Division of Internal Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Infection. 2013 Feb;41(1):231-5. doi: 10.1007/s15010-012-0340-8. Epub 2012 Oct 5.
We report on an unusual familial outbreak of a coxsackie virus infection in Switzerland in which five family members were affected. Most of the patients presented with signs of meningitis, and four were hospitalized.
In three individuals, the virus was detected in the cerebrospinal fluid, pharynx, and stool, respectively. The genome was sequenced in specimens of two patients.
The nucleotide sequences of both virus strains were identical. Blast search revealed that the first half of the sequence was 88 % homologous to Enterovirus 75 (EV-75), 87 % with Echovirus 11 (E-11), and 84 % homologous to Coxsackie virus A9 (CV-A9). The second half of the sequence was 77 % homologous to EV-75, 75 % to E-11, and 91 % to CV-A9.
We propose that the isolated virus strain is a recombinant strain with a 5' untranslated region and with the start of the VP4 sequence originating from E-11/EV-75 and the rest of the genome originating from CV-A9. Interestingly, this novel virus strain showed an exceptional virulence and rapid spread. Two weeks after the initial outbreak in this family, a similar outbreak was observed in a second geographic area roughly 100 km distant to the primary identification site, and another 2 months later this virus strain was found to circulate in the western part of Switzerland some 250 km distant to the primary locus. These findings suggest that genetic recombination has resulted in a novel enterovirus with features of high virulence, contagiosity, and spreading.
我们报告了瑞士一起不寻常的柯萨奇病毒家族性暴发疫情，共有 5 名家庭成员受到感染。大多数患者表现出脑膜炎的迹象，其中 4 人住院。
在 3 名患者中，分别在脑脊液、咽部分别检测到病毒，在粪便中检测到病毒。对 2 名患者的标本进行了基因组测序。
两种病毒株的核苷酸序列完全相同。Blast 搜索显示，病毒序列的前半部分与肠道病毒 75 型（EV-75）同源性为 88%，与埃可病毒 11 型（E-11）同源性为 87%，与柯萨奇病毒 A9 型（CV-A9）同源性为 84%。序列后半部分与 EV-75 同源性为 77%，与 E-11 同源性为 75%，与 CV-A9 同源性为 91%。
我们提出，分离的病毒株是一种重组株，其 5'非翻译区和 VP4 序列的起始部分来源于 E-11/EV-75，其余基因组来源于 CV-A9。有趣的是，这种新型病毒株表现出异常的毒力和快速传播。在该家庭首次暴发疫情后 2 周，在距离初次鉴定地点约 100 公里的另一个地理区域观察到类似的暴发疫情，2 个月后，在距离初次发病地点约 250 公里的瑞士西部发现该病毒株在流行。这些发现表明，遗传重组导致了一种新型肠病毒，具有高毒力、传染性和传播性的特点。
