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Journal of Clinical Microbiology, November 2006, p. 4095-4100, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.00653-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

High Prevalence of Human Enterovirus A Infections in Natural Circulation of Human Enteroviruses{triangledown} ,{dagger}

Elisabet Witsø,1* Gustavo Palacios,2 Ondrej Cinek,3 Lars C. Stene,1 Bjørn Grinde,1 Diana Janowitz,2 W. Ian Lipkin,2 and Kjersti S. Rønningen1

Norwegian Institute of Public Health, Oslo, Norway,1 Jerome L. and Dawn Greene Infectious Disease Laboratory, Mailman School of Public Health, Columbia University, New York, New York,2 Motol University Hospital, Second Medical School, Charles University in Prague, Prague, Czech Republic3

Received 27 March 2006/ Returned for modification 22 June 2006/ Accepted 21 August 2006

Human enterovirus (HEV) infections can be asymptomatic or cause only mild illness; recent evidence may implicate HEV infection in type 1 diabetes mellitus and myocarditis. Here, we report the molecular characterization of HEV obtained in serial monthly collections from healthy Norwegian infants. A total of 1,255 fecal samples were collected from 113 healthy infants beginning at age 3 months and continuing to 28 months. The samples were analyzed for HEV nucleic acid by real-time PCR. Fifty-eight children (51.3%) had HEV infections. One hundred forty-five positive samples were typed directly by nucleotide sequencing of the VP1 region. HEV-A was detected most frequently, with an overall prevalence of 6.8%. HEV-B was present in 4.8% of the samples and HEV-C in only 0.2% of the samples. No poliovirus or HEV-D group viruses were detected. Twenty-two different serotypes were detected in the study period: the most common were EV71 (14.5%), CAV6 (10.5%), CAV4 (8.9%), E18 (8.9%), and CBV3 (7.3%). These findings suggest that the prevalence of HEV infections in general, and HEV-A infections in particular, has been underestimated in epidemiological studies based on virus culture.

* Corresponding author. Mailing address: Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway. Phone: 47 22 04 23 82. Fax: 47 22 04 24 47. E-mail: elisabet.witso{at}fhi.no.

{triangledown} Published ahead of print on 30 August 2006.

{dagger} Supplemental material for this article may be found at http://jcm.asm.org.

Journal of Clinical Microbiology, November 2006, p. 4095-4100, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.00653-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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