Title Human enteroviruses associated with and without diarrhea in Thailand between 2010 and 2016.
Author Chansaenroj, Jira; Tuanthap, Supansa; Thanusuwannasak, Thanundorn; Duang-In, Ausanee; Klinfueng, Sirapa; Thaneskongtong, Napha; Vutithanachot, Viboonsuk; Vongpunsawad, Sompong; Poovorawan, Yong
Journal PLoS One Publication Year/Month 2017
PMID 28750058 PMCID PMC5531555
Affiliation + expend 1.Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Non-bacterial acute gastroenteritis (AGE) associated with virus infection affects individuals living in developing countries, especially children. To investigate whether shedding of certain human enterovirus (EV) is more frequently detected in the stool of individuals with AGE of unknown etiology than individuals without AGE symptoms, we tested fecal samples collected from 2,692 individuals with diarrhea between January 2010 and December 2016. Samples were tested for rotavirus, norovirus, and EV by reverse-transcription polymerase chain reaction (RT-PCR) and adenovirus by PCR. EV-positive samples were subjected to sequencing and phylogenetic analysis to identify EV species and types. Findings were compared to EV found in 1,310 fecal samples from individuals without AGE who were diagnosed with hand, foot, and mouth disease (HFMD). While the majority of viruses identified in AGE consisted of human rotavirus (22.7%), norovirus (11.4%) and adenovirus (9.3%), we identified EV (6.2%) belonging mainly to species B, C, and rhinovirus. In contrast, >92% of EV found without AGE symptoms belonged to species A. Although AGE symptoms are not often attributed to EV infection, EV was associated with diarrhea of unknown etiology at least in 3.4% of AGE cases. While CV-A6 was most likely to be found in stools of HFMD patients, rhinovirus A and C were the two most common EV species associated with AGE. Elucidating group-specific EV infection in diseases with and without AGE will be useful in assisting identification, clinical management, and the surveillance of EV infection in the community.

StrainID RV Species Serotype Length(nt) Country Year Strain Name
ANC04354 A None 504 Thailand 2016 B3256
ANC04404 A 81 504 Thailand 2015 B2038
ANM04355 A None 493 Thailand 2016 B3035
ANM04405 A 54 490 Thailand 2015 B2074
ANP04352 A None 497 Thailand 2016 B3370
ANP04407 A None 491 Thailand 2015 B2398
ANS04353 A None 500 Thailand 2016 B3259
ANS04403 A 81 491 Thailand 2015 B2035
ANS04408 A None 498 Thailand 2016 B2839
ANZ04406 A None 505 Thailand 2015 B2167
BNM00790 B None 503 Thailand 2015 B2399
BNP00792 B 69 498 Thailand 2016 B2966
BNZ00776 B None 498 Thailand 2016 B3150
BNZ00791 B None 474 Thailand 2016 B2679
CNC03074 C None 476 Thailand 2015 B2073
CNC03079 C None 481 Thailand 2015 B2376
CNM03075 C None 480 Thailand 2015 B2097
CNM03080 C None 488 Thailand 2016 B2516
CNP03077 C None 479 Thailand 2015 B2136
CNP03082 C None 483 Thailand 2016 B2830
CNS03073 C None 429 Thailand 2015 B2058
CNS03078 C None 491 Thailand 2015 B2301
CNS03083 C None 469 Thailand 2016 B2891
CNZ03076 C None 480 Thailand 2015 B2106
CNZ03081 C None 503 Thailand 2016 B2681
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