Efficacy of Widely Used Hand Disinfectants Against Human Echovirus Type 11 in China

Background: In the summer of 2019 an outbreak of Nosocomial infections in a newborn nursery occurred in a Shunde hospital near Foshan, resulting in five babies deaths. Echovirus-11 was proven to be the responsible agent. Echovirus-11 infections are a significant health threat in the hospitals and occasionally cause severe neurological complications and even death in children. Although good hand hygiene is important for controlling infection, relevant data regarding the efficacy of widely used hand disinfectants against Echovirus-11 are still lacking. Aim: To investigate the virucidal activity of widely used hand disinfectants against Echovirus-11. Methods: The 13 widely used hand disinfectants from Guangdong hospitals were tested for virucidal activity against Echovirus-11 with the identification test of residual disinfectants removal and the suspension test with a 60 s exposure time based on Technical Standard For Disinfection (2002). Findings: Both Disinfectant A and Disinfectant C achieved a mean log10 reduction factor in Echovirus-11 titre of ≥ 5.00, respectively, within 60 s. Disinfectant B, Disinfectant D, Disinfectant H and Disinfectant M had an effect on Echovirus-11 in a mean log10 reduction factor of ≥ 4.00.By contrast, Disinfectant E, Disinfectant F, Disinfectant G, Disinfectant I, Disinfectant J, Disinfectant K and Disinfectant L didn't improved the mean log10 reduction factor in Echovirus-11 titre with producing a factor of ＜4 after a 60 s exposure time.Conclusions: 46.2% (6/13 products) of widely used hand disinfectants have effectiveness against Echovirus-11. In general, it is risky to rely too much on hand disinfectants. In case of epidemic season or definite enterovirus contamination, washing hands with soap and water is recommended for reducing viral contamination of enterovirus 11 in clinical practice, rather than hand hygiene with alcohol-based hand disinfectants alone.

Echovirus type 6 transmission clusters and the role of environmental surveillance in early warning, the Netherlands, 2007 to 2016

Background In the Netherlands, echovirus type 6 (E6) is identified through clinical and environmental enterovirus surveillance (CEVS and EEVS). Aim We aimed to identify E6 transmission clusters and to assess the role of EEVS in surveillance and early warning of E6. Methods We included all E6 strains from CEVS and EEVS from 2007 through 2016. CEVS samples were from patients with enterovirus illness. EEVS samples came from sewage water at pre-specified sampling points. E6 strains were defined by partial VP1 sequence, month and 4-digit postcode. Phylogenetic E6 clusters were detected using pairwise genetic distances. We identified transmission clusters using a combined pairwise distance in time, place and phylogeny dimensions. Results E6 was identified in 157 of 3,506 CEVS clinical episodes and 92 of 1,067 EEVS samples. Increased E6 circulation was observed in 2009 and from 2014 onwards. Eight phylogenetic clusters were identified; five included both CEVS and EEVS strains. Among these, identification in EEVS did not consistently precede CEVS. One phylogenetic cluster was dominant until 2014, but genetic diversity increased thereafter. Of 14 identified transmission clusters, six included both EEVS and CEVS; in two of them, EEVS identification preceded CEVS identification. Transmission clusters were consistent with phylogenetic clusters, and with previous outbreak reports. Conclusion Algorithms using combined time–place–phylogeny data allowed identification of clusters not detected by any of these variables alone. EEVS identified strains circulating in the population, but EEVS samples did not systematically precede clinical case surveillance, limiting EEVS usefulness for early warning in a context where E6 is endemic.

Ongoing outbreak of aseptic meningitis associated with echovirus type 30 in the City of Novi Sad, Autonomous Province of Vojvodina, Serbia, June – July 2010

Since June 2010, incidence of aseptic meningitis has increased in Novi Sad, Autonomous Province of Vojvodina, Serbia. From 2 June to 25 July 2010, 80 cases of aseptic meningitis were notified, with an incidence rate ranging from 10 to 366 per 100,000 population in different local communities. The majority of cases (n=64) were aged between two and 15 years. Echovirus 30 was cultured from two of four cerebrospinal fluid specimens. The outbreak, for which no common source has yet been identified, is ongoing.

Evolutionary Dynamics and Temporal/Geographical Correlates of Recombination in the Human Enterovirus Echovirus Types 9, 11, and 30

ABSTRACT The relationship between virus evolution and recombination in species B human enteroviruses was investigated through large-scale genetic analysis of echovirus type 9 (E9) and E11 isolates (n = 85 and 116) from 16 European, African, and Asian countries between 1995 and 2008. Cluster 1 E9 isolates and genotype D5 and A E11 isolates showed evidence of frequent recombination between the VP1 and 3Dpol regions, the latter falling into 23 (E9) and 43 (E11) clades interspersed phylogenetically with 46 3Dpol clades of E30 and with those of other species B serotypes. Remarkably, only 2 of the 112 3Dpol clades were shared by more than one serotype (E11 and E30), demonstrating an extremely large and genetically heterogeneous recombination pool of species B nonstructural-region variants. The likelihood of recombination increased with geographical separation and time, and both were correlated with VP1 divergence, whose substitution rates allowed recombination half-lives of 1.3, 9.8, and 3.1 years, respectively, for E9, E11, and E30 to be calculated. These marked differences in recombination dynamics matched epidemiological patterns of periodic epidemic cycles of 2 to 3 (E9) and 5 to 6 (E30) years and the longer-term endemic pattern of E11 infections. Phylotemporal analysis using a Bayesian Markov chain Monte Carlo method, which placed recombination events within the evolutionary reconstruction of VP1, showed a close relationship with VP1 lineage expansion, with defined recombination events that correlated with their epidemiological periodicity. Whether recombination events contribute directly to changes in transmissibility that drive epidemic behavior or occur stochastically during periodic population bottlenecks is an unresolved issue vital to future understanding of enterovirus molecular epidemiology and pathogenesis.

Widespread Circulation of Echovirus Type 13 Demonstrated by Increased Seroprevalence in Toyama, Japan, between 2000 and 2003

ABSTRACT To confirm the magnitude of an echovirus type 13 (E13) outbreak in 2002 and to evaluate whether genetic and antigenic changes in E13 influenced the occurrence of the outbreak, we measured titers of neutralizing (NT) antibody against the Toyama, 2002-240-SF, and prototype Del Carmen E13 strains among inhabitants of Toyama before and after 2002. The rate of positivity for NT antibodies against both 2002-240-SF and Del Carmen in 2003 made a remarkable upturn in children 0 to 14 years old, compared to that in 2000. Titers of NT antibody against strain 2002-240-SF of inhabitants were slightly higher than those against Del Carmen, whereas anti-E13 rabbit serum raised against either strain Del Carmen or 2002-240-SF showed almost the same titer of NT antibody against both strains. These data indicate that the antigenic properties of the strains may be slightly different. Differences in amino acids between strains 2002-240-SF and Del Carmen in the VP4, VP2, VP3, and VP1 regions may affect both antigenic and receptor binding properties, even though they do not seem to be significant enough to escape widespread immunity. One of the factors of the outbreak was thought to be the increase in susceptibility in the young generation.