title: Human febrile illness caused by encephalomyocarditis virus infection, Peru.
abstract: Etiologic studies of acute febrile disease were conducted in sites across South America, including Cusco and Iquitos, Peru. Patients' clinical signs and symptoms were recorded, and acute- and convalescent-phase serum samples were obtained for serologic examination and virus isolation in Vero E6 and C6/36 cells. Virus isolated in Vero E6 cells was identified as encephalomyocarditis virus (EMCV) by electron microscopy and by subsequent molecular diagnostic testing of samples from 2 febrile patients with nausea, headache, and dyspnea. The virus was recovered from acute-phase serum samples from both case-patients and identified with cardiovirus-specific reverse transcription-PCR and sequencing. Serum samples from case-patient 1 showed cardiovirus antibody by immunoglobulin M ELISA (acute phase <8, convalescent phase >1,024) and by neutralization assay (acute phase <10, convalescent phase >1,280). Serum samples from case-patient 2 did not contain antibodies detectable by either assay. Detection of virus in serum strongly supports a role for EMCV in human infection and febrile illness.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. soberste@cdc.gov
authors.forename: M Steven
authors.initials: MS
authors.lastname: Oberste
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gotuzzo
authors.forename: Patrick
authors.initials: P
authors.lastname: Blair
authors.forename: W Allan
authors.initials: WA
authors.lastname: Nix
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Ksiazek
authors.forename: James A
authors.initials: JA
authors.lastname: Comer
authors.forename: Pierre
authors.initials: P
authors.lastname: Rollin
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Goldsmith
authors.forename: James
authors.initials: J
authors.lastname: Olson
authors.forename: Tadeusz J
authors.initials: TJ
authors.lastname: Kochel