Background
Methods
The collections of clinical specimens in this outbreak
Viral RNA extraction, direct reverse transcription-polymerase chain reaction and sequences determination
Virus Isolation and identification
Identification of the genotype of CVA9
Sequence Analysis
Serology detection of Coxsackievirus IgM antibody
Neutralization Test
Nucleotide sequence accession numbers
Results
Epidemiological investigation of this outbreak
Laboratory confirmation of CVA9 as the pathogenic agent in this outbreak
Cases | Molecular detection | Serology detection | |||||
---|---|---|---|---|---|---|---|
Direct RT-PCR for pan-enterovirus | Virus isolation/serotyping | ELISA testing for Coxsackievirus IgM of 22 acute-phase sera | Neutralization Test | ||||
CSF | Stool | CSF | Stool | Neutralization titer in acute-phase | Neutralization titer in convalescent | ||
1 | + | + | +/CVA9 | +/CVA9 | + | <1:20 | 1:501 |
2 | + | + | - | - | + | <1:20 | 1:1000 |
3 | + | + | - | +/CVA9 | + | <1:20 | >1:1024 |
4 | + | / | +/CVA9 | / | - | / | / |
5 | - | + | - | +/CVA9 | + | / | / |
6 | - | + | - | +/CVA9 | + | / | / |
7 | - | + | - | +/CVA9 | + | / | / |
8 | - | + | - | +/CVA9 | + | / | / |
9 | - | + | - | - | + | / | / |
10 | - | + | - | - | - | / | / |
11 | / | + | / | - | - | / | / |
12 | / | + | / | - | - | / | / |
13 | / | + | / | - | - | / | / |
14 | / | - | / | - | + | / | / |
15 | / | - | / | - | + | / | / |
Total
|
4
|
12
|
2//CVA9
|
6//CVA9
|
10
|
At least four times higher for all three pairs of paired serum samples
|