Junttila Nina, Lévêque Nicolas, Kabue Jean Pierre, Cartet Gaëlle, Mushiya Fidèle, Muyembe-Tamfum Jean-Jacques, Trompette Aurélien, Lina Bruno, Magnius Lars O, Chomel Jean-Jacques, Norder Helene
Swedish Institute for Infectious Disease Control, Solna, Sweden.
J Med Virol. 2007 Apr;79(4):393-400. doi: 10.1002/jmv.20825.
Surveillance of acute flaccid paralysis often identifies enteroviruses not typeable by virus neutralization in cell culture. During 2000 and 2001, 186 isolates from 138 children with acute flaccid paralysis in the Democratic Republic of the Congo were sent for typing to the National Reference Centre for Enteroviruses in Lyon, France. The 5' UTR of the viral genome could be amplified by PCR for 158 isolates from 114 patients. Isolates from 89 patients were neutralizable, and contained non-polio enterovirus types. Seventeen children were infected with more than one entero- or adenovirus; another three were co-infected with both these viruses. Serological typing failed with 19 isolates from 13 (9%) patients. The VP1 region of these strains could be amplified by PCR and sequenced, which revealed that five children were infected with CV-A17, EV-70, EV-76, EV-77, or CV-A13. Two patients were doubly infected, one with CV-A24 and E-9, and another with E-27 and EV-81. Isolates from six children contained strains with divergent VP1 region. The amino acid sequences of these complete VP1 regions diverged >or=28% from published types indicating that they represented two new enterovirus types, tentatively designated EV-93 belonging to HEV-B and EV-94 within HEV-D. The latter enterovirus has in parallel been isolated from sewage in Egypt. In conclusion, there was a high frequency of "untypable" enterovirus isolates from cases with acute flaccid paralysis in the Democratic Republic of the Congo. Six of these were shown to represent two enteroviruses not previously described.
急性弛缓性麻痹监测常常能识别出在细胞培养中无法通过病毒中和法分型的肠道病毒。2000年至2001年期间，刚果民主共和国138例急性弛缓性麻痹患儿的186株病毒分离株被送往法国里昂的国家肠道病毒参考中心进行分型。114例患者的158株病毒分离株的病毒基因组5'非翻译区可通过聚合酶链反应（PCR）扩增。89例患者的分离株可被中和，且包含非脊髓灰质炎肠道病毒类型。17名儿童感染了不止一种肠道病毒或腺病毒；另有3名儿童同时感染了这两种病毒。13例（9%）患者的19株病毒分离株血清学分型失败。这些毒株的VP1区域可通过PCR扩增并测序，结果显示5名儿童感染了A组柯萨奇病毒17型（CV-A17）、肠道病毒70型（EV-70）、肠道病毒76型（EV-76）、肠道病毒77型（EV-77）或A组柯萨奇病毒13型（CV-A13）。2例患者为双重感染，1例感染了A组柯萨奇病毒24型（CV-A24）和E-9，另1例感染了E-27和肠道病毒81型（EV-81）。6名儿童的分离株包含VP1区域不同的毒株。这些完整VP1区域的氨基酸序列与已公布类型的差异≥28%，表明它们代表两种新的肠道病毒类型，暂定为属于B组肠道病毒的EV-93和D组肠道病毒中的EV-94。后一种肠道病毒同时也在埃及的污水中分离到。总之，刚果民主共和国急性弛缓性麻痹病例中“无法分型”的肠道病毒分离株频率很高。其中6株被证明代表两种先前未描述的肠道病毒。
