Sentinel surveillance for human enterovirus 71 in Sarawak, Malaysia: lessons from the first 7 years

Podin, Yuwana; Gias, E; Ong, Flora; Leong, Yee-Wei; Yee, Siew-Fung; Yusof, Mohd Apandi; Perera, David; Teo, Bibiana; Wee, Thian-Yew; Yao, Sik-Chi; Yao, Sik-King; Kiyu, Andrew; Arif, Mohd Taha; Cardosa, Mary Jane

doi:10.1186/1471-2458-6-180

Cited by 190 publications

(188 citation statements)

References 23 publications

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“…Consistent with previous reports in other countries and regions, [1,9,10] the majority of HFMD cases (accounting for approximately 90% of total cases) in mainland China were children under 5 years old, with the peak incidence occurring at 1−3 years of age ( Figure 1). As a common febrile illness of early childhood, enteroviral infection occurred mainly among preschool-aged children.…”

Section: Resultssupporting

confidence: 79%

Ding¹,

Yu²,

Qiao³

2017

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Section: Resultssupporting

confidence: 79%

Ding¹,

Yu²,

Qiao³

2017

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“…This finding is probably because our expanded surveillance detected more patients with neurologic disease. Since 1997, multiple cases of EV71 infection have been associated with severe aseptic meningitis and pulmonary edema in the Asia–Pacific region, including Taiwan, Malaysia, Singapore, and Japan ( 26 , 32 – 37 ). In addition, E30 was the second most common genotype detected during this period in this study and in previous studies from other countries; Asia and European countries reported that E30 was the predominant genotype ( 1 , 4 , 11 ).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Hyeon¹,

Hwang²,

Kim³

et al. 2013

Emerg. Infect. Dis.

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The epidemiology of enteroviral infection in South Korea during 1999–2011 chronicles nationwide outbreaks and changing detection and subtyping methods used over the 13-year period. Of 14,657 patients whose samples were tested, 4,762 (32.5%) samples were positive for human enterovirus (human EV); as diagnostic methods improved, the rate of positive results increased. A seasonal trend of outbreaks was documented. Genotypes enterovirus 71, echovirus 30, coxsackievirus B5, enterovirus 6, and coxsackievirus B2 were the most common genotypes identified. Accurate test results correlated clinical syndromes to enterovirus genotypes: aseptic meningitis to echovirus 30, enterovirus 6, and coxsackievirus B5; hand, foot and mouth disease to coxsackievirus A16; and hand, foot and mouth disease with neurologic complications to enterovirus 71. There are currently no treatments specific to human EV infections; surveillance of enterovirus infections such as this study provides may assist with evaluating the need to research and develop treatments for infections caused by virulent human EV genotypes.

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Section: Introductionmentioning

confidence: 99%

“…Several outbreaks have also been recorded in Australia (Gilbert et al, 1988;Sanders et al, 2006;McMinn et al, 2001b). Co-circulation of EV71 and CVA16 has contributed to serious HFMD outbreaks in China in (Zhang et al, 2009), Taiwan in 1998(Lin et al, 2003), and Malaysia in 1997(Podin et al, 2006.The enterovirus genome is a positive ssRNA molecule of approximately 7500 nt, comprising a single ORF flanked 59Abbreviations: CVA16, coxsackievirus A16; EV71, enterovirus 71; HEV, human enterovirus; HFMD, hand-foot-and-mouth disease; PV, poliovirus; UTR, untranslated region.The GenBank/EMBL/DDBJ accession numbers for the 59UTR sequences of EV71 and CVA16 are GU236109-GU236113 and GU236100-GU236108, respectively; and for the VP1 sequences are FJ868281 and GU142870-GU142873, and FJ868280, GU142867-GU142869 and GU232771-GU232775, respectively. and 39 by untranslated regions (UTRs).…”

mentioning

confidence: 99%

Molecular characterization of enterovirus 71 and coxsackievirus A16 using the 5′ untranslated region and VP1 region

Zhou

Kong

Wang

et al. 2011

Journal of Medical Microbiology

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Enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) are members of the species Human enterovirus A, and are both major and independent aetiological agents of hand-foot-and-mouth disease. The human enterovirus (HEV) 59 untranslated region (UTR) is fundamentally important for efficient virus replication and for virulence, whilst the VP1 region correlates well with antigenic typing by neutralization, and can be used for virus identification and evolutionary studies. A comparison was undertaken of the 59UTR and VP1 nucleotide sequences of five EV71 clinical isolates and 10 CVA16 clinical isolates from one laboratory with the 59UTR and VP1 sequences of 104 EV71 strains and 45 CVA16 strains available in GenBank. The genetic relationships were analysed using standard phylogenetic methods. The EV71 phylogenetic analysis showed that the VP1 sequences were clustered into three genogroups, A, B and C, with genogroups B and C further divided into five subgenogroups, B1-B5 and C1-C5, respectively. All EV71 strains were clustered similarly in the 59UTR and VP1 trees, except for one Taiwanese strain, which demonstrated different clustering in the two trees, suggesting a recombination event in the phylogeny. The CVA16 phylogenetic analysis showed that the VP1 sequences were clustered into two genogroups, A and B, with genogroup B further divided into B1 (B1a and B1b), B2 and a possible B3; and that a similar pattern and grouping of all strains were displayed in the 59UTR tree. This study demonstrated that comparing the two regions provides evidence of epidemiological linkage of HEV-A strains, and that mutation in the two regions plays a vital role in the evolution of these viruses. The combination of molecular typing and phylogenetic sequence analysis will be beneficial in both individual patient diagnosis and public health measures. INTRODUCTIONEnterovirus 71 (EV71) and coxsackievirus A16 (CVA16), members of the species Human enterovirus A in the genus Enterovirus, family Picornaviridae, are both major and independent aetiological agents of large outbreaks of handfoot-and-mouth disease (HFMD). In contrast to CVA16, EV71-associated HFMD is more frequently associated with serious neurological complications and fatalities (McMinn et al., 2001b). Initial EV71 isolates were identified in the USA and Australia in the early 1970s, and in HFMD outbreaks in Sweden and Japan (Wong et al., 2010). Since 1997, the Asia-Pacific region has had several large EV71 epidemics, including in the Chinese mainland, Taiwan, Singapore, Malaysia and Japan. Several outbreaks have also been recorded in Australia (Gilbert et al., 1988;Sanders et al., 2006;McMinn et al., 2001b). Co-circulation of EV71 and CVA16 has contributed to serious HFMD outbreaks in China in (Zhang et al., 2009), Taiwan in 1998(Lin et al., 2003), and Malaysia in 1997(Podin et al., 2006.The enterovirus genome is a positive ssRNA molecule of approximately 7500 nt, comprising a single ORF flanked 59Abbreviations: CVA16, coxsackievirus A16; EV71, enterovirus 71; HEV, human enterovirus; ...

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Sentinel surveillance for human enterovirus 71 in Sarawak, Malaysia: lessons from the first 7 years

Cited by 190 publications

References 23 publications

Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Molecular characterization of enterovirus 71 and coxsackievirus A16 using the 5′ untranslated region and VP1 region

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Sentinel surveillance for human enterovirus 71 in Sarawak, Malaysia: lessons from the first 7 years

Cited by 190 publications

References 23 publications

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Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Molecular characterization of enterovirus 71 and coxsackievirus A16 using the 5′ untranslated region and VP1 region

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