Aichi Virus Shedding in Patients with Diarrhea | CDC EID::Volume 17, Number 8–August 2011

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Volume 17, Number 8–August 2011
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Aichi Virus Shedding in High Concentrations in Patients with Acute Diarrhea

Jan Felix Drexler, Sigrid Baumgarte, Luciano Kleber de Souza Luna, Monika Eschbach-Bludau, Alexander N. Lukashev, and Christian Drosten Comments to Author

Author affiliations: University of Bonn Medical Centre, Bonn, Germany (J.F. Drexler, M. Eschbach-Bludau, C. Drosten); Institute of Hygiene and the Environment, Hamburg, Germany (S. Baumgarte); Bernhard Nocht Institute for Tropical Medicine, Hamburg (L.K. de Souza Luna); and Chumakov Institute of Poliomyelitis and Viral Encephalitides, Moscow, Russia (A.N. Lukashev)

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Abstract
We assessed Aichi virus shedding in patients with gastroenteritis and negative test results for other viral and bacterial infections. High concentrations of up to 1.32 × 1012 RNA copies/g stool were found in 10 (2.0%) of 499 outpatients sampled in northern Germany, 2004. These data substantiate Aichi virus pathogenicity in humans.

The family Picornaviridae includes 12 established genera, and representatives of 5 of these have been found in humans (Enterovirus, Hepatovirus, Parechovirus, Cardiovirus, and Kobuvirus). Among those, human pathogenicity has been proven consistently only for enteroviruses (including polioviruses), hepatitis A virus, and parechoviruses. Several as-yet-unclassified picornaviruses have been found over the past few years in humans, termed cosavirus, klassevirus, and salivirus (1–3). For gastrointestinal pathogens, data on virus quantity in stool can exclude ingestion from nutritional sources of viruses that may be detected but do not replicate in the human gut. Prevalence studies with appropriate control groups and proof of the absence of co-infections with other pathogens are required to provide evidence in favor of human pathogenicity. For most of the novel viruses, these data are still awaited.

A novel human picornavirus termed Aichi virus (AiV; genus Kobuvirus), was described initially in 1991 (4) and epidemiologically linked with spontaneous and food-associated diarrhea in humans (5,6). Recently, it was also detected in sewage-polluted water (7). However, no quantitative data of AiV shedding have become available so far, possibly because of technical peculiarities such as high genomic GC content (≈60%) and strong RNA secondary structures, which may have contributed to a lack of sequence information and prevented more precise molecular detection. In this study, we analyzed well-established cohorts of patients with gastroenteritis and an appropriate control group. Stool samples from patients who had negative test results for other common viruses and bacterial infections showed high AiV shedding by highly sensitive real-time reverse transcription PCR (RT-PCR), thereby substantiating AiV human pathogenicity.

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Suggested Citation for this Article

Drexler JF, Baumgarte S, de Souza Luna LK, Eschbach-Bludau M, Lukashev AN, Drosten C. Aichi virus shedding in high concentrations in patients with acute diarrhea. Emerg Infect Dis [serial on the Internet]. 2011 Aug [date cited]. http://www.cdc.gov/EID/content/17/8/101556.htm

DOI: 10.3201/eid1708.101556

Comments to the Authors

Please use the form below to submit correspondence to the authors or contact them at the following address:

Christian Drosten, Institute of Virology, University of Bonn Medical Centre, 53127 Bonn, Germany; email: drosten@virology-bonn.de