. This study represents an overview of non-polio enteroviruses (NPEVs) isolated from acute flaccid paralysis (AFP) surveillance in Shandong Province, China from 1988 to 2013. Altogether 792 and 170 NPEV isolates were isolated from stool specimens of 9263 AFP cases and 1059 contacts, respectively. Complete VP1 sequencing and typing on all 962 isolates revealed 53 NPEV types in which echovirus (E) 6 (7.6%), E14 (7.6%), E11 (7.4%), coxsackievirus (CV) B3 (7.4%), E25 (5.6%), CVB5 (4.9%), E7 (4.5%) and EV-A71 (4.4%) were the eight most commonly reported serotypes. Distinct summer-fall seasonality was observed, with June-October accounting for 79.3% of isolation from AFP cases with known month of specimen collection. Increase of isolation of EV-A71 and CVA--the predominant pathogens for the hand, foot, and mouth disease--was observed in recent years. Sequence analysis on VP1 coding region of EV-A71 and E6 suggested Shandong strains had great genetic divergence with isolates from other countries. The results described in this study provide valuable information on the circulation and emergence of different EV types in the context of limited EV surveillance in China.
Subject(s)
Enterovirus Infections/epidemiology , Enterovirus Infections/virology , Enterovirus/isolation & purification , Muscle Hypotonia/epidemiology , Muscle Hypotonia/virology , Paralysis/epidemiology , Paralysis/virology , Acute Disease , China/epidemiology , Enterovirus/classification , Enterovirus/genetics , Enterovirus Infections/history , Female , Genes, Viral , Genotype , History, 20th Century , History, 21st Century , Humans , Male , Molecular Sequence Data , Muscle Hypotonia/history , Paralysis/history , Phylogeny , Population Surveillance , Seasons , SerogroupSubject(s)
Muscle Hypotonia/diagnosis , Muscle Hypotonia/history , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Brain/pathology , Creatine Kinase/blood , Electromyography , Genetic Testing , History, 20th Century , Humans , Infant , Magnetic Resonance Imaging , Muscle Hypotonia/etiology , Pediatrics/history , Periodicals as TopicABSTRACT
The nature and cause of President Abraham Lincoln's unusual physical features have long been debated, with the greatest attention directed at two monogenic disorders of the transforming growth factor ß system: Marfan syndrome and multiple endocrine neoplasia type 2B. The present report examines newly discovered phenotypic information about Lincoln's biological mother, Nancy Hanks Lincoln, and concludes that (a) Lincoln's mother was skeletally marfanoid, (b) the President and his mother were highly concordant for the presence of numerous facial features found in various transforming growth factor ß disorders, and (c) Lincoln's mother, like her son, had hypotonic skeletal muscles, resulting in myopathic facies and 'pseudodepression'. These conclusions establish that mother and son had the same monogenic autosomal dominant marfanoid disorder. A description of Nancy Hanks Lincoln as coarse-featured, and a little-known statement that a wasting disease contributed to her death at age 34, lends support to the multiple endocrine neoplasia type 2B hypothesis.
