Prevalence and genetic characteristics of Saffold cardiovirus in China from 2009 to 2012

Zhang, Xiao-Ai; Lu, Qing-Bin; Wo, Ying; Zhao, Jin; Huang, Dou-Dou; Guo, Chen-Tao; Xu, Hong-Mei; Liu, En-Mei; Liu, Wei; Cao, Wu-Chun

In our study, SAFVs were co-detected with other viruses in 14 (82.4%), 9 (75.0%), and 28 (32.6) specimens in ARTI, diarrhea and HFMD patients respectively. For ARTI and diarrhea cohorts, no differential clinical manifestations were inferred from the patients with SAFV single detection or SAFV co-detection, probably due to small sample size for comparison. However, for HFMD patients, we found the co-detection of SAFV could aggravate the clinical outcome of EV71 infection. We are uncertain whether SAFV/EV71 co-detection can lead to synergies in the HFMD pathogenic mechanism, and therefore responsible for the pathogenesis of severe HFMD, which need further investigation in the future. Previous studies have demonstrated the existence of SAFV in CSF, but it was only limited to the case report 25, 34 . In 2011, SAFV-3 was isolated from the CSF sample of a 9-year old boy with aseptic meningitis 34 . SAFV-2 was subsequently detected in the CSF and fecal samples of one child with cerebellitis as well as in the CSF, blood, and myocardium of another child who died suddenly with no history of illness 25 . In the current study, the existence of SAFV-3 was observed in the CSF and SAFV-2 was observed in serum samples from the patients with HFMD-associated encephalitis. Furthermore, among half of the SAFV-positive CSFs and sera, SAFV was the solely detected pathogen. This information provided the first valid estimation of SAFV in pediatric encephalitis.