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Epidemiology and Pathogenesis of Human Enteroviruses

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A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 13521

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Special Issue Editor

Dr. Luis Sarmiento

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Guest Editor

Immunovirology Unit, Department of Clinical Sciences, Skåne University Hospital, Lund University, 20502 Malmo, Sweden
Interests: human enteroviruses; viral pathogenesis; immunology; virus–host interactions; chronic viral infection; molecular epidemiology of enteroviruses
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Human enteroviruses are non-enveloped viruses with a single positive-strand RNA genome belonging to the Enterovirus genus of the Picornaviridae family. Currently, human enteroviruses comprise more than 100 types, which are grouped into four species (Enterovirus A–D). This group of viruses typically causes acute and self-limiting diseases, including aseptic meningitis; encephalitis; myocarditis; herpangina; hand, foot and mouth disease; acute hemorrhagic conjunctivitis and respiratory infections. However, the full spectrum of illness caused by individual enteroviral serotypes remains unclear. In addition to acute illnesses, enteroviruses have also been associated with chronic diseases such as type 1 diabetes, chronic viral cardiomyopathy, chronic fatigue syndrome, and post-poliomyelitis muscular atrophy.

Despite extensive investigations over the recent decades, much remains unknown about the epidemiology and pathogenesis of enterovirus infections in humans. Except for the poliovirus vaccine, there is as yet no vaccine or specific therapy for most human enteroviral infections. Filling gaps in knowledge about pathogenesis, transmission dynamics, epidemiology, and evolution of human enteroviruses will open new conceptual avenues for vaccine and antiviral development. This Special Issue of Microorganisms will therefore welcome original research articles, clinical reports, and review articles related to recent discoveries about the epidemiology and pathogenesis of human enteroviruses.

Dr. Luis Sarmiento
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Enterovirus
Coxsackievirus
Poliovirus
Echovirus
Pathogenesis
Phylogeny
Molecular epidemiology

Published Papers (5 papers)

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Research

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12 pages, 1246 KiB

Open AccessArticle

National Surveillance of Acute Flaccid Paralysis Cases in Senegal during 2017 Uncovers the Circulation of Enterovirus Species A, B and C

by Ndack Ndiaye, Amary Fall, Ousmane Kébé, Davy Kiory, Hamet Dia, Malick Fall, Ndongo Dia, Amadou Alpha Sall, Martin Faye and Ousmane Faye

Microorganisms 2022, 10(7), 1296; https://doi.org/10.3390/microorganisms10071296 - 27 Jun 2022

Cited by 1 | Viewed by 1479

Abstract

Polioviruses have been eliminated in many countries; however, the number of acute flaccid paralysis cases has not decreased. Non-polio enteroviruses are passively monitored as part of the polio surveillance program. Previous studies have shown that some enteroviruses do not grow in conventional cell lines used for the isolation of poliovirus according to the WHO guidelines. In order to evaluate the presence of enteroviruses, real-time RT-PCR was performed on Human Rhabdomyosarcoma (RD)-positive and RD-negative stool samples. A total of 310 stool samples, collected from children under the age of 15 years with acute flaccid paralysis in Senegal in 2017, were screened using cell culture and real-time RT-PCR methods. The selected isolates were further characterized using Sanger sequencing and a phylogenetic tree was inferred based on VP1 sequences. Out of the 310 stool samples tested, 89 were positive in real-time RT-PCR. A total of 40 partial VP1 sequences were obtained and the classification analysis showed that 3 (13%), 19 (82.6%), and 1 (4.4%) sequences from 23 RD-positive non-polio enterovirus isolates and 3 (17.6%), 7 (41.1%), and 7 (41.1%) sequences from 17 RD-negative stool samples belonged to the species EV-A, B, and C, respectively. Interestingly, the EV-B sequences from RD-negative stool samples were grouped into three separate phylogenetic clusters. Our data exhibited also a high prevalence of the EV-C species in RD-negative stool samples. An active country-wide surveillance program of non-polio enteroviruses based on direct RT-PCR coupled with sequencing could be important not only for the rapid identification of the involved emergence or re-emergence enteroviruses, but also for the assessment of AFP’s severity associated with non-polio enteroviruses detected in Senegal. Full article

(This article belongs to the Special Issue Epidemiology and Pathogenesis of Human Enteroviruses)

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12 pages, 580 KiB

Open AccessArticle

Cases of Acute Flaccid Paralysis Associated with Coxsackievirus A2: Findings of a 20-Year Surveillance in the Russian Federation

by Olga E. Ivanova, Armen K. Shakaryan, Nadezhda S. Morozova, Yulia A. Vakulenko, Tatyana P. Eremeeva, Liubov I. Kozlovskaya, Olga Y. Baykova, Elena Y. Shustova, Yulia M. Mikhailova, Natalia I. Romanenkova, Nadezhda R. Rozaeva, Natela I. Dzhaparidze, Nadezhda A. Novikova, Vladimir V. Zverev, Lyudmila N. Golitsyna and Alexander N. Lukashev

Microorganisms 2022, 10(1), 112; https://doi.org/10.3390/microorganisms10010112 - 06 Jan 2022

Cited by 5 | Viewed by 2074

Abstract

Surveillance for acute flaccid paralysis syndrome (AFP) in children under 15 is the backbone of the Global Polio Eradication Initiative. Laboratory examination of stool samples from AFP cases allows the detection of, along with polioviruses, a variety of non-polio enteroviruses (NPEV). The etiological significance of these viruses in the occurrence of AFP cases has been definitively established only for enteroviruses A71 and D68. Enterovirus Coxsackie A2 (CVA2) is most often associated with vesicular pharyngitis and hand, foot and mouth disease. Among 7280 AFP cases registered in Russia over 20 years (2001–2020), CVA2 was isolated only from five cases. However, these included three children aged 3 to 4 years, without overt immune deficiency, immunized with 4–5 doses of poliovirus vaccine in accordance with the National Vaccination Schedule. The disease resulted in persistent residual paralysis. Clinical and laboratory data corresponded to poliomyelitis developing during poliovirus infection. These findings are compatible with CVA2 being the cause of AFP. Molecular analysis of CVA2 from these patients and a number of AFP cases in other countries did not reveal association with a specific phylogenetic group, suggesting that virus genetics is unlikely to explain the pathogenic profile. The overall results highlight the value of AFP surveillance not just for polio control but for studies of uncommon AFP agents. Full article

(This article belongs to the Special Issue Epidemiology and Pathogenesis of Human Enteroviruses)

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15 pages, 2297 KiB

Open AccessArticle

Enterovirus Surveillance (EVSurv) in Germany

by Kathrin Keeren, Sindy Böttcher and Sabine Diedrich

Microorganisms 2021, 9(10), 2005; https://doi.org/10.3390/microorganisms9102005 - 22 Sep 2021

Cited by 10 | Viewed by 2908

Abstract

The major aim of the enterovirus surveillance (EVSurv) in Germany is to prove the absence of poliovirus circulation in the framework of the Global Polio Eradication Program (GPEI). Therefore, a free-of-charge enterovirus diagnostic is offered to all hospitals for patients with symptoms compatible with a polio infection. Within the quality proven laboratory network for enterovirus diagnostic (LaNED), stool and cerebrospinal fluid (CSF) samples from patients with suspected aseptic meningitis/encephalitis or acute flaccid paralysis (AFP) are screened for enterovirus (EV), typing is performed in all EV positive sample to exclude poliovirus infections. Since 2006, ≈200 hospitals from all 16 German federal states have participated annually. On average, 2500 samples (70% stool, 28% CSF) were tested every year. Overall, the majority of the patients studied are children <15 years. During the 15-year period, 53 different EV serotypes were detected. While EV-A71 was most frequently detected in infants, E30 dominated in older children and adults. Polioviruses were not detected. The German enterovirus surveillance allows monitoring of the circulation of clinically relevant serotypes resulting in continuous data about non-polio enterovirus epidemiology. Full article

(This article belongs to the Special Issue Epidemiology and Pathogenesis of Human Enteroviruses)

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10 pages, 1403 KiB

Open AccessArticle

Molecular Characterization of Coxsackievirus A24v from Feces and Conjunctiva Reveals Epidemiological Links

by Magilé C. Fonseca, Mario Pupo-Meriño, Luis A. García-González, Mayra Muné, Sonia Resik, Heléne Norder and Luis Sarmiento

Microorganisms 2021, 9(3), 531; https://doi.org/10.3390/microorganisms9030531 - 05 Mar 2021

Cited by 2 | Viewed by 1941

Abstract

Coxsackievirus A24 variant (CVA24v), the main causative agent of acute hemorrhagic conjunctivitis (AHC), can be isolated from both the eyes and lower alimentary tract. However, the molecular features of CVA24v in feces is not well-documented. In this study, we compared the VP1 and 3C sequences of CVA24v strains isolated from feces during AHC epidemics in Cuba in 1997, 2003, and 2008–2009 with those obtained from conjunctival swabs during the same epidemic period. The sequence analyses of the 3C and VP1 region of stool isolates from the three epidemics showed a high degree of nucleotide identity (ranging from 97.3–100%) to the corresponding conjunctival isolates. The phylogenetic analysis showed that fecal CVA24v isolates from the 1997 and 2003 Cuban outbreaks formed a clade with CVA24v strains isolated from conjunctival swabs in Cuba and other countries during the same period. There were three amino acid changes (3C region) and one amino acid change (VP1 region) in seven CVA24v strains isolated sequentially over 20 days from fecal samples of one patient, suggesting viral replication in the intestine. Despite these substitutions, the virus from the conjunctival swab and fecal samples were genetically very similar. Therefore, fecal samples should be considered as a reliable alternative sample type for the routine molecular diagnosis and molecular epidemiology of CVA24v, also during outbreaks of AHC. Full article

(This article belongs to the Special Issue Epidemiology and Pathogenesis of Human Enteroviruses)

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Review

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20 pages, 1973 KiB

Open AccessReview

Enterovirus D: A Small but Versatile Species

by Ines Cordeiro Filipe, Mariana Soares Guedes, Evgeny M. Zdobnov and Caroline Tapparel

Microorganisms 2021, 9(8), 1758; https://doi.org/10.3390/microorganisms9081758 - 17 Aug 2021

Cited by 6 | Viewed by 3832

Abstract

Enteroviruses (EVs) from the D species are the causative agents of a diverse range of infectious diseases in spite of comprising only five known members. This small clade has a diverse host range and tissue tropism. It contains types infecting non-human primates and/or humans, and for the latter, they preferentially infect the eye, respiratory tract, gastrointestinal tract, and nervous system. Although several Enterovirus D members, in particular EV-D68, have been associated with neurological complications, including acute myelitis, there is currently no effective treatment or vaccine against any of them. This review highlights the peculiarities of this viral species, focusing on genome organization, functional elements, receptor usage, and pathogenesis. Full article

(This article belongs to the Special Issue Epidemiology and Pathogenesis of Human Enteroviruses)

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