Enterovirus Genotype in Humans, Italy | CDC EID

EID Journal Home > Volume 16, Number 6–June 2010

Volume 16, Number 6–June 2010
Dispatch
Enterovirus Genotype EV-104 in Humans, Italy, 2008–2009
Antonio Piralla, Francesca Rovida, Fausto Baldanti, and Giuseppe Gerna
Author affiliation: Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Policlinico, San Matteo, Pavia, Italy

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Abstract
In an epidemiologic investigation of respiratory infections in Italy, October 2008–September 2009, we tested samples from patients for respiratory viruses. Human enterovirus genotype EV-104 (identified in Switzerland) was found in 3 immunocompromised and 2 immunocompetent patients. EV-104 is closely related to human rhinoviruses; thus, both types of viruses should be sought in respiratory syndromes.
Human rhinoviruses (HRVs) and enteroviruses (HEVs) have been grouped within the same genus (Enterovirus) because of their identical genomic organization and high sequence homology (1). However, HRVs infect primarily the respiratory tract, whereas HEVs infect primarily the gastrointestinal tract, from which they can spread to distant sites, such as the central nervous system or myocardial tissue. In addition, HRVs and HEVs differ in several in vitro properties, such as cell tropism, optimal growth temperature, and low pH sensitivity. Notwithstanding these different characteristics, some HEVs possess a respiratory tract tropism similar to that of HRVs; they infect both infants and adults and cause infections of the upper and lower respiratory tracts. Several HEV genotypes, including enterovirus 68; coxsackieviruses (CVs) A9, A21, B2, and B4; and echoviruses 9 and 11, have reportedly been recovered from respiratory secretions or from tissues of patients with bronchitis, bronchiolitis, or pneumonia (2–6). In an extended epidemiologic study of HEV respiratory infections in children in France in 2008, respiratory syndromes were the second most common HEV-induced pathologic condition after meningitis (31% vs. 44%); HEV caused infections of the lower respiratory tract in 43 (54%) of 79 respiratory infections (7).

In Switzerland during 2004–2007, a new enterovirus genotype, EV-104, was reported in association with respiratory signs and symptoms and acute otitis media in 8 children from various regions of the country (8). In the past, this virus probably escaped detection because cell cultures lacked sensitivity or because appropriate molecular methods were not used. In addition, only a small percentage of detected HEVs are actually typed. EV-104 belongs to the HEV-C species, and its closest serotypes are CV-A19, CV-A22, and CV-A1 (9).

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Enterovirus Genotype in Humans, Italy | CDC EID