Epidemic Outbreak of Acute Haemorrhagic Conjunctivitis Caused by Coxsackievirus A24 in Thailand, 2014

Overview

Journal Epidemiol Infect

Publisher Cambridge University Press

Specialties Infectious Diseases
Public Health

Date 2015 Apr 1

PMID 25824006

Citations 14

Authors

J Chansaenroj

S Vongpunsawad

J Puenpa

A Theamboonlers

V Vuthitanachot

P Chattakul

D Areechokchai

Y Poovorawan

Affiliations

Soon will be listed here.

Abstract

Acute haemorrhagic conjunctivitis outbreaks are often attributed to viral infection. In 2014, an unprecedented nationwide outbreak of infectious conjunctivitis occurred in Thailand, which affected >300 000 individuals over 3 months. To identify and characterize the virus responsible for the epidemic, eye swab specimens from 119 patients were randomly collected from five different provinces. Conserved regions in the enteroviral 5'-UTR and adenovirus hexon gene were analysed. Enterovirus was identified in 71·43% (85/119) of the samples, while no adenovirus was detected. From enterovirus-positive samples, the coxsackievirus A24 variant (70·59%, 84/119) and echovirus (0·84%, 1/119) were identified. Additional sequencing of full-length VP1 and 3C genes and subsequent phylogenetic analysis revealed that these clinical isolates form a new lineage cluster related to genotype IV-C5. In summary, the coxsackievirus A24 variant was identified as an aetiological agent for the recent acute haemorrhagic conjunctivitis outbreak in Thailand.

Citing Articles

Epidemiology and spatiotemporal analysis of acute hemorrhagic conjunctivitis in Zhejiang province, China (2004-2023).

Sun W, Chen Y, Qin S, Miao Z Front Public Health. 2025; 13:1509495.

PMID: 39968230 PMC: 11833792. DOI: 10.3389/fpubh.2025.1509495.

Clinical Features and Epidemiological Insights of Acute Epidemic Conjunctivitis: A Multicentric Cross-Sectional Study in North Central India.

Aishwarya A, Agarwal A, Saxena D, Jain V, Singh A, Agarwal R Rom J Ophthalmol. 2025; 68(4):372-378.

PMID: 39936060 PMC: 11809833. DOI: 10.22336/rjo.2024.68.

An Outbreak of Acute Hemorrhagic Conjunctivitis Caused by Coxsackievirus A24 in Eastern Uttar Pradesh, India 2023.

Behera S, Mishra N, Yadav R, Shukla A, Kumari M, Rajput S Intervirology. 2024; 67(1):106-113.

PMID: 39437765 PMC: 11524537. DOI: 10.1159/000540952.

Identification of coxsackievirus A-24 GIV C5 strain as the cause of acute hemorrhagic conjunctivitis outbreak in Hyderabad, India in 2022.

Chavan N, Rani V, Shinde P, Shinde M, Pavani S, Srinath M Heliyon. 2024; 10(11):e32254.

PMID: 38947457 PMC: 11214445. DOI: 10.1016/j.heliyon.2024.e32254.

Non-Polio Enterovirus C Replicate in Both Airway and Intestine Organotypic Cultures.

Moreni G, van Eijk H, Koen G, Johannesson N, Calitz C, Benschop K Viruses. 2023; 15(9).

PMID: 37766230 PMC: 10537321. DOI: 10.3390/v15091823.

References

Oh M, Park S, Choi Y, Kim H, Lee K, Park W . Acute hemorrhagic conjunctivitis caused by coxsackievirus A24 variant, South Korea, 2002. Emerg Infect Dis. 2003; 9(8):1010-2. PMC: 3020616. DOI: 10.3201/eid0908.030190. View

Park S, Lee C, Jang H, Kim E, Oh M, Choe K . Rapid identification of the coxsackievirus A24 variant by molecular serotyping in an outbreak of acute hemorrhagic conjunctivitis. J Clin Microbiol. 2005; 43(3):1069-71. PMC: 1081220. DOI: 10.1128/JCM.43.3.1069-1071.2005. View

Kosrirukvongs P, Kanyok R, Sitritantikorn S, Wasi C . Acute hemorrhagic conjunctivitis outbreak in Thailand, 1992. Southeast Asian J Trop Med Public Health. 1996; 27(2):244-9. View

Supanaranond K, Takeda N, Yamazaki S . The complete nucleotide sequence of a variant of Coxsackievirus A24, an agent causing acute hemorrhagic conjunctivitis. Virus Genes. 1992; 6(2):149-58. DOI: 10.1007/BF01703064. View

Shukla D, Kumar A, Srivastava S, Dhole T . Molecular identification and phylogenetic study of coxsackievirus A24 variant isolated from an outbreak of acute hemorrhagic conjunctivitis in India in 2010. Arch Virol. 2012; 158(3):679-84. DOI: 10.1007/s00705-012-1520-7. View

Ayoub E, Shafik C, Gaynor A, Mohareb E, Amin M, Yassin A . A molecular investigative approach to an outbreak of acute hemorrhagic conjunctivitis in Egypt, October 2010. Virol J. 2013; 10:96. PMC: 3614871. DOI: 10.1186/1743-422X-10-96. View

Ishiko H, Takeda N, Miyamura K, Tanimura M, Yamanaka T, Kasuga K . Phylogenetically different strains of a variant of coxsackievirus A 24 were repeatedly introduced but discontinued circulating in Japan. Arch Virol. 1992; 126(1-4):179-93. DOI: 10.1007/BF01309694. View

. Acute hemorrhagic conjunctivitis caused by coxsackievirus A24--Caribbean. MMWR Morb Mortal Wkly Rep. 1987; 36(16):245-6, 251. View

Mirkovic R, SCHMIDT N, Melnick J . Enterovirus etiology of the 1970 Singapore epidemic of acute conjunctivitis. Intervirology. 1974; 4(2):119-27. DOI: 10.1159/000149850. View

10.

Sriwanna P, Chieochansin T, Vuthitanachot C, Vuthitanachot V, Theamboonlers A, Poovorawan Y . Molecular characterization of human adenovirus infection in Thailand, 2009-2012. Virol J. 2013; 10:193. PMC: 3693972. DOI: 10.1186/1743-422X-10-193. View

11.

Casas I, Palacios G, Trallero G, Cisterna D, Freire M, Tenorio A . Molecular characterization of human enteroviruses in clinical samples: comparison between VP2, VP1, and RNA polymerase regions using RT nested PCR assays and direct sequencing of products. J Med Virol. 2001; 65(1):138-48. View

12.

Palacios G, Oberste M . Enteroviruses as agents of emerging infectious diseases. J Neurovirol. 2005; 11(5):424-33. DOI: 10.1080/13550280591002531. View

13.

Lin K, Chern C, Chu P, Chang C, Wang H, Sheu M . Genetic analysis of recent Taiwanese isolates of a variant of coxsackievirus A24. J Med Virol. 2001; 64(3):269-74. DOI: 10.1002/jmv.1046. View

14.

Puenpa J, Mauleekoonphairoj J, Linsuwanon P, Suwannakarn K, Chieochansin T, Korkong S . Prevalence and characterization of enterovirus infections among pediatric patients with hand foot mouth disease, herpangina and influenza like illness in Thailand, 2012. PLoS One. 2014; 9(6):e98888. PMC: 4041783. DOI: 10.1371/journal.pone.0098888. View

15.

Chu P, Ke G, Chang C, Lin J, Sun C, Huang W . Molecular epidemiology of coxsackie A type 24 variant in Taiwan, 2000-2007. J Clin Virol. 2009; 45(4):285-91. DOI: 10.1016/j.jcv.2009.04.013. View

16.

De W, Huanying Z, Hui L, Corina M, Xue G, Leng L . Phylogenetic and molecular characterization of coxsackievirus A24 variant isolates from a 2010 acute hemorrhagic conjunctivitis outbreak in Guangdong, China. Virol J. 2012; 9:41. PMC: 3305440. DOI: 10.1186/1743-422X-9-41. View

17.

Wu B, Qi X, Xu K, Ji H, Zhu Y, Tang F . Genetic characteristics of the coxsackievirus A24 variant causing outbreaks of acute hemorrhagic conjunctivitis in Jiangsu, China, 2010. PLoS One. 2014; 9(1):e86883. PMC: 3901726. DOI: 10.1371/journal.pone.0086883. View

18.

Lim K . An epidemic of conjunctivitis in Singapore in 1970. Singapore Med J. 1971; 12(5):247-9. View

19.

Kaufman H . Adenovirus advances: new diagnostic and therapeutic options. Curr Opin Ophthalmol. 2011; 22(4):290-3. DOI: 10.1097/ICU.0b013e3283477cb5. View