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Open Access Research

An outbreak of aseptic meningitis caused by coxsackievirus A9 in Gansu, the People's Republic of China

Aili Cui1, Deshan Yu2, Zhen Zhu1, Lei Meng2, Hui Li2, Jianfeng Liu2, Guiyan Liu3, Naiying Mao1 and Wenbo Xu1*

Author Affiliations

1 National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, PR China

2 Gansu Center for Disease Control and Prevention, 12 Donggangxi Road, Lanzhou 730030, PR China

3 Jilin Center for Disease Control and Prevention, 35 Gongnongda Road, Changchun 130021, PR China

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Virology Journal 2010, 7:72  doi:10.1186/1743-422X-7-72

Published: 6 April 2010

Abstract

Background

An outbreak of aseptic meningitis occurred in Tianshui city of Gansu Province, the People's Republic of China, from March to June 2005. A total of 85 patients were clinical confirmed as aseptic meningitis in this outbreak.

Results

CVA9 was mainly responsible for this outbreak supported by the clinical manifestations of the patients, epidemiological data of the outbreak, the results of RT-PCR and complete VP1 sequence determination, conventional neutralization assays, IgM serological assays, viral isolation and phylogenetics analysis. Through phylogenetic analysis and homogeneity analysis for partial VP1 gene, the nucleotide and amino acid homologies between Gansu isolates and former Chinese CVA9 strains were 88.2%-96.1% and 97.2%-99.2%, respectively. Multiple transmission chains of CVA9 occurred in different provinces or years in China. Moreover, in order to clarify the genotype of CVA9, Gansu CVA9 strains isolated in this outbreak were compared with other CVA9 isolates based on VP1/2A junction regions (genotyping region) and they might belong to a new genotype of CVA9, which could be assigned for genotype XIII,

Conclusions

CVA9 was confirmed as the pathogen responsible for this outbreak. The phylogenetic analysis indicated that the CVA9 strains isolated in this outbreak might belong to a new genotype.