title: Circulation of enteroviruses in Cyprus assessed by molecular analysis of clinical specimens and sewage isolates.
abstract: OBJECTIVE
  To study the circulation of non-polio enteroviruses in the Cypriot population and assess the clinical relevance of different serotypes by the analysis of clinical specimens and environmental samples.
  
  
  RESULTS
  Sewage samples were collected on a monthly basis for 2 years from all five districts of Cyprus. Enteroviruses were isolated using the VIRADEN method and typed by partial VP1 region sequencing. In addition, all enterovirus-positive clinical samples received during this 2-year period were typed, and a phylogenetic comparison of clinical and sewage samples based on the partial VP1 sequences was made. A significant difference between the most common serotypes found in sewage and clinical samples was observed. While Coxsackieviruses B constituted the most frequent serotypes in sewages, Echoviruses 30 and 18 prevailed in clinical samples.
  
  
  CONCLUSIONS
  The phylogenetic analysis revealed that certain enterovirus strains circulate in the population over long period of time, while others are observed only sporadically and disappear quickly. For some serotypes, it was observed that several strains were cocirculating in the population but only some of them being detected also in clinical specimens.
  
  
  CONCLUSIONS
  This study, for the first time, compares enteroviruses isolated from environmental samples and clinical specimens on a molecular level, which allowed for strain identification and discrimination. A more comprehensive molecular analysis of these strains will help identify factors, which determine different degrees of pathogenicity.
authors: Department of Molecular Virology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus. richter@cing.ac.cy
authors: J
authors: J
authors: Richter
authors: C
authors: C
authors: Tryfonos
authors: C
authors: C
authors: Christodoulou