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Coxsackievirus B3-associated aseptic meningitis: an emerging infection in Hong Kong

Ann H Wong1, C S Lau, Peter K C Cheng

  • 1Virology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong SAR, China.

Journal of Medical Virology
|January 26, 2011
PubMed

Insights

An increase in coxsackievirus B3 (CVB3) caused aseptic meningitis was observed in Hong Kong. This enterovirus (EV) showed potential antigenic changes and a specific VP1 gene mutation linked to central nervous system disease.

Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Enterovirus (EV) infections are common in children, often leading to aseptic meningitis.
  • A notable increase in coxsackievirus B3 (CVB3) associated aseptic meningitis cases was detected in Hong Kong during the summer of 2008.
  • This rise represented 11.6% of all infected individuals during the surveillance period.

Purpose of the Study:

  • To analyze the 10-year epidemiology and circulating patterns of CVB3 in Hong Kong.
  • To investigate the clinical presentations of CVB3-associated aseptic meningitis.
  • To understand the local circulation of Enteroviruses (EV) in relation to CVB3 activity.

Main Methods:

  • Enteroviruses (EV) were isolated from various clinical samples using multiple cell lines (HEp2-C, MRC-5, Vero).
  • Virus identification and characterization involved indirect immunofluorescence (IF) with monoclonal antibodies (mAB), neutralization tests, and partial VP1 gene sequencing.
  • Epidemiological data from 1999 to 2008 were reviewed.

Main Results:

  • A majority of 2008 CVB3 isolates were untypeable by mAB, suggesting antigenic variation.
  • Sequence analysis indicated clustering of 2008 isolates with a recent strain from Fuyang, China.
  • CVB3 activity peaked in 2005 and 2008, with isolates from these years showing a T-to-A amino acid change at VP1 codon 277, potentially linked to central nervous system (CNS) disease.

Conclusions:

  • The study highlights increased CVB3 activity and potential antigenic changes in Hong Kong between 1999-2008.
  • A specific VP1 gene mutation (T277A) in CVB3 isolates may be associated with increased neurovirulence and CNS disease.
  • Ongoing surveillance and molecular characterization are crucial for understanding EV dynamics and informing public health responses.

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