Enterovirus A71 Meningoencephalitis Outbreak, Rostov-on-Don, Russia, 2013

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Enterovirus A type 71 (EV-A71) is a significant cause of hand, foot, and mouth disease and herpangina, with potential for severe neurological complications.
• Subgenotype C4 lineage of EV-A71 has been associated with large-scale outbreaks in Asia.
• Previous circulation of EV-A71, even with asymptomatic infections, may precede neuroinvasive disease outbreaks.

Purpose of the Study:

• To investigate the characteristics of an enterovirus outbreak in Rostov-on-Don, Russia.
• To identify the causative agent and its origin.
• To understand the potential for neuroinfection emergence following EV-A71 circulation.

Main Methods:

• Retrospective analysis of enterovirus infection cases reported in Rostov-on-Don.
• Identification of the enterovirus type and subgenotype through molecular methods (implied).
• Epidemiological investigation to trace the origin and spread of the outbreak.

Main Results:

• A total of 78 enterovirus infections were recorded, with 25 cases of neuroinfection.
• The outbreak was attributed to an enterovirus A type 71 (EV-A71) subgenotype C4 lineage.
• The identified EV-A71 subgenotype C4 lineage had likely spread from China approximately three years prior to the outbreak.

Conclusions:

• The outbreak in Rostov-on-Don was caused by a specific EV-A71 subgenotype C4 lineage with a probable Chinese origin.
• Enterovirus-associated neuroinfections can emerge in regions with prior EV-A71 circulation, even if infections were largely asymptomatic.
• This highlights the importance of surveillance for EV-A71, including asymptomatic cases, to predict and prevent future neuroinfection outbreaks.