title: Coxsackieviruses in ontario, january 2005 to december 2011.
abstract: BACKGROUND
  In 2010, there was an increase in enterovirus meningitis in the province of Ontario, Canada. Concurrently, there was also an increase in coxsackievirus A9-positive specimens in Alberta, Canada. This study aimed to describe the results of an investigation into the increase in coxsackievirus (A9 serotype) in 2010 in Ontario.
  
  
  METHODS
  For the purpose of this study, we report on specimens tested by viral culture at Public Health Ontario Laboratory as part of routine laboratory testing from January 1, 2005 to December 31, 2011.
  
  
  RESULTS
  Coxsackieviruses represented more than one third of enteroviruses detected, with A9 being the serotype most commonly identified. The most common specimen source in which A9 was isolated was cerebrospinal fluid, followed by nasopharyngeal swabs and stool. Patients in whom A9 was detected were older than individuals with any other coxsackievirus serotype.
  
  
  CONCLUSIONS
  The increase in enterovirus meningitis in Ontario in 2010 was likely due to an increase in A9 circulation. A9 was most commonly identified among children; however A9 may cause severe illness in both children and adults. Monitoring the circulation and epidemiology of enteroviruses can inform clinicians about circulating pathogens to optimize clinical testing and antibiotic use.
authors.affiliation: Public Health Ontario, 81 Resources Road, Etobicoke, Toronto, ON M9P 3T1, Canada. Electronic address: adriana.peci@oahpp.ca.
authors.forename: Adriana
authors.initials: A
authors.lastname: Peci
authors.affiliation: Public Health Ontario, 81 Resources Road, Etobicoke, Toronto, ON M9P 3T1, Canada.
authors.forename: Anne-Luise
authors.initials: AL
authors.lastname: Winter
authors.affiliation: Public Health Ontario, 81 Resources Road, Etobicoke, Toronto, ON M9P 3T1, Canada.
authors.forename: Alireza
authors.initials: A
authors.lastname: Eshaghi
authors.affiliation: Public Health Ontario, 81 Resources Road, Etobicoke, Toronto, ON M9P 3T1, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Marchand-Austin
authors.affiliation: Public Health Ontario, 81 Resources Road, Etobicoke, Toronto, ON M9P 3T1, Canada.
authors.forename: Romy
authors.initials: R
authors.lastname: Olsha
authors.affiliation: Public Health Ontario, 81 Resources Road, Etobicoke, Toronto, ON M9P 3T1, Canada.
authors.forename: Nino
authors.initials: N
authors.lastname: Lombardi
authors.affiliation: Public Health Ontario, 81 Resources Road, Etobicoke, Toronto, ON M9P 3T1, Canada; University of Toronto, Ontario, Canada.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Gubbay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000145:classification* / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000266:history / Q000821:virology; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D012621:Seasons; D065288:Serogroup; D055815:Young Adult
keywords: Cerebrospinal fluid; Coxsackievirus A9; Enterovirus; Epidemiology; Surveillance