Molecular characterization of a coxsackievirus A24 variant that caused an outbreak of acute haemorrhagic conjunctivitis in Spain, 2004.
BACKGROUND
Coxsackievirus A24 variant is one of the major etiological agents involved in acute haemorrhagic conjunctivitis.


METHODS
An outbreak of acute hemorrhagic conjunctivitis occurred in the Southeast of Spain between September and November 2004. Cellular and molecular methods were used to identify and characterize the viral agent associated with the epidemic.


RESULTS
Enterovirus was detected in the conjunctival swabs of 35 patients. None of the viruses isolated could be typed by conventional neutralization assays; however, amplification and sequencing of the 3'-end VP1 region of 19 of the samples identified coxsackievirus A24 variant as the serotype causing the outbreak. Phylogenetic analysis of the 5'-half VP1 region of the genome revealed that Spanish sequences, like other strains isolated during outbreaks of hemorrhagic conjunctivitis in American and African countries in 2003 and 2004, were closely related to the isolates detected in Korea (2002), thus proving their worldwide spread.


CONCLUSIONS
This is the first report of an epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Spain. Molecular typing in combination with phylogenetic analysis is useful to study the enterovirus epidemiology associated with epidemics.
Cabrerizo
Maria
M
National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. mcabrerizo@isciii.es
Echevarria
Juan E
JE
Otero
Almudena
A
Lucas
Paloma
P
Trallero
Gloria
G
D016000:Cluster Analysis; D003228:Conjunctiva / Q000821:virology; D003232:Conjunctivitis, Acute Hemorrhagic / Q000453:epidemiology* / Q000821:virology; D003384:Coxsackievirus Infections / Q000453:epidemiology* / Q000821:virology; D004196:Disease Outbreaks; D030015:Enterovirus C, Human / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D009500:Neutralization Tests; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D013030:Spain / Q000453:epidemiology
D012367:RNA, Viral