CIENCIASMEDICASNEWS: Ahead of Print - Multirecombinant Enterovirus A71 Subgenogroup C1 Isolates Associated with Neurologic Disease, France, 2016–2017 - Volume 25, Number 6—June 2019 - Emerging Infectious Diseases journal

Stéphanie Tomba Ngangas, Alexander Lukashev, Gwendoline Jugie, Olga Ivanova, Jean-Michel Mansuy, Catherine Mengelle, Jacques Izopet, Anne-Sophie L’honneur, Flore Rozenberg, David Leyssene, Denise Hecquet, Stéphanie Marque-Juillet, David Boutolleau, Sonia Burrel, Hélène Peigue-Lafeuille, Christine Archimbaud, Kimberley Benschop, Cécile Henquell, Audrey Mirand, and Jean-Luc Bailly

Author affiliations: Université Clermont Auvergne, Clermont-Ferrand, France (S. Tomba Ngangas, G. Jugie, H. Peigue-Lafeuille, C. Archimbaud, C. Henquell, A. Mirand, J.-L. Bailly); Sechenov University, Moscow, Russia (A. Lukashev); Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products, Moscow (O. Ivanova); Centre Hospitalier Universitaire de Toulouse, Toulouse, France (J.-M. Mansuy, C. Mengelle, J. Izopet); Assistance Publique-Hôspitaux de Paris Cochin, Paris, France (A.-S. L’honneur, F. Rozenberg); Centre Hospitalier de la Côte Basque, Bayonne, France (D. Leyssene); Centre Hospitalier Universitaire Amiens, Amiens, France (D. Hecquet); Centre Hospitalier de Versailles, Le Chesnay, France (S. Marque-Juillet); Assistance Publique-Hôspitaux de Paris Pitié-Salpêtrière-Charles Foix, Paris (D. Boutolleau, S. Burrel); CHU Clermont-Ferrand, Clermont-Ferrand (H. Peigue-Lafeuille, C. Archimbaud, C. Henquell, A. Mirand, J.-L. Bailly); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (K. Benschop)

Abstract

In 2016, an upsurge of neurologic disease associated with infection with multirecombinant enterovirus A71 subgenogroup C1 lineage viruses was reported in France. These viruses emerged in the 2000s; 1 recombinant is widespread. This virus lineage has the potential to be associated with a long-term risk for severe disease among children.

Thumbnail of Geographic locations and numbers of enterovirus A71 (EV-A71) subgenogroup C1v2015 infections reported during 2015–2017. A) Countries in which EV-A71 C1v2015 was reported. The year the virus was first reported is indicated. The size of Europe is increased for easier visualization. B) Geographic distribution and number of cases of EV-A71 C1v2015 infection reported in hospitals, by department, France, 2016–2017. C) Geographic distribution of clinical manifestations associated with EV-A

Figure 1. Geographic locations and numbers of enterovirus A71 (EV-A71) subgenogroup C1v2015 infections reported during 2015–2017. A) Countries in which EV-A71 C1v2015 was reported. The year the virus was first reported is indicated....

Enterovirus A71 (EV-A71) comprises 7 genogroups (A–G) and various subgenogroups (e.g., B0–B5, C1–C5) (1). B4, B5, and C4 viruses circulate mainly in Asia, and C1 and C2 viruses have been detected in Europe (2). In 2016, an upsurge in neurologic manifestations of enterovirus infection was reported in France (3). These cases were associated with an emerging lineage of subgenogroup C1 enteroviruses first reported in 2015 in Germany and later in Spain and 4 other countries (Figure 1, panel A) (4–8). Our aim was to obtain the full genomes of the viruses from the specimens collected in France and track down the origin of this emerging lineage, hereafter referred to as C1v2015.