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Luis Sarmiento-Pérez

Assistant researcher

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Isolation of Coxsackievirus A24 variant from patients with hemorrhagic conjunctivitis in Cuba, 2008-2009


  • Magilé C Fonseca
  • Luis Sarmiento
  • Sonia Resik
  • Niurka Pereda
  • Hermis Rodríguez
  • Vivian Kourí
  • Pedro Ariel Martínez
  • Alexander Piñón
  • Daniel Limonta
  • Pedro Más
  • Lai Heng Hung

Summary, in English

BACKGROUND: An outbreak of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009.

OBJECTIVE: To determinate the etiological agent associated with the Cuban outbreaks of acute hemorrhagic conjunctivitis during 2008 and 2009.

STUDY DESIGN: Conjunctival swabs and/or faecal samples from 382 patients with clinical diagnosis suggestive of acute hemorrhagic conjunctivitis were subject to viral culture in HEp-2 human laryngeal epidermoid carcinoma cells. Positive samples were identified by a specific Coxsackievirus A24 variant PCR and the 3C protease region of 16 isolates was sequenced for phylogenetic analysis.

RESULTS: Enterovirus cytopathic effect was observed in 138 cases (36%). A higher percent of CA24v was recovered from faecal samples, 19 out of 45 cases (42.2%), than from conjunctival swabs, 127 out of 355 samples (35.8%). All isolates were identified as Coxsackievirus A24 variant. Phylogenetic analysis revealed that 2008 and 2009 Cuban outbreaks were caused by the same virus strains and that isolates were closely related to those from Taiwan (2006-2007), China (2007-2008) and Singapore (2005) with a bootstrap value of 71%.

CONCLUSIONS: Outbreaks of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009 were caused by Coxsackievirus A24 variant. The faecal-oral route is another mode of transmission of CA24v in the acute hemorrhagic conjunctivitis outbreaks. Phylogenetic analysis of Cuban CA24v strains involved in an acute hemorrhagic conjunctivitis outbreak in 2008 and 2009 confirms a new introduction of the CA24 variant into the Americas from South-east Asia.

Publishing year







Journal of Clinical Virology





Document type

Journal article




  • Clinical Medicine


  • Base Sequence
  • Cell Line, Tumor
  • Conjunctivitis, Acute Hemorrhagic/diagnosis
  • Coxsackievirus Infections/epidemiology
  • Cuba/epidemiology
  • Enterovirus C, Human/classification
  • Feces/virology
  • Genotype
  • Humans
  • Phylogeny
  • RNA, Viral/genetics




  • ISSN: 1386-6532