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Epidemiological, molecular and clinical features of Enterovirus 109 infection in children and in adult stem cell transplant recipients

Maurizia Debiaggi1, Elisa Rita Ceresola2, Michela Sampaolo2, Emilio Paolo Alessandrino3, Roberto Brerra1, Aurora Piazza1, Massimo Clementi2 and Filippo Canducci2*

Author Affiliations

1 Department of Morphological and Clinical Sciences, Section of Microbiology, University of Pavia, Pavia, Italy

2 Laboratory of Microbiology and Virology, San Raffaele Scientific Institute and Vita-Salute, San Raffaele University, Milan, Italy

3 Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, Pavia, Italy

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Virology Journal 2012, 9:183  doi:10.1186/1743-422X-9-183

Published: 4 September 2012



A novel human enterovirus (HEV) type within the species HEV-C, named EV109, was discovered from cases of respiratory illness in Nicaragua in September 2010. The aim of this study, was to retrospectively examine the presence and the role of EV109 in respiratory samples from two patients populations; infants below the age of 2 years, hospitalized for acute respiratory diseases (ARDs) and adult hematopoietic stem cell transplantation recipients.


A total of 1149 nasopharingeal aspirates were collected and tested for the presence of EV109 by reverse transcription-PCR (RT-PCR). In positive samples, the presence of the most common respiratory viruses was also assayed and clinical symptoms were evaluated. Samples from 2 of the 974 infants tested positive for EV109 RNA (0.2%) and belonged to patients with lower ARDs; co-infection with other viral pathogens under study was observed in both cases. In transplant recipients, one out of the 175 samples analyzed, from a patients with upper respiratory simptoms tested positive for HEV 109 in the absence of co-infecting viruses. Sequence analysis of amplified EV109 genomic regions, showed only a few nucleotide differences when compared with the Nicaraguan strains.


Overall these results indicate that HEV109 variants have circulated and differentiated in different lineages worldwide. Although more cases and larger studies are needed, HEV109 infection may be associated to ARDs both in infants and in hematopoietic stem cell transplantation recipients. If these preliminary observations will be confirmed, improved molecular methods with a wider panel of potential pathogens will be useful for monitoring these categories of patients.

Enterovirus 109; Rhinoviruses; Acute respiratory disease