An outbreak of the enterovirus infection in the city of Vitebsk due to a contamination of drinking water by enteroviruses

The conducted virologic, serological and molecular-and-biological investigations showed that virus Coxsakie B4, isolated from cerebrospinal fluid and rhinopharyngeal lavages of patients, was the main etiological agent, which caused mainly an outbreak of enterovirus infection in the city of Vitebsk in 2001. Coxsakie B4 viruses were found in 30% of samples by using the cultural method and in 76.9% of samples - by polymerase chain reaction (PCR) while carrying out the sanitary-and-virologic investigations in drinking water, including in infection foci. Besides, we found infectious non-cytolitic enteroviruses (EV) with changed biological properties (which could not be detected by the classic cultural method) in drinking water by using the method of PCR integrated with cell culture in the "-" strand of EV RNA. Peculiar clinical-and-epidemiological characteristics of the disease outbreak, i.e. "explosive" onset, multiple clinical forms, mixed EV infections and disease decay after drinking-water chlorination, as well as the isolation of one and the same EV serotype from patients and from water testify to a possible water origin of the outbreak.

enteroviruses, infection outbreak, drinking water, Vitebsk