Abstract
Enterovirus (EV) infection is common in infants, but the information with regard to the molecular epidemiology and the associations between types and clinical variables is very scarce. This study includes 195 children <3 months old with fever, attended from March 2010 to December 2012 in an emergency department of a tertiary paediatric hospital in whom EV infection was confirmed by real-time PCR in blood and/or cerebrospinal fluid. Clinical and epidemiological data was prospectively collected. In 152 (77.9 %) patients, EVs could be typed. The most common type was Echovirus-5 (E5; 32, 21.1 %), followed by Echovirus-11 (E11; 18, 11.8 %), Echovirus-21 and Echovirus-25 (E21, E25; 11 each one, 7.2 %) and Coxsackievirus-B4 (CVB4; 6, 6.6 %). The majority of types appeared in spring, but E5 and E25 were found mainly during summer (p < 0.01). E21 was associated with high-grade fever (p < 0.01); E5 with exanthema (p = 0.03) and CVB4 tended to cause meningitis more often than the other types (p = 0.07).
Conclusion: The most common EV types were Echovirus-5 and Echovirus-11. Some significant associations between types and epidemiologic and clinical findings were observed.
What is Known—What is New • Enteroviruses cause a normally benign illness in young infants, except in some cases. |
• The molecular epidemiology of Enterovirus infection is not well known in European countries. |
• This study describes a large number of infants with Enterovirus infection and shows the seasonality of different types, and their associations with epidemiologic and clinical variables. |
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Acknowledgments
We are thankful to Eva del Amo, Pedro Brotons and Ricard Casadevall for their technical support in this study.
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There are no conflicts of interest to declare.
Financial disclosure
This study was partially supported by ‘Agència d'Avaluació de Tecnologia i Recerca Mèdiques’ (AATRM). The funders have not influenced the design or analysis, nor have they had any role in preparation of the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments, or comparable ethical standards. The study was approved by the institutional ethics committee (Sant Joan de Déu Ethical Assistance Committee).
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All authors contributed to the conceptualization of the study. All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed to the development of the final manuscript.
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Communicated by David Nadal
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Rodà, D., Pérez-Martínez, E., Cabrerizo, M. et al. Clinical characteristics and molecular epidemiology of Enterovirus infection in infants <3 months in a referral paediatric hospital of Barcelona. Eur J Pediatr 174, 1549–1553 (2015). https://doi.org/10.1007/s00431-015-2571-z
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DOI: https://doi.org/10.1007/s00431-015-2571-z