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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorGonzález-Sanz, Rubén
dc.contributor.authorCasas-Alba, Didac
dc.contributor.authorLaunes, Cristian
dc.contributor.authorMuñoz-Almagro, Carmen
dc.contributor.authorRuiz-García, María Montserrat
dc.contributor.authorAlonso, Mercedes
dc.contributor.authorAntón Pagarolas, Andres
dc.date.accessioned2019-03-26T07:42:44Z
dc.date.available2019-03-26T07:42:44Z
dc.date.issued2019-02-24
dc.identifier.citationGonzález-Sanz R, Casas-Alba D, Launes C, Muñoz-Almagro C, Ruiz-García MM, Alonso M, et al. Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016. Euro Surveill. 2019; 24(7):1800089.
dc.identifier.issn1560-7917
dc.identifier.urihttp://hdl.handle.net/11351/3861
dc.descriptionEncephalitis; Enterovirus; Outbreaks
dc.description.abstractIntroductionEnterovirus A71 (EV-A71) is an emerging pathogen that causes a wide range of disorders including severe neurological manifestations. In the past 20 years, this virus has been associated with large outbreaks of hand, foot and mouth disease with neurological complications in the Asia-Pacific region, while in Europe mainly sporadic cases have been reported. In spring 2016, however, an EV-A71 outbreak associated with severe neurological cases was reported in Catalonia and spread further to other Spanish regions.AimOur objective was to investigate the epidemiology and clinical characteristics of the outbreak.MethodsWe carried out a retrospective study which included 233 EV-A71-positive samples collected during 2016 from hospitalised patients. We analysed the clinical manifestations associated with EV-A71 infections and performed phylogenetic analyses of the 3'-VP1 and 3Dpol regions from all Spanish strains and a set of EV-A71 from other countries.ResultsMost EV-A71 infections were reported in children (mean age: 2.6 years) and the highest incidence was between May and July 2016 (83%). Most isolates (218/233) were classified as subgenogroup C1 and 217 of them were grouped in one cluster phylogenetically related to a new recombinant variant strain associated with severe neurological diseases in Germany and France in 2015 and 2016. Moreover, we found a clear association of EV-A71-C1 infection with severe neurological disorders, brainstem encephalitis being the most commonly reported.ConclusionAn emerging recombinant variant of EV-A71-C1 was responsible for the large outbreak in 2016 in Spain that was associated with many severe neurological cases.
dc.language.isoeng
dc.publisherEuropean Centre for Disease Prevention and Control
dc.relation.ispartofseriesEurosurveillance;24(7)
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceScientia
dc.subjectVirus - Epidemiologia - Espanya
dc.subjectEpidemiologia molecular
dc.subjectNeurologia - Malalties
dc.subject.meshEnterovirus
dc.subject.meshEncephalitis
dc.subject.meshSpain
dc.subject.mesh/epidemiology
dc.subject.meshDisease Outbreaks
dc.titleMolecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.2807/1560-7917.ES.2019.24.7.1800089
dc.subject.decsenterovirus
dc.subject.decsencefalitis
dc.subject.decsEspaña
dc.subject.decs/epidemiología
dc.subject.decsbrotes de enfermedades
dc.relation.publishversionhttps://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.7.1800089
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[González-Sanz R] Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain. [Casas-Alba D] Institut de Recerca Sant Joan de Déu, Barcelona, Spain. [Launes C] CIBER de epidemiología y Salud Pública, Madrid, Spain. Institut de Recerca Sant Joan de Déu, Barcelona, Spain. [Muñoz-Almagro C] CIBER de epidemiología y Salud Pública, Madrid, Spain. Universitat Internacional de Catalunya, Barcelona, Spain. Institut de Recerca Sant Joan de Déu, Barcelona, Spain. [Ruiz-García MM] Hospital General de Elche, Alicante, Spain. [Alonso M] Hospital Infantil Universitario Niño Jesús, Madrid, Spain. [Antón A] Hospital Universitari Vall d'Hebron, Barcelona, Spain.
dc.identifier.pmid30782267
dc.identifier.wosWOS:000458642200003
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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