Molecular and immunocytochemical identification of coxsackievirus A-24 variant from the acute haemorrhagic conjunctivitis outbreak in Taiwan in 2007.
OBJECTIVE
Acute haemorrhagic conjunctivitis (AHC) is a highly contagious conjunctivitis associated with enteroviruses. Coxsackie A-24 variant (CA-24v) and enterovirus-70 (EV-70) are the two major causative agents. During October 2007, an epidemic of AHC occurred in Taiwan, affecting more than 11 000 people. The aim of this study was to determine the aetiological agent associated with the outbreak in patients diagnosed with AHC and treated at the Cathay General Hospital, Taipei (CGHT) and Cathay General Hospital Sijhih (CGHS), Taiwan during October 2007.


METHODS
Virus isolates were obtained from six patients (four from CGHS and two from CGH), and a total of seven specimens (one throat and one rectal, and five eye swabs) were collected. The specimens were inoculated onto the MRC-5 cell lines. The viral isolation was confirmed by performing real-time reverse transcription-polymerase chain reaction (RT-PCR) and indirect immunofluorescence assay (IFA).


RESULTS
The conjunctival, throat, and rectal swabs collected in this study were all tested positive for a variant of CA-24. All seven viral isolates were characterized as a variant of CA-24 and confirmed by IFA and real-time RT-PCR.


CONCLUSIONS
The findings suggest that the outbreak of AHC that occurred during October 2007 in the northern area of Taiwan was caused by a variant of coxsackie A-24. Further phylogenic analysis is underway to further classify this CA-24v strain.
Kuo
P-C
PC
Department of Ophthalmology, Cathay General Hospital Sijhih Branch, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan, Republic of China.
Lin
J-Y-S
JY
Chen
L-C
LC
Fang
Y-T
YT
Cheng
Y-C
YC
Wu
H-Y
HY
Tsai
C-Y
CY
Chen
Y-S
YS
Lin
S-Y
SY
Wu
C-L
CL
Ling
Q-D
QD
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003232:Conjunctivitis, Acute Hemorrhagic / Q000453:epidemiology / Q000821:virology*; D004196:Disease Outbreaks; D030015:Enterovirus C, Human / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult