Analysis of Enterovirus evolution in Canada over a 23-year period
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Date
2019
Authors
McDermid, Andrew
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Abstract
The non-polio Enteroviruses (NPEV) cause a glut of severe diseases which are especially burdensome in the pediatric population. This study uses a novel approach to evaluate the relationship between recombination amongst non-polio enteroviruses and circulation. The National Centre for Enterovirus (NCEV) surveillance system showed that from 1991-2013 there were 2628 Enterovirus positive samples surveyed including 2167 (83.9%) Enterovirus B strains, 326 (12.6%) Enterovirus A strains, 85 (3.3%) Enterovirus D strains and 5 (0.2%) Enterovirus C strains. Echovirus 30 (Enterovirus B) was the most prevalent serotype followed by Coxsackievirus A16 (Enterovirus A) followed by several other Enterovirus B serotypes.
To evaluate the genetics of these species 269 strains from 17 Enterovirus B serotypes, 2 Enterovirus A serotypes and 1 Enterovirus D serotype were chosen for full genome sequencing. These serotypes were representative of 93.4% of Enterovirus B strains, 91.1% of Enterovirus A strains, and 100% of Enterovirus D circulating. Phylogenetic analysis was used to genotype strains and used to identify hundreds of recombination events between serotypes. Comparisons between VP1 average pairwise identities between serotypes and recombination events did not show a definitive association between the two. However, a significant association between temporal co-circulation and recombination events was identified, as well as an association between geographic co-circulation and recombination events.
Enterovirus B genotypes were evaluated chronologically by serotype and compared to surveillance data to test the hypothesis that outbreaks were associated with recombination events. However, outbreaks strains were identified in years preceding the outbreaks and identified recombination events were not associated with any outbreaks. Recombination events between Canadian strains within the Enterovirus A species or the Enterovirus D species were not found.
This study presents new information about the dynamics of NPEV circulation and recombination. It also highlights complexities of genetics analyses through genotyping and tracking genotypes through the surveillance period. Finally, this study sets the stage for future pairings of full genomic analyses with surveillance and stresses the importance of continued surveillance.
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Keywords
Infectious Disease, Enterovirus, Echovirus, Coxsackievirus, National Microbiology Laboratory, Public Health Agency of Canada, Surveillance, Viral Genetics, Recombination, Virus, Aseptic Meningitis, Acute Flaccid Paralysis, Hand Foot and Mouth Disease