Via the Institut Pasteur du Cambodge in Phnom Penh: Enterovirus EV71 genotype C4. Excerpt:
Enterovirus EV71 genotype C4 identified at Institut Pasteur du Cambodge as the major cause of neurorespiratory syndrome in young children in Cambodia reported since April 2012.
The Virology Unit at Institut pasteur du Cambodge headed by Dr Philippe Buchy has identified the human enterovirus 71 (EV71), genotype C4 as the principal etiologic agent responsible for the outbreak of hand, foot and mouth disease (HFMD) currently affecting children in Cambodia and Thailand, and other countries in Southeast Asia.
“Following an initial report by the clinicians of the Kantha Bopha hospital that, despite their best efforts, dozens of deaths had occurred in young children presenting with encephalitis associated with pulmonary edema, human enterovirus serotype 71 (EV71) was identified by the Institut Pasteur in Cambodia.
"The virus was then also detected in mild or severe hand, foot and mouth disease (HFMD) cases in many hospitals throughout the country through a surveillance system established by the Ministry of Health, WHO, National Institute of Public Health with the support of many partners like US CDC.
"We analyzed 3 isolates randomly selected from patients originating from different Cambodian provinces over a 4-week period [this analysis was since completed with over 20 new strains].
Approximately 841 base pairs of the VP1 gene (positions 2268 to 3109) were sequenced and aligned with sequences of strains isolated in Viet Nam in 2011 and 2012 (data kindly provided by Thanh Tran Tan, Jeremy Farrar, Rogier van Doorn; Oxford University Clinical Research Unit — Ho Chi Minh City — Viet Nam/Wellcome Trust Major Overseas Programme), in Shanghai in 2011 and 2012 (data provided by Ralf Altmeyer and Ke Lan; Institut Pasteur of Shanghai), and with various sequences available in GenBank and originating from other Asian countries (e.g., Singapore, Malaysia).
The phylogenetic analysis shows that the EV71 sequences from Cambodia cluster with those of the EV71 strains genotype C4 isolated in Viet Nam in 2011 and 2012 (homology at the nucleotide level: 98.78-99.39 percent; homology at the amino acid level: 98.78-100 percent) [and] are closely related to the sequences of the C4 genotype viruses detected in 2010-2012 in China (homology at the nucleotide level: 98.17-99.39 percent; homology at the amino acid level: 98.17-100 percent).
Further genomic characterization is still ongoing. These preliminary data, however, suggest that strains in Cambodia are part of the ongoing outbreak of EV71 that is proceeding across Asia and involves strains similar to those observed in other countries in the region.