Numerous serotypes which belong to the genus Enterovirus (EV) show variability in their virulence and clinical manifestations. They are also known to undergo changes caused by mutations and recombination during their circulation in the environment and the population. Various EV serotypes are prevalent in groundwater, wastewater and surface waters. Our previous studies showed that oral infection induces pancreatitis depending on specific conditions, such as gravidity, in an outbred murine model. Our aim in the present study was to further explore the pancreatic histopathology in an outbred mouse model following oral infection with clinical isolates from a patient who had aseptic meningitis and an isolate from a treated-sewage sample recovered from the residential area of the patient. The isolates were identified as coxsackievirus B4 (CVB4) in tissue culture. The CVB4 sewage-isolate induced pancreatitis after oral infection. In contrast, pancreatitis was absent following infection with the clinical isolates. Comparison of polyprotein sequences showed that the treated-sewage strains differed from the patient's isolates by 9 and 11 amino acids. We conclude that the isolates of clinical and environmental origin differed in their pathogenic properties and showed genetic variation.

2nd Faculty of Medicine Department of Pediatrics Charles University Prague and University Hospital Motol Prague Czech Republic

Department of Medical Microbiology Regional Authority of Public Health Banska Bystrica Cesta k nemocnici 25 Banska Bystrica Slovak Republic

Faculty of Medicine Enterovirus Laboratory Institute of Microbiology Slovak Medical University Limbova 12 83303 Bratislava Slovak Republic

Faculty of Public Health Slovak Medical University Limbova 12 83303 Bratislava Slovak Republic

Martinske biopticke centrum s r o 5 Spanyola 47A street 010 01 Zilina Slovak Republic

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