Journal of Clinical Virology - Volume 82 - Supplement 1 - September 2016

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S4 Abstracts / Journal of Clinical Virology 82S (2016) S1–S142
During the period 2009–2016 we followed a total of 898
patients with either chickenpox or shingles. A complete analysis
of anamnestic data was performed and statistically evaluated. Fur-
thermore, in 567 virus isolates from these patients, genotypization
of VZV was performed.
Results confirmed our previous findings (on a smaller cohort)
and showed a higher prevalence of VZV E2 genotype (compared
to the E1strain), contrary to the reports from western Europe. In
the patients with chickenpox the E1 strain was found in 28,3% of
isolates, while the E2 strain in 70,5% of isolates. In patients with
shingles/herpes zoster the prevalences of the individual strains
were 33.3% of E1 and 66.1% of E2. In general, the E2 strains were
more prevalent in the Czech population with 385 positive patients
out out of the 567 total (67.9%). As part of this typization study sev-
eral VZV strains with newly DNA polymorphisms were described.
In addition, we have performed Next-Generation-Sequencing
(NGS) analysis in 13 VZV isolates. This led to the identification of an
European strain with two newmutations in an immunosuppressed
child. Several of these strains were also analyzed for their virulence
by the real-timemonitoring of the infection in cell culture using the
xCELLigence system.
Taken together we present molecular epidemiology data on a
large cohort of VZV positive patients and their correlation with
both anamnestic data and disease characteristics. In this study, new
variants of the VZV strains were found and several genotypes were
correlated to the virulence of the individual strains.
Molecular epidemiology is a useful tool for both epidemiological
analyses of the individual VZV strain and correlations between the
severity of the disease and individual variants.
This work was supported by the Institutional Long-Term Devel-
opmental Support 1011, the project P304/10/1161 from the Grant
Agency of Czech Republic and SV/FVZ201503.
Abstract no: 174
Presentation at ESCV 2016: Oral 7
Increased detection of enterovirus type D68
associated with acute flaccid paralysis and
severe respiratory illness in Wales,
January–February 2016
Catherine Moore ∗, Simon Cottrell ,
Joanne Watkins , Brendan Mason ,
Christopher Williams , Rachel Jones
1 Public Health Wales Molecular Diagnostics Unit,
United Kingdom
2 Public Health Wales CDSC, United Kingdom
3 Wales Specialist Virology Centre, United Kingdom
A case of acute flaccid paralysis in a two year old child was noti-
fied to Public Health Wales in December 2015. Enterovirus RNA
was subsequently detected in a faeces sample by in-house RT-PCR.
Investigations for poliovirus were negative and enterovirus type
D68 (EV-D68) was detected by specific RT-PCR.
Retrospective analysis of respiratory samples collected from
children presenting with severe disease during December 2015
were screened by generic enterovirus RT-PCR, this was then fol-
lowed by testing all those found enterovirus positive and all CSF
samples testing enterovirus positive for EV-D68. Two more cases
were identified during this time period, both presenting with
severe respiratory illness.
Prospective testing was then undertaken of all respiratory and
CSF samples submitted for respiratory virus detection from across
Wales following the same protocols during January and February
2016. In total, 112 samples were found to be enterovirus positive,
56 of which were positive for EV-D68. As previously described, EV-
D68 was not found in any CSF samples but was readily detected
in respiratory samples during the acute phase of illness. Further
genetic characterisation of the enteroviruses (EV-D68 and non EV-
D68) detected as part of this work is ongoing.
Although EV-D68 was found in all age groups, children under
the age of 5 years were disproportionally affected, in-keeping with
the descriptions from the US outbreak in 2013. Further associ-
ated neurological complications were described for two children,
including development of a squint in one child and limb weakness
in another. However, respiratory complications were the main pre-
senting features with 8 children and one adult requiring intensive
care therapy.
With the eradication of poliovirus imminent, it has been
well documented that increased surveillance of polio and non-
poliovirus enteroviruses should be undertaken importantly, this
EV-D68 epidemic in Wales highlights the limitations in current
strategies that rely cases of neurological disease and detections in
CSF. Since 2014, Public Health Wales routinely tests all respiratory
samples submitted through the influenza surveillance scheme from
primary care for enteroviruses. One sample from the surveillance
scheme tested positive for EV-D68 at the beginning of February
2016 when the number of cases detected in hospital patients was
at its peak. We now plan to routinely test all respiratory samples
for enteroviruses as part of the routine respiratory panel with the
aim to improve detection rates of all enteroviruses and especially
those not readily detectable in CSF such as EV-D68.
Abstract no: 180
Presentation at ESCV 2016: Oral 8
Does a chill cause a cold?
R. Price ∗, C. Graham , S. Ramalingam
1 University of Edinburgh, UK
2 Wellcome Trust Clinical Research Facility,
University of Edinburgh, UK
3 Department of Laboratory Medicine, Royal
Infirmary of Edinburgh, UK
The common cold is one of the commonest upper respiratory
tract infections (URTI) in theworld. URTI are caused by awide range
of infectious agents, and often precede more serious lower respira-
tory tract infections (LRTI). URTI have a seasonal pattern, occurring
more frequently during the colder months, with peaks in activity
at the start of autumn and spring.
The study aimed to examine the seasonality of the causative
agents of URTI and the effects of meteorological factors on this sea-
sonal variation. Meteorological data for the Edinburgh Gogarbank
areawas acquired for five variables: temperature, pressure, relative
humidity, wind speed and dew point. Results of respiratory sam-
ples tested at the Royal Infirmary of Edinburgh between 2009 and
2015 were analysed. The agents identified were rhinovirus, adeno-
virus, influenza viruses A and B, parainfluenza viruses (HPIV) 1, 2
and 3, respiratory syncytial virus (RSV), human metapneumovirus
(HMPV) and Mycoplasma pneumoniae.
Statistical tests were performed with SPSS to assess the rela-
tionship between the seasonal variation of these agents and
the meteorological factors. These statistical tests included t-tests,
ANOVA and post-hoc analysis and the creation of generalised linear
models.
Seasonal patterns were identified for each agent by graph-
ical representation with meteorological seasonality. T-test and