Establishment of Asia-Pacific Network for Enterovirus Surveillance

Abstract

Enteroviruses (EV), the major pathogens of hand, foot, and mouth disease (HFMD) and herpangina, affect millions of children each year. Most human enteroviruses cause self-limited infections except polioviruses, enterovirus A71 (EV-A71), enterovirus D68 (EV-D68), and several echoviruses (Echo) and coxsackieviruses (CV). Especially, EV-A71 has repeatedly caused large-scale outbreaks in the Asia-Pacific region since 1997. Some Asian countries have experienced cyclical outbreaks of severe EV-A71 infections and initiated development of EV-A71 vaccines. Five EV-A71 vaccine candidates have been clinically evaluated and three of them were approved for marketing in China. However, none of the China-approved products seek marketing approval in other countries.This situation supports a role for collaboration among Asian countries to facilitate clinical trials and licensure of EV-A71 vaccines. Additionally, enterovirus D68 outbreaks have been reported in the US and Taiwan currently and caused severe complications and deaths. Hence, an Asia-Pacific Network for Enterovirus Surveillance (APNES) has been established to estimate disease burden, understand virus evolution, and facilitate vaccine development through harmonizing laboratory diagnosis and data collection. Founded in 2017, the APNES is comprised of internationally recognized experts in the field of enterovirus in Asian countries working to raise awareness of this potentially fatal and debilitating disease. This article demonstrated the summaries of the first expert meeting

Seroprevalence of EV-A71 neutralizing antibodies following the 2011 epidemic in HCMC, Vietnam

“…Genogroup C also comprises five genotypes (C1~C5) and C3-C5 recently have been involved in epidemics in Asia and Europe. Additionally, genotype C4 could be further classified as subgenotype C4a and C4b [5].…”

“…In addition, it could lead to central nervous system (CNS) infection without HFMD manifestation. EV-A71 might occasionally cause herpangina although the major causative agent of herpangina is coxsackieviruses [5]. Enterovirus remains prevalent in the Asia-Pacific region where large populations were infected every year with EV-A71 particularly as a major cause of neurological complications and mortality.…”

“…Enterovirus remains prevalent in the Asia-Pacific region where large populations were infected every year with EV-A71 particularly as a major cause of neurological complications and mortality. Since 1997, cyclical EV-A71 outbreaks have occurred in Asian countries including Brunei, Cambodia, China, Malaysia, Singapore, Taiwan, Thailand, and Vietnam [5]. EV-A71 exhibits a high degree of genetic diversity which emphasizes the importance of epidemiological monitoring in the Asia-Pacific region [5].…”

“…Since 1997, cyclical EV-A71 outbreaks have occurred in Asian countries including Brunei, Cambodia, China, Malaysia, Singapore, Taiwan, Thailand, and Vietnam [5]. EV-A71 exhibits a high degree of genetic diversity which emphasizes the importance of epidemiological monitoring in the Asia-Pacific region [5]. In Philippines, the HFMD surveillance demonstrated the positive rate of EV-A71 is between 2.0-5.4% with genotype C2 circulating from 2000 to 2016 [6].…”

“…To harmonize the enterovirus surveillance in the Asia-Pacific region, the Asia-Pacific Network for Enterovirus Surveillance (APNES) was established in 2017. In 2018, APNES has reported that EV-A71 continued circulating in the Asia-Pacific region where genotype B5 (Sarawak, Malaysia) and C4 (Thailand) have been detected [5,9].…”