Instituto Oswaldo Cruz, Rio de Janeiro, Brazil.
Laboratório Central de Saúde Pública do Ceará, Ceará, Brazil.
Clin Microbiol Infect. 2019 Feb;25(2):252.e5-252.e8. doi: 10.1016/j.cmi.2018.08.018. Epub 2018 Aug 25.
To describe an outbreak of acute myalgia accompanied by elevated levels of muscle enzymes that occurred in the northeast region of Brazil from December 2016 through to May 2017.
Clinical data were analysed and laboratory tests were performed in 86 specimens obtained from 52 individuals with suspected acute myalgia. A broader reactive enterovirus real-time RT-PCR followed by a semi-nested PCR amplification of partial VP1 gene were performed to identify the causative agent.
Eighty-six clinical samples were received in our laboratory during the myalgia outbreak. Median age of individuals was 39 years. Sudden acute myalgia and dark urine were the most common symptoms. Creatine phosphokinase levels were elevated with mean value ∼16 893 U/L. Human enterovirus was detected in 67% (58/86) of the patient's specimens (urine, serum, faeces and rectal swab). The enterovirus positivity per patient was 82.7% (43/52). Echovirus 30 (E-30) (82% of the typed specimens, 18/22; 76.4% (13/17) of the typed specimens per patient) was the main enterovirus identified. In addition to E-30, CV-A16 (1/22) and E-6 (3/22) were detected in 4% and 14% of the typed specimens, respectively. No deaths occurred.
The 2016-2017 outbreak of acute myalgia that occurred in the northeast region of Brazil can be associated with E-30. Despite the clinical manifestations, a favourable outcome was observed for all patients.
描述 2016 年 12 月至 2017 年 5 月期间巴西东北部地区发生的伴有肌肉酶水平升高的急性肌痛暴发情况。
分析临床数据并对 52 例疑似急性肌痛患者的 86 份标本进行实验室检测。采用更广泛的反应性肠道病毒实时 RT-PCR 检测，然后对部分 VP1 基因进行半巢式 PCR 扩增，以鉴定病原体。
在肌痛暴发期间，我们实验室共收到 86 份临床样本。个体的中位年龄为 39 岁。最常见的症状是突发急性肌痛和深色尿。肌酸磷酸激酶水平升高，平均值为 16893 U/L。在 67%（58/86）的患者标本（尿液、血清、粪便和直肠拭子）中检测到人类肠道病毒。每位患者的肠道病毒阳性率为 82.7%（43/52）。肠道病毒 30 型（E-30）（22 个分型标本中的 82%，每个患者的 17 个分型标本中的 76.4%，18/22；17/22）是主要鉴定出的肠道病毒。除 E-30 外，还在 4%（1/22）和 14%（3/22）的分型标本中检测到柯萨奇病毒 A16 和 E-6。无死亡病例。
2016-2017 年巴西东北部地区发生的急性肌痛暴发与 E-30 有关。尽管临床表现严重，但所有患者的预后均良好。
