title: Analysis of an echovirus 18 outbreak in Thuringia, Germany: insights into the molecular epidemiology and evolution of several enterovirus species B members.
abstract: In October and November 2010, six children and one woman were presented with symptoms of aseptic meningitis in Jena, Thuringia, Germany. Enterovirus RNA was detected in the cerebrospinal fluid of all patients by RT-PCR, and preliminary molecular typing revealed echovirus 18 (E-18) as causative agent. Virus isolates were obtained from stool samples of three patients and several contact persons. Again, most isolates were typed as E-18. In addition, coxsackievirus B5 (CV-B5) and echovirus 25 (E-25) were found to co-circulate. As only few complete E-18 sequences are available in GenBank, the entire genomes of these isolates were determined using direct RNA-sequencing technology. We did not find evidence for recombination between E-18, E-25 or CV-B5 during the outbreak. Viral protein 1 gene sequences and the cognate 3D polymerase gene sequences of each isolate and GenBank sequences were analysed in order to define type-specific recombination groups (recogroups).
authors.affiliation: Institute of Infection Medicine, Christian-Albrecht University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany. krumbholz@infmed.uni-kiel.de.|Institute of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany. krumbholz@infmed.uni-kiel.de.|Institute of Medical Microbiology, Jena University Hospital, Jena, Germany. krumbholz@infmed.uni-kiel.de.|Medical Laboratory Dr. Krause and colleagues MVZ GmbH, Steenbeker Weg 23, 24106, Kiel, Germany. krumbholz@infmed.uni-kiel.de.
authors.forename: Andi
authors.initials: A
authors.lastname: Krumbholz
authors.affiliation: Institute of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.|Institute of Medical Microbiology, Jena University Hospital, Jena, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Egerer
authors.affiliation: Institute of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Braun
authors.affiliation: Institute of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Schmidtke
authors.affiliation: Thuringian State Authority for Consumer Protection (TLV), Bad Langensalza, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Rimek
authors.affiliation: Public Health Authority, City Council of Jena, Jena, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Kroh
authors.affiliation: Department of Pediatrics, Jena University Hospital, Jena, Germany.
authors.forename: Bert
authors.initials: B
authors.lastname: Hennig
authors.affiliation: Leibniz Institute on Aging - Fritz Lipmann Institute (FLI), Jena, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Groth
authors.affiliation: Institute of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Sauerbrei
authors.affiliation: Institute of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Zell
mesh_terms: D002555:Cerebrospinal Fluid / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004457:Echovirus Infections / Q000453:epidemiology*; D029822:Enterovirus B, Human / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D019143:Evolution, Molecular; D005243:Feces / Q000821:virology; D005260:Female; D016679:Genome, Viral; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000453:epidemiology*; D017720:Molecular Epidemiology; D058889:Molecular Typing; D012367:RNA, Viral / Q000134:cerebrospinal fluid / Q000235:genetics / Q000302:isolation & purification; D011995:Recombination, Genetic; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: Enterovirus; Germany; Lineages; Meningitis; Molecular epidemiology; RNA-sequencing; Recogroups; Recombination