Early human enterovirus infections in healthy Swedish children participating in the PRODIA pilot study

Authors

  • Marja-Leena Simonen-Tikka,

    1. Intestinal Viruses Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
    Search for more papers by this author
  • Anna-Kaisa Hiekka,

    1. Intestinal Viruses Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
    Search for more papers by this author
  • Päivi Klemola,

    1. Intestinal Viruses Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
    Search for more papers by this author
  • Tuija Poussa,

    1. StatConsulting TuijaPoussa, Nokia, Finland
    Search for more papers by this author
  • Johnny Ludvigsson,

    1. Division of Paediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    Search for more papers by this author
  • Riitta Korpela,

    1. Institute of Biomedicine, Pharmacology, University of Helsinki, Finland
    Search for more papers by this author
  • Outi Vaarala,

    1. Immune Response Unit, Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
    Search for more papers by this author
  • Merja Roivainen

    Corresponding author
    1. Intestinal Viruses Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
    • Intestinal Viruses Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, P.O. Box 30, FIN-00271 Helsinki, Finland.
    Search for more papers by this author

Abstract

Human enteroviruses (HEV) are common, especially in childhood and during the enterovirus season, causing mainly asymptomatic infections but also mild and severe illnesses. Numerous studies have shown the association between HEV infections and type 1 diabetes. Here, the prevalence of HEV infections was studied in healthy Swedish children with increased HLA-associated risk for type 1 diabetes participating in the PRODIA pilot study in which children were randomized to receive probiotics or placebo during the first 6 months of life. Stool specimens collected from 197 children in every 3 months from the age of 3 to 24 months were screened for HEV using traditional viral culturing method and identified with reverse transcriptase polymerase chain reaction (RT-PCR) and sequencing of the partial VP1 coding part of the viral genome. Altogether 4.8% (52/1,094) of the specimens were HEV-positive and 22.3% (44/197) of the children excreted HEV during the follow-up. HEV-A and HEV-B were present in 2.1 and 2.7% of the specimens, respectively. HEV-C and HEV-D viruses were not detected. In total, 17 different HEV serotypes were detected and the most common findings were CV-A9 (13.5%), CV-A16 (11.5%), and CV-A2 (9.6%). The majority of the infections (92.3%) were during the enterovirus season extending from July to December. Probiotic treatment did not affect significantly the risk of HEV infections during the 2-year follow-up although a trend for transient decrease for HEV positivity (HEV-A and/or HEV-B) by the age of 12 months was observed in children who received probiotics [OR 0.40; 95% confidence interval 0.15 to 1.08; P-value 0.071, generalized estimating (GEE) analysis]. According to the results, HEV-A findings were nearly as common as HEV-B findings among the healthy children participating in this study. Also it was shown that serotypes belonging to HEV-A species can be detected by means of viral culturing. J. Med. Virol. 84:923–930, 2012. © 2012 Wiley Periodicals, Inc.

Ancillary