title: High frequency of human enterovirus species C circulation in Madagascar.
abstract: Four poliomyelitis outbreaks caused by vaccine-derived polioviruses have been reported recently, including one in Madagascar in 2002. In all cases, the viral strains involved were recombinant between poliovirus vaccine strains and nonpoliovirus strains, probably enterovirus species C. Nevertheless, little is known about the circulation and epidemiology of enteroviruses in the regions where these outbreaks occurred. To assess the circulation of enteroviruses (particularly enterovirus species C) in Madagascar, we genetically characterized 55 enterovirus strains isolated between 1994 and 2002. The strains were identified and compared by partially sequencing the region encoding the VP1 capsid protein. Phylogenetic analysis and pairwise comparison with prototype enterovirus strains distinguished two different species: 25 isolates belonged to human enterovirus B species, and 30 isolates were identified as coxsackievirus A13, A15, A17, A18, A20, A21, and A24, belonging to the human enterovirus species C. The relatively high frequency and the wide distribution of species C coxsackie A viruses in different regions of Madagascar suggest that they had been silently and widely circulating in the country during the whole study period. The circulation of coxsackie A viruses, combined with the low routine oral polio vaccine coverage, may have played a role in the emergence of the recent outbreak in Madagascar.
authors.affiliation: Unité de Virologie, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar. mala@pasteur.mg
authors.forename: Mala
authors.initials: M
authors.lastname: Rakoto-Andrianarivelo
authors.forename: Dominique
authors.initials: D
authors.lastname: Rousset
authors.forename: Richter
authors.initials: R
authors.lastname: Razafindratsimandresy
authors.forename: Stéphane
authors.initials: S
authors.lastname: Chevaliez
authors.forename: Sophie
authors.initials: S
authors.lastname: Guillot
authors.forename: Jean
authors.initials: J
authors.lastname: Balanant
authors.forename: Francis
authors.initials: F
authors.lastname: Delpeyroux
mesh_terms: D000595:Amino Acid Sequence; D045744:Cell Line, Tumor; D004268:DNA-Binding Proteins / Q000737:chemistry / Q000235:genetics; D030015:Enterovirus C, Human / Q000145:classification* / Q000235:genetics*; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D008270:Madagascar / Q000453:epidemiology; D008969:Molecular Sequence Data; D010802:Phylogeny; D010940:Plant Proteins; D017422:Sequence Analysis, DNA; D015534:Trans-Activators; D014157:Transcription Factors / Q000737:chemistry / Q000235:genetics
chemical_list: D004268:DNA-Binding Proteins; D010940:Plant Proteins; D015534:Trans-Activators; D014157:Transcription Factors