In 2017, numerous cases of acute haemorrhagic conjunctivitis (AHC) were reported in the Caribbean and in South America. Preliminary reports identified adenoviruses and enteroviruses in some patient samples but, until now, none of the etiologic agents have been fully characterized. We report the full-length genomic sequences of 4 coxsackievirus A24 (CV-A24) isolates collected from AHC patients in French Guiana during this outbreak (May and June 2017). These isolates are very closely related and belong to the genotype IV of CV-A24 variant, which consists of strains sampled worldwide during AHC outbreaks in the 2000s and 2010s. No recombination events were detected within the genomic sequences, indicating that members of this genotype have continuously circulated worldwide for more than 10 years without undergoing recombination with other enteroviruses. This unusual trait could be due to their ocular tropism that could impede genetic exchanges between these viruses and other enteroviruses, which replicate mainly in the gut.

Keywords:
Coxsackievirus, Conjunctivitis, Enterovirus C species
1.
Akcay E, Carhan A, Hondur G, Tufan ZK, Demir N, Kilic S, Ensari EN, Ugurlu N, Cagil N: Molecular identification of viral agents associated with acute conjunctivitis: a prospective controlled study. Braz J Infect Dis 2017; 21: 391–395.
2.
Jhanji V, Chan TC, Li EY, Agarwal K, Vajpa­yee RB: Adenoviral keratoconjunctivitis. Surv Ophthalmol 2015; 60: 435–443.
3.
International Society for Infectious Diseases: Conjunctivitis – Mexico: (Tamaulipas). April 13, 2017. ProMED archive No. 20170413.4968931. https://www.promedmail.org/post/20170413.4968931.
4.
Pan American Health Organization: Epidemiological Update: Conjunctivitis. July 25, 2017. http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=40941&lang=en.
5.
Santé Publique France: Epidémie de conjonctivite virale aux Antilles. June 30, 2017. http://invs.santepubliquefrance.fr/fr/content/download/138210/497674/version/138151/file/pe_conjonctivite_antilles_300617.pdf.
6.
Vennema H; International Society for Infectious Diseases: Conjunctivitis – Americas (05): Caribbean (Bonaire). July 4, 2017. Promed archive No. 20170704.5150640. https://www.promedmail.org/post/20170704.5150640.
7.
Santé Publique France: Epidémie de conjonctivites virales aux Antilles. Le point épidémio. 11/2017. http://invs.santepubliquefrance.fr/fr/content/download/137211/493525/version/137149/file/pe_conjonctivite_antilles_310517.pdf.
8.
Santé Publique France: Epidémie de conjonctivites virales aux Antilles. Le point épidémio. 15/2017. http://invs.santepubliquefrance.fr/fr/content/download/138482/498840/version/138152/file/pe_conjonctivite_antilles_130717.pdf.
9.
Bessaud M, Jegouic S, Joffret ML, Barge C, Balanant J, Gouandjika-Vasilache I, Delpeyroux F: Characterization of the genome of human enteroviruses: design of generic primers for amplification and sequencing of different regions of the viral genome. J Virol Methods 2008; 149: 277–284.
10.
Bessaud M, Pillet S, Ibrahim W, Joffret ML, Pozzetto B, Delpeyroux F, Gouandjika-Vasilache I: Molecular characterization of human enteroviruses in the Central African Republic: uncovering wide diversity and identification of a new human enterovirus A71 genogroup. J Clin Microbiol 2012; 50: 1650–1658.
11.
Bessaud M, Sadeuh-Mba SA, Joffret ML, Razafindratsimandresy R, Polston P, Volle R, Rakoto-Andrianarivelo M, Blondel B, Njouom R, Delpeyroux F: Whole genome sequencing of enterovirus species C isolates by high-throughput sequencing: development of generic primers. Front Microbiol 2016; 7: 1294.
12.
Nidaira M, Kuba Y, Saitoh M, Taira K, Maeshiro N, Mahoe Y, Kyan H, Takara T, Okano S, Kudaka J, Yoshida H, Oishi K, Kimura H: Molecular evolution of VP3, VP1, 3C(pro) and 3D(pol) coding regions in coxsackievirus group A type 24 variant isolates from acute hemorrhagic conjunctivitis in 2011 in Okinawa, Japan. Microbiol Immunol 2014; 58: 227–238.
13.
Mirkovic RR, Schmidt NJ, Yin-Murphy M, Melnick JL: Enterovirus etiology of the 1970 Singapore epidemic of acute conjunctivitis. Intervirology 1974; 4: 119–127.
14.
Nilsson EC, Jamshidi F, Johansson SM, Oberste MS, Arnberg N: Sialic acid is a cellular receptor for coxsackievirus A24 variant, an emerging virus with pandemic potential. J Virol 2008; 82: 3061–3068.
15.
Baggen J, Hurdiss DL, Zocher G, Mistry N, Roberts RW, Slager JJ, Guo H, van Vliet ALW, Wahedi M, Benschop K, Duizer E, de Haan CAM, de Vries E, Casasnovas JM, de Groot RJ, Arnberg N, Stehle T, Ranson NA, Thibaut HJ, van Kuppeveld FJM: Role of enhanced receptor engagement in the evolution of a pandemic acute hemorrhagic conjunctivitis virus. Proc Natl Acad Sci USA 2018; 115: 397–402.
16.
Marguerite N, Brottet E, Pages F, Jaffar-Bandjee MC, Schuffenecker I, Josset L, Vilain P, Filleul L: A major outbreak of conjunctivitis caused by coxsackievirus A24, Reunion, January to April 2015. Euro Surveill 2016; 21: 30271.
17.
Yen YC, Chu PH, Lu PL, Lin YC, Shi YY, Chou LC, Wang CF, Lin YY, Su HJ, Lin CC, Zeng JY, Tyan YC, Ke GM, Chu PY: Phylodynamic characterization of an ocular-tropism coxsackievirus A24 variant. PLoS One 2016; 11:e0160672.
18.
Dussart P, Cartet G, Huguet P, Leveque N, Hajjar C, Morvan J, Vanderkerckhove J, Ferret K, Lina B, Chomel JJ, Norder H: Outbreak of acute hemorrhagic conjunctivitis in French Guiana and West Indies caused by coxsackievirus A24 variant: phylogenetic analysis reveals Asian import. J Med Virol 2005; 75: 559–565.
19.
Zhang L, Zhao N, Huang X, Jin X, Geng X, Chan TC, Liu S: Molecular epidemiology of acute hemorrhagic conjunctivitis caused by coxsackie A type 24 variant in China, 2004–2014. Sci Rep 2017; 7: 45202.
20.
Lin KH, Chern CL, Chu PY, Chang CH, Wang HL, Sheu MM, Huang WL, Pongsuwanna Y, Yamamoto S, Yoshino S, Ishiko H, Takeda N: Genetic analysis of recent Taiwanese isolates of a variant of coxsackievirus A24. J Med Virol 2001; 64: 269–274.
21.
Kroneman A, Vennema H, Deforche K, v d Avoort H, Penaranda S, Oberste MS, Vinje J, Koopmans M: An automated genotyping tool for enteroviruses and noroviruses. J Clin Virol 2011; 51: 121–125.
© 2018 S. Karger AG, Basel
2018
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