title: Two outbreaks of acute hemorrhagic conjunctivitis in Africa due to genotype III coxsackievirus A24 variant.
abstract: Reported here are two outbreaks of acute hemorrhagic conjunctivitis that occurred in the Democratic Republic of the Congo and in Morocco in the summers of 2003 and 2004, respectively, with a large impact on public health. Virus was isolated from the conjunctival swabs of 30 Congolese and 20 Moroccan patients. Enterovirus-specific cytopathic effect was observed in all samples. None of the strains could be typed using a conventional neutralization assay with the Melnick intersecting pools; however, by sequencing the VP1 region, the viruses could be identified as coxsackie A24 variants. Phylogenetic analysis of the 3C protease region revealed that these strains were closely related to each other as well as to genotype III isolates detected in Korea in 2002, thus proving their worldwide spread. This is the first report of an epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Africa since 1987 and the first ever from Morocco.
authors.affiliation: Centre National de Référence des Entérovirus, Hôpital E. Herriot, Hospices Civils de Lyon, Lyon, France. nicolas.leveque@chu-lyon.fr
authors.forename: N
authors.initials: N
authors.lastname: Lévêque
authors.forename: I Lahlou
authors.initials: IL
authors.lastname: Amine
authors.forename: I L
authors.initials: IL
authors.lastname: Amine
authors.forename: G
authors.initials: G
authors.lastname: Cartet
authors.forename: A B
authors.initials: AB
authors.lastname: Hammani
authors.forename: Y C
authors.initials: YC
authors.lastname: Khazraji
authors.forename: B
authors.initials: B
authors.lastname: Lina
authors.forename: J J
authors.initials: JJ
authors.lastname: Muyembe
authors.forename: H
authors.initials: H
authors.lastname: Norder
authors.forename: J J
authors.initials: JJ
authors.lastname: Chomel
mesh_terms: D000818:Animals; D002460:Cell Line; D003232:Conjunctivitis, Acute Hemorrhagic / Q000453:epidemiology / Q000821:virology*; D003384:Coxsackievirus Infections / Q000453:epidemiology / Q000821:virology*; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004196:Disease Outbreaks; D030015:Enterovirus C, Human / Q000235:genetics* / Q000302:isolation & purification; D005838:Genotype; D006801:Humans; D008969:Molecular Sequence Data; D009018:Morocco / Q000453:epidemiology; D010802:Phylogeny; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods