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Open AccessArticle

Identification and Phylogenetic Characterization of Human Enteroviruses Isolated from Cases of Aseptic Meningitis in Brazil, 2013–2017

Laboratório de Enterovírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040900, Brazil
Departamento de Neurologia, Faculdade de Medicina, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Rio de Janeiro 24033900, Brazil
Secretaria Estadual de Saúde de Pernambuco, Recife, PE 50751530, Brazil
Setor de Virologia, Laboratório Central de Saúde Pública de Pernambuco, Recife, PE 50751530, Brazil
Secretaria Estadual de Saúde do Paraná, Brazil—Divisão de Vigilância de doenças transmissíveis, Paraná 80230140, Brazil
Laboratório Central de Saúde Pública do Estado do Paraná, Curitiba, Paraná 80060190, Brazil
Centro de Epidemiologia da SMS, Curitiba, Paraná 80060130, Brazil
Laboratory of Technological Development in Virology, Oswaldo Cruz, Institute, Fiocruz, Rio de Janeiro 21040900, Brazil
Author to whom correspondence should be addressed.
These authors contributed equally to this study.
Viruses 2019, 11(8), 690;
Received: 26 March 2019 / Revised: 5 June 2019 / Accepted: 12 June 2019 / Published: 29 July 2019
(This article belongs to the Special Issue Enteroviruses)
PDF [2281 KB, uploaded 29 July 2019]


Aseptic meningitis is a common viral infection associated with human enteroviruses. The aim of the present study was to identify and characterize the enteroviruses associated with outbreaks and sporadic cases of aseptic meningitis that occurred in different regions of Brazil between 2013 and 2017. Cerebrospinal fluids obtained from patients admitted to public health facilities were analyzed. A total of 303 patients were positive for Human Enteroviruses (EV) by cell culture isolation with a median isolation rate throughout the year of 12%. We were able to identify enterovirus serotypes in 295 clinical specimens. Nineteen different serotypes were identified; the large majority corresponded to HEV-B species. Echovirus 30 (E-30) and Echovirus 6 (E-6) were the most prevalent genotypes (66.8%). Sequence analysis suggested that circulating E-30 was closely related to E-30 from other American countries; while E-6 was derived from Europe. Most of the patients consisted of children ≤ 15 years old. The temporal distribution of all aseptic meningitis and EV-positive cases showed an obvious seasonal pattern during autumn. Our results have provided valuable information about the enteroviral etiology of the aseptic meningitis cases in Brazil pointing to the importance of enterovirus surveillance in neurological diseases. View Full-Text
Keywords: aseptic meningitis; enterovirus; echovirus-30; echovirus-6 aseptic meningitis; enterovirus; echovirus-30; echovirus-6

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Ramalho, E.; Sousa, I., Jr.; Burlandy, F.; Costa, E.; Dias, A.; Serrano, R.; Oliveira, M.; Lopes, R.; Debur, M.; Burger, M.; Riediger, I.; Oliveira, M.L.; Nascimento, O.; da Silva, E.E. Identification and Phylogenetic Characterization of Human Enteroviruses Isolated from Cases of Aseptic Meningitis in Brazil, 2013–2017. Viruses 2019, 11, 690.

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