A Novel Mode of Transmission for Human Enterovirus Infection Is Swimming in Contaminated Seawater: Implications in Public Health and in Epidemiological Surveillance

摘要

Enteroviruses (EVs; Picornaviridae) are among the most common viruses infecting humans worldwide [1]. These positive‐RNA viruses possess a high genetic diversity (89 serotypes), and they can evolve through genetic mutations or recombination events that are associated with the potential emergence of new epidemic serotypes [2, 3]. Although the majority of human EV infections remain asymptomatic, these viruses are associated with a large diversity of clinical syndromes, ranging from minor febrile illness to severe and potentially fatal pathologies, including aseptic meningitis, encephalitis, myopericarditis, acute flaccid paralysis, and severe neonatal sepsis‐like disease [1, 4]. The primary mode of direct or indirect transmission of EV remains the fecal‐oral route [4]. However, other efficient modes of transmission, such as respiratory or eye mucosal routes, have been reported [5, 6]. Patterns such as direct person‐to‐person contact seem to be important in many outbreaks of EV infection. However, because human EVs are enteric viruses, water‐related transmission remains of primary importance for indirect viral transmission and represents a potentially significant human health risk [7, 8]. Consequently, the information regarding the detection of EV in water, such as epidemiological data related to waterborne diseases, is crucial to modern public health survey systems [8].