Incidence Rates of Enterovirus 71 Infections in Young Children during a Nationwide Epidemic in Taiwan, 2008–09

Lee, Min Shi; Chiang, Pai-Shan; Luo, Shu Ting; Huang, Mei; Liou, Guan Yuan; Tsao, Kuo Chien; Lin, Tzou Yien

doi:10.1371/journal.pntd.0001476

Cited by 37 publications

(34 citation statements)

References 33 publications

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“…A recent prospective cohort study showed that 29% of EV71 infections were asymptomatic [21]. To our surprise, our study found that 62.3% of children aged over 1 year old later developed anti-EV71 antibody titers ≥1:128, although none of these children were confirmed with a clinical diagnosis of HFMD at a hospital or health care provider.…”

Section: Discussioncontrasting

confidence: 52%

Seroepidemiology of human enterovirus71 and coxsackievirusA16 in Jiangsu province, China

Liu

et al. 2012

Virol J

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BackgroundThe major etiology of hand, foot and mouth disease (HFMD) is infection with human enterovirus A (HEV-A). Among subtypes of HEV-A, coxsackievirusA16 (CoxA16) and enterovirus 71 (EV71) are major causes for recurrent HFMD among infants and children in Jiangsu Province, mainland China. Here, we analyzed maternal antibodies between prenatal women and their neonates, to determine age-specific seroprevalence of human EV71 and CoxA16 infections in infants and children aged 0 to 15 years. The results may facilitate the development of immunization against HFMD.MethodsThis study used cross-section of 40 pairs of pregnant women and neonates and 800 subjects aged 1 month to 15 years old. Micro-dose cytopathogenic effects measured neutralizing antibodies against EV71 and CoxA16. Chi-square test compared seroprevalence rates between age groups and McNemar test, paired-Samples t-test and independent-samples t-test analyzed differences of geometric mean titers.ResultsA strong correlation between titers of neutralizing antibody against EV71 and CoxA16 in prenatal women and neonates was observed (rEV71 = 0.67, rCoxA16 = 0.56, respectively, p < 0.05). Seroprevalence rates of anti-EV71 antibody gradually decreased with age between 0 to 6 months old, remained low between 7 to 11 months (5.0–10.0%), and increased between 1 and 4 years (22.5–87.5%). Age-specific seroprevalence rates of anti-EV71 antibody stabilized in >80% of children between 5 to 15 years of age. However, seroprevalence rates of anti-CoxA16 antibody were very low (0.0–13.0%) between 0 to 6 months of age, gradually increased between 7 months to 4 years (15.0–70.0%), and stabilized at 54.0% (108/200) between 5 to 15 years. Seroprevalence rates against EV71 and CoxA16 were low under 1 year (0.0–10.0%), and showed an age dependent increase with high seroprevalence (52.5–62.5%) between 4 and10 years of age.ConclusionsConcomitant infection of EV71 and CoxA16 was common in Jiangsu Province. Therefore, development of bivalent vaccine against both EV71 and CoxA16 is critical. The optimal schedule for vaccination may be 4 to11 months of age.

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Section: Discussioncontrasting

confidence: 52%

Seroepidemiology of human enterovirus71 and coxsackievirusA16 in Jiangsu province, China

Liu

et al. 2012

Virol J

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“…It would be important to monitor cross-reactive neutralizing antibody profiles using sera collected from vaccinated children in the future. Moreover, longitudinal enterovirus surveillance data are critical to formulate vaccination policy [9,14] and are warranted in Vietnam.…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory methods for measuring EV71 serum neutralizing antibody titers followed standard protocols [14]. Twofold serially diluted sera (1:8 -1:512) and virus working solution containing 100 TCID 50 of EV71 strain, were mixed on 96-well microplates and incubated with rhabdomyosarcoma cells.…”

Section: Methodsmentioning

confidence: 99%

Genetic and Antigenic Characterization of Enterovirus 71 in Ho Chi Minh City, Vietnam, 2011

et al. 2013

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Enterovirus 71 (EV71) frequently causes fatal infections in young children in Asia. In 2011, EV71 epidemics occurred in southern Vietnam. We conducted genetic and antigenic analysis of the EV71 isolates and found that 94% of them were genotype C4a related to two lineages circulating in China and 6% were genotype C5 which have circulated in Vietnam since 2003. Antigenic variants were not detected. EV71 vaccines are being developed. Longitudinal enterovirus surveillance data are critical to formulate vaccination policy in Vietnam.

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“…Clinical specimens were collected from a child cohort study conducted in northern Taiwan [21]–[23]. In the cohort study, sera were obtained from participating children in the following schedule: neonates at birth (cord blood), and children at 6, 12, 24, and 36 months of age.…”

Section: Methodsmentioning

confidence: 99%

Comparing Molecular Methods for Early Detection and Serotyping of Enteroviruses in Throat Swabs of Pediatric Patients

et al. 2012

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BackgroundEnteroviruses include over 100 serotypes and usually cause self-limited infections with non-specific symptoms in children, with the exceptions of polioviruses and enterovirus 71 which frequently cause neurologic complications. Therefore, early detection and serotyping of enteroviruses are critical in clinical management and disease surveillance. Traditional methods for detection and serotyping of enteroviruses are virus isolation and immunofluorescence assay, which are time-consuming. In this study, we compare virus isolation and two molecular tests for detection and serotyping of enteroviruses in clinical samples.MethodsOne hundred and ten throat swabs were collected from pediatric outpatients with enterovirus-like illnesses (hand-foot-mouth disease, herpangina, and non-specific febrile illness). Virus isolation was conducted using multiple cell lines and isolated viruses were serotyped using immunofluorescent assay. In the molecular tests, a semi-nested RT-PCR and a novel CODEHOP platform were used to detect the 5′UTR and VP1 genes of enteroviruses, respectively. Amplified nucleotides were sequenced and genotyped.ResultsAmong the 110 cases, 39(35%), 52(47%), and 46(42%) were tested positive with these three tests, respectively. Using the consensus results of these three tests as the gold standard, agreement of the VP1 CODEHOP test was 96%, which is higher than those of the virus isolation (89%) and the 5′-UTR test (88%). The VP1 CODEHOP test also has the best performance on serotyping confirmed with serum neutralization tests.ConclusionsThe VP1 CODEHOP test performed well for detection and serotyping of enteroviruses in clinical specimens and could reduce unnecessary hospitalization cares during enterovirus seasons.

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Incidence Rates of Enterovirus 71 Infections in Young Children during a Nationwide Epidemic in Taiwan, 2008–09

Cited by 37 publications

References 33 publications

Seroepidemiology of human enterovirus71 and coxsackievirusA16 in Jiangsu province, China

Seroepidemiology of human enterovirus71 and coxsackievirusA16 in Jiangsu province, China

Genetic and Antigenic Characterization of Enterovirus 71 in Ho Chi Minh City, Vietnam, 2011

Comparing Molecular Methods for Early Detection and Serotyping of Enteroviruses in Throat Swabs of Pediatric Patients

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