An Outbreak of Concurrent Echovirus 30 and Coxsackievirus A1 Infections Associated with Sea Swimming among a Group of Travelers to Mexico

Abstract

We identified multiple enteroviruses among the travelers. Clustered illness onsets suggest point-source exposure, which likely was a sea swim in sewage-contaminated seawater. Novel molecular amplification and sequencing methodologies were required to recognize the rarely identified CVA1, but it is ambiguous whether CVA1 infection caused illness. Travelers should be aware of risks associated with swimming in natural waters when visiting areas where there is limited sewage treatment.