title: Epidemic outbreak of acute haemorrhagic conjunctivitis caused by coxsackievirus A24 in Thailand, 2014.
abstract: Acute haemorrhagic conjunctivitis outbreaks are often attributed to viral infection. In 2014, an unprecedented nationwide outbreak of infectious conjunctivitis occurred in Thailand, which affected >300 000 individuals over 3 months. To identify and characterize the virus responsible for the epidemic, eye swab specimens from 119 patients were randomly collected from five different provinces. Conserved regions in the enteroviral 5'-UTR and adenovirus hexon gene were analysed. Enterovirus was identified in 71·43% (85/119) of the samples, while no adenovirus was detected. From enterovirus-positive samples, the coxsackievirus A24 variant (70·59%, 84/119) and echovirus (0·84%, 1/119) were identified. Additional sequencing of full-length VP1 and 3C genes and subsequent phylogenetic analysis revealed that these clinical isolates form a new lineage cluster related to genotype IV-C5. In summary, the coxsackievirus A24 variant was identified as an aetiological agent for the recent acute haemorrhagic conjunctivitis outbreak in Thailand.
authors.affiliation: Centre of Excellence in Clinical Virology,Department of Pediatrics,Faculty of Medicine,Chulalongkorn University,Bangkok,Thailand.
authors.forename: J
authors.initials: J
authors.lastname: Chansaenroj
authors.affiliation: Centre of Excellence in Clinical Virology,Department of Pediatrics,Faculty of Medicine,Chulalongkorn University,Bangkok,Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Vongpunsawad
authors.affiliation: Centre of Excellence in Clinical Virology,Department of Pediatrics,Faculty of Medicine,Chulalongkorn University,Bangkok,Thailand.
authors.forename: J
authors.initials: J
authors.lastname: Puenpa
authors.affiliation: Centre of Excellence in Clinical Virology,Department of Pediatrics,Faculty of Medicine,Chulalongkorn University,Bangkok,Thailand.
authors.forename: A
authors.initials: A
authors.lastname: Theamboonlers
authors.affiliation: Chum Phae Hospital,Chum Phae,Khon Kaen,Thailand.
authors.forename: V
authors.initials: V
authors.lastname: Vuthitanachot
authors.affiliation: Bueng Kan Provincial Hospital,Bueng Kan,Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Chattakul
authors.affiliation: The Bureau of Epidemiology,Department of Disease Control,Division of the Ministry of Public Health,Thailand.
authors.forename: D
authors.initials: D
authors.lastname: Areechokchai
authors.affiliation: Centre of Excellence in Clinical Virology,Department of Pediatrics,Faculty of Medicine,Chulalongkorn University,Bangkok,Thailand.
authors.forename: Y
authors.initials: Y
authors.lastname: Poovorawan
mesh_terms: D020121:5' Untranslated Regions; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003232:Conjunctivitis, Acute Hemorrhagic / Q000453:epidemiology* / Q000821:virology*; D003384:Coxsackievirus Infections / Q000453:epidemiology* / Q000821:virology*; D004196:Disease Outbreaks; D029822:Enterovirus B, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D030015:Enterovirus C, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D013785:Thailand / Q000453:epidemiology; D014764:Viral Proteins / Q000235:genetics; D055815:Young Adult
chemical_list: D020121:5' Untranslated Regions; D014764:Viral Proteins
keywords: Conjunctivitis; Thailand; coxsackievirus A24; enterovirus; epidemic; outbreak
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