Abstract：
BACKGROUND: Enterovirus D68 (EV-D68) is an important reemerging pathogen that causes severe acute respiratory infection and acute flaccid paralysis, mainly in children. Since 2014, EV-D68 outbreaks have been reported in the United States, Europe, and east Asia; however, no outbreaks have been reported in southeast Asian countries, including Myanmar, during the previous 10 years.
METHODS: EV-D68 was detected in nasopharyngeal swabs from children with acute lower respiratory infections in Myanmar. The samples were previously collected from children aged 1 month to 12 years who had been admitted to the Yankin Children Hospital in Yangon, Myanmar, between May 2017 and January 2019. EV-D68 was detected with a newly developed EV-D68-specific real-time PCR assay. The clade was identified by using a phylogenetic tree created with the Bayesian Markov chain Monte Carlo method.
RESULTS: During the study period, nasopharyngeal samples were collected from 570 patients. EV-D68 was detected in 42 samples (7.4 %)-11 samples from 2017 to 31 samples from 2018. The phylogenetic tree revealed that all strains belonged to clade B3, which has been the dominant clade worldwide since 2014. We estimate that ancestors of currently circulating genotypes emerged during the period 1980-2004.
CONCLUSIONS: To our knowledge, this is the first report of EV-D68 detection in children with acute lower respiratory infections in Yangon, Myanmar, in 2017-2018. Detection and detailed virologic analyses of EV-D68 in southeast Asia is an important aspect of worldwide surveillance and will likely be useful in better understanding the worldwide epidemiologic profile of EV-D68 infection.
METHODS: EV-D68 was detected in nasopharyngeal swabs from children with acute lower respiratory infections in Myanmar. The samples were previously collected from children aged 1 month to 12 years who had been admitted to the Yankin Children Hospital in Yangon, Myanmar, between May 2017 and January 2019. EV-D68 was detected with a newly developed EV-D68-specific real-time PCR assay. The clade was identified by using a phylogenetic tree created with the Bayesian Markov chain Monte Carlo method.
RESULTS: During the study period, nasopharyngeal samples were collected from 570 patients. EV-D68 was detected in 42 samples (7.4 %)-11 samples from 2017 to 31 samples from 2018. The phylogenetic tree revealed that all strains belonged to clade B3, which has been the dominant clade worldwide since 2014. We estimate that ancestors of currently circulating genotypes emerged during the period 1980-2004.
CONCLUSIONS: To our knowledge, this is the first report of EV-D68 detection in children with acute lower respiratory infections in Yangon, Myanmar, in 2017-2018. Detection and detailed virologic analyses of EV-D68 in southeast Asia is an important aspect of worldwide surveillance and will likely be useful in better understanding the worldwide epidemiologic profile of EV-D68 infection.
摘要：
背景：肠道病毒D68（EV-D68）是一种重要的复发病原体，可引起严重的急性呼吸道感染和急性弛缓性麻痹，主要是在儿童。自2014年以来，美国报告了EV-D68爆发，欧洲,和东亚；然而，东南亚国家没有爆发疫情的报道，包括缅甸,在过去的10年里。
方法：在缅甸急性下呼吸道感染患儿的鼻咽拭子中检测到EV-D68。样本先前是从仰光延金儿童医院收治的1个月至12岁的儿童中收集的，缅甸,2017年5月至2019年1月。用新开发的EV-D68特异性实时PCR测定法检测EV-D68。通过使用贝叶斯马尔可夫链蒙特卡罗方法创建的系统发育树来识别进化枝。
结果：在研究期间，收集570例患者的鼻咽样本。从2017年的42个样本（7.4％）-11个样本到2018年的31个样本中检测到EV-D68。系统发育树显示，所有菌株都属于B3进化枝，自2014年以来一直是全球的优势进化枝。我们估计当前循环基因型的祖先出现在1980-2004年期间。
结论：据我们所知，这是仰光急性下呼吸道感染儿童EV-D68检测的第一份报告，缅甸,2017-2018年。在东南亚，EV-D68的检测和详细的病毒学分析是全球监测的重要方面，可能有助于更好地了解EV-D68感染的全球流行病学概况。
方法：在缅甸急性下呼吸道感染患儿的鼻咽拭子中检测到EV-D68。样本先前是从仰光延金儿童医院收治的1个月至12岁的儿童中收集的，缅甸,2017年5月至2019年1月。用新开发的EV-D68特异性实时PCR测定法检测EV-D68。通过使用贝叶斯马尔可夫链蒙特卡罗方法创建的系统发育树来识别进化枝。
结果：在研究期间，收集570例患者的鼻咽样本。从2017年的42个样本（7.4％）-11个样本到2018年的31个样本中检测到EV-D68。系统发育树显示，所有菌株都属于B3进化枝，自2014年以来一直是全球的优势进化枝。我们估计当前循环基因型的祖先出现在1980-2004年期间。
结论：据我们所知，这是仰光急性下呼吸道感染儿童EV-D68检测的第一份报告，缅甸,2017-2018年。在东南亚，EV-D68的检测和详细的病毒学分析是全球监测的重要方面，可能有助于更好地了解EV-D68感染的全球流行病学概况。
