title: Widespread circulation of a new echovirus 30 variant causing aseptic meningitis and non-specific viral illness, South-East France, 2013.
abstract: BACKGROUND
  Human enteroviruses (HEVs) are major cause of aseptic meningitis. A new outbreak of E-30 occurred between April and September 2013 in Marseille, South-East France.
  
  
  OBJECTIVE
  Better understand what happen locally when an E-30 outbreak occurs.
  
  
  METHODS
  Laboratory data (identification and characterization of circulating E-30 strains by partial/complete genome sequencing) were analyzed together with clinical data from emergency ward of the public hospital of Marseille.
  
  
  RESULTS
  Compared with data from previous years, we observed an excess of HEV infections between April and September 2013. A total of 202 patients were tested positive of which 79% (160/202) had a cerebrospinal fluid tested positive. Because we performed genotyping using clinical specimens, we obtained representative molecular data related to patients tested positive and found a majority (105/119) of echoviruses 30 (E-30). Phylogenetic analysis revealed that E-30 circulating in Europe since 2000 belong to a unique lineage and showed at the intra-genogroup level the temporal circulation of E-30. Molecular data also indicated that majority of E-30 detected (92%) were almost identical. Compared with data from previous years, this outbreak was finally associated with an excess of patients admitted to an emergency ward for meningitis but also for non-specific viral illness.
  
  
  CONCLUSIONS
  Our data provide new insights into microevolution of E-30: almost all E-30 emerged from local circulation of one parental virus. Moreover, our findings showed that HEV outbreaks cause an excess of emergency ward consultations but probably also an excess of consultations to general practitioners who receive majority of the non-specific viral illness.
authors: Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France; Virology Laboratory, IHU Méditerranée Infection, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France. Electronic address: antoine.nougairede@univ-amu.fr.
authors: Antoine
authors: A
authors: Nougairede
authors: Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors: Mael
authors: M
authors: Bessaud
authors: Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors: Simon-Djamel
authors: SD
authors: Thiberville
authors: Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France.
authors: Geraldine
authors: G
authors: Piorkowski
authors: Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France; Virology Laboratory, IHU Méditerranée Infection, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France.
authors: Laetitia
authors: L
authors: Ninove
authors: Virology Laboratory, IHU Méditerranée Infection, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France.
authors: Christine
authors: C
authors: Zandotti
authors: Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France; Virology Laboratory, IHU Méditerranée Infection, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France.
authors: Remi N
authors: RN
authors: Charrel
authors: Pediatric Emergency Unit, North Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France; Observatoire Régional des Urgences PACA, Hyères, France.
authors: Noel
authors: N
authors: Guilhem
authors: Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", 13385 Marseille, France; Virology Laboratory, IHU Méditerranée Infection, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France.
authors: Xavier
authors: X
authors: de Lamballerie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002555:Cerebrospinal Fluid / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004196:Disease Outbreaks; D004457:Echovirus Infections / Q000453:epidemiology* / Q000821:virology; D029822:Enterovirus B, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D019143:Evolution, Molecular; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D008582:Meningitis, Aseptic / Q000453:epidemiology* / Q000821:virology; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: Echovirus 30; Enterovirus; France; Meningitis; Outbreak