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H. Ishiko, R. Miura, Y. Shimada, S. Yamazaki, Y. Tagawa, K. Aoki, S. Ohno, S.I. Bhuiyan, F. Huq; The Molecular Diagnosis of Enteroviruses Caused the Pandemic of Acute Haemorrhagic Conjunctivitis in Bangladesh in 2002 . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4647.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine and characterize the causative agent for the pandemic of acute haemorrhagic conjunctivitis (AHC) in Bangladesh in the autumn, 2002. Methods: Specimens: Conjunctival swabs were obtained from the AHC patients in Bangladesh. RT-PCR: A partial enterovirus genome including the entire VP4 region was amplified directly from the swabs without viral isolation, and the nucleotide sequence was determined. Phylogeny-based identification: The nucleotide sequences of VP4 detected from the conjunctival swabs were analyzed by phylogenetic analysis based on neighbor-joining method, along with 65 enterovirus (EV) prototype strains and coxsackievirus A24 variant (CV-A24v) strains isolated from different parts of the world in the past 30 years (Ishiko, H., et al., Molecular diagnosis of human enteroviruses by phylogeny-based classification by use of the VP4 sequence. J Infect Dis 185:744. 2002). Results: The phylogenetic tree showed that all nucleotide sequences from the swabs formed a distinct cluster with the CV-A24v prototype strain, and thus identified as CV-A24v. Furthermore, to characterize molecular epidemiological feature of the CV-A24v, the VP4 sequences were analyzed along with those of the 29 CV-A24v isolates from different parts of the world. It was found that the CV-A24v isolates were divided into two groups; the 1970-1987 years group and the 1988-1998 years group. The CV-A24v gene obtained from Bangladesh was genetically related to those from different parts of the world during the period of 1988-1998 years. Conclusions: Acute hemorrhagic conjunctivitis is an emerging disease caused by two enteroviruses, CV-A24v and EV70, which appeared in the late 1960s. Since then, CV-A24v has often caused small and large epidemics mainly in Asian countries. More recently, the pandemic of AHC spread over the Asia including Singapore, China, Republic of Korea and Bangladesh. The molecular diagnostic method based on RT-PCR and VP4-based phylogenetic analysis revealed that the AHC outbreak in Bangladesh was caused by CV-A24v. The method we have developed was proved to be of great use for global epidemiological investigations as well as rapid diagnosis of emerging or reemerging infections caused by human enteroviruses.
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