An Investigation of Epidemic Enterovirus 71 Infection in Taiwan, 2008

Lee, Min Shi; Lin, Tzou Yien; Chiang, Pai-Shan; Li, Wen Chen; Luo, Shu Ting; Tsao, Kuo Chien; Liou, Guan Yuan; Huang, Mei; Hsia, Shao Hsuan; Huang, Yhu Chering; Chang, Shih Cheng

doi:10.1097/inf.0b013e3181e52945

Cited by 59 publications

(44 citation statements)

References 33 publications

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“…In Malaysia, the prevalent subgenotypes were C1, C2, B3, and B4 in 1997, but C1 and C3 in 2000 and B5 and C1 in 2003 and 2005, respectively [33]. The epidemic genotypes in Taiwan were C2 in 1998 but B4 from 2000 to 2003, C5 in 2006, and B5 in 2008 [34,35]. …”

Section: Discussionmentioning

confidence: 99%

Enterovirus genotypes causing hand foot and mouth disease in Shanghai, China: a molecular epidemiological analysis

Cao

et al. 2013

BMC Infect Dis

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BackgroundA rapid expansion of hand, foot, and mouth disease (HFMD) outbreaks has occurred and caused deaths in China in recent years, but little is known about the other etiologic agents except enterovirus 71 (EV71) and coxsackievirus A 16 (CA16). The objective of this study is to determine the genotype compositions of enterovirus causing HFMD in Shanghai and identify any associations between enterovirus types and clinical manifestations.MethodsStool specimens were collected from patients hospitalized for treatment of HFMD, from May 2010 to April 2011. Enterovirus was detected by reverse transcription PCR and directly genotyped by sequencing the PCR products. Phylogenetic analysis was based on the VP1 partial gene.ResultsOf 290 specimens, 277 (95.5%) tested positive for enterovirus. The major genotypes were EV71 (63.8%), CA10 (9.0%), CA6 (8.3%), CA16 (6.9%), CA12 (2.4%), and CA4 (1.4%). The EV71 strains belonged to the C4a subtype and CA16 belonged to the B subtype. CA6 was closely related to strains detected in Japan, Taiwan and China, and CA10, CA12 and CA4 were phylogenetically similar to other strains circulating in China. Mean hospital stays and the prevalence of complications in patients with EV71 infection were higher than those in patients in CA6, CA10 or CA16 infection (P < 0.05 for all comparisons). Children with CA12 infection were the youngest, and most likely have the highest risk of complications when compared to the other non-EV71 infection groups.ConclusionsThis study demonstrated a diversified pathogen compositions attributing to HFMD and clinical symptoms differing in enterovirus genotypes. It deserves our attention as early identification of enterovirus genotypes is important for diagnosis and treatment of HFMD patients.

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Section: Discussionmentioning

confidence: 99%

Enterovirus genotypes causing hand foot and mouth disease in Shanghai, China: a molecular epidemiological analysis

Cao

et al. 2013

BMC Infect Dis

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“…Hand, foot and mouth disease (HFMD) is a childhood disease causing substantial disease burden, particularly in Western Pacific Region [1–4]. Although HFMD is mainly a self-limited disease, severe complications may occur including brain-stem encephalitis, acute flaccid paralysis and aseptic meningitis [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of Enterovirus 71 Antibody Among Children in China

Yang

et al. 2015

Pediatric Infectious Disease Journal

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Background Hand, foot and mouth disease mostly affects children and carries a substantial disease burden in the Western Pacific region. Enterovirus 71 (EV71) is the most virulent causative agent, and a monovalent vaccine against EV71 will soon become commercially available in China. An improved understanding of EV71 epidemiology could aid policy decisions regarding childhood immunization in China. Objective We aimed to assess and summarize information to date from individual seroepidemiologic studies of EV71 in mainland China in order to determine patterns of the age-specific risk of infection. Methods A systematic review and meta-analysis of studies of children aged 0–15 years, published in English or Chinese, was conducted. Estimates of seroprevalence were summarized by age group. A mixed-effects regression model was used to explore factors co-varying with EV71 seroprevalence. Results We identified 42 published studies, including 15 in English. We found that an average of 78% of neonates were seropositive to EV71 infection but such maternally conferred immunity almost completely waned by 5 months. The seroprevalence of EV71 antibody increased directly with age among pre-school children, from 26% (95% CI, 18–33%) at 1 year to 70% (95% CI, 62–78%) at 5 years. Age of subjects, sample size, sampling year, sampling method, geographic latitude and publication language were associated with variations of individual seroprevalence estimates. Conclusions Seroprevalence of EV71 antibody gradually declined during the first five months in infants. Infection with EV71 was most likely to occur between 2 and 4 years. Our findings may be useful in informing population-based EV71 vaccination strategies.

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“…EV71 has been the cause of numerous epidemics of central nervous system infections in Europe and the Asia-Pacific region over the last 15 years (4,5,24,26,27). Although EV71 infection may be mild or unrecognized, brainstem encephalitis and noncardiogenic pulmonary edema caused many deaths in Asian outbreaks between 1997 and 2010.…”

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confidence: 99%

Fluoxetine Is a Potent Inhibitor of Coxsackievirus Replication

Zuo

Quinn²,

Kye³

et al. 2012

Antimicrob Agents Chemother

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ABSTRACTNo antiviral drugs currently exist for the treatment of enterovirus infections, which are often severe and potentially life threatening. Molecular screening of small molecule libraries identified fluoxetine, a selective serotonin reuptake inhibitor, as a potent inhibitor of coxsackievirus replication. Fluoxetine did not interfere with either viral entry or translation of the viral genome. Instead, fluoxetine and its metabolite norfluoxetine markedly reduced the synthesis of viral RNA and protein. In view of its favorable pharmacokinetics and safety profile, fluoxetine warrants additional study as a potential antiviral agent for enterovirus infections.

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An Investigation of Epidemic Enterovirus 71 Infection in Taiwan, 2008

Cited by 59 publications

References 33 publications

Enterovirus genotypes causing hand foot and mouth disease in Shanghai, China: a molecular epidemiological analysis

Enterovirus genotypes causing hand foot and mouth disease in Shanghai, China: a molecular epidemiological analysis

Seroprevalence of Enterovirus 71 Antibody Among Children in China

Fluoxetine Is a Potent Inhibitor of Coxsackievirus Replication

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