Coxsackievirus B3, Shandong Province, China, 1990–2010

Zexin Tao¹, Yanyan Song¹, Yan Li, Yao Liu, Ping Jiang, Xiaojuan Lin, Guifang Liu, Lizhi Song, Haiyan Wang, and Aiqiang Xu

Author affiliations: Shandong Center for Disease Control and Prevention, Jinan, People’s Republic of China (Z. Tao, Y. Li, Y. Liu, X. Lin, G. Liu, L. Song, H. Wang, A. Xu); Shandong University School of Public Health, Jinan (Y. Song, A. Xu); and Stony Brook University, Stony Brook, New York, USA (P. Jiang)

Abstract

To determine the cause of a 2008 outbreak of aseptic meningitis in Shandong Province, China, we analyzed samples from outbreak patients and coxsackievirus B3 samples collected during 1990–2010 surveillance. The cause of the outbreak was coxsackievirus B3, genogroup D. Frequent travel might increase importation of other coxsackievirus B3 genogroups.

Coxsackievirus B3 (CVB3) (family Picornaviridae, genus Enterovirus) is a major human pathogen (1–3), and CVB3-associated aseptic meningitis is an emerging concern (4). In the summer of 2008, an aseptic meningitis outbreak occurred in southern Shandong Province, People’s Republic of China. Shandong is a coastal province with a population of 94.7 million. The huge number of hospitalized children caught the attention of public health officials and media and triggered an extensive study on the causative agent. To help determine the cause of the outbreak, we analyzed samples from outbreak case-patients and conducted a molecular epidemiology study of CVB3 isolates collected in Shandong during 1990–2010.