Enterovirus 71 Neutralizing Antibodies Seroepidemiological Research among Children in Guangzhou, China between 2014 and 2015: A Cross-Sectional Study

Zhang, Dingmei; Yan, Chen; Chen, Xiashi; He, Zhenjian; Zhu, Xun; Hao, Yuantao

doi:10.3390/ijerph14030319

Cited by 11 publications

(8 citation statements)

References 16 publications

(18 reference statements)

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“…A systematic review has demonstrated that the antibody level against EV71 or CoxA16 dramatically increased among children aged 1-4 years [27]. Zhang et al believed that the immune level to enterovirus would accordingly increase with increasing age [28]. Our results also clarified that younger children have a greater likelihood of HFMD reinfection.…”

Section: Discussionsupporting

confidence: 63%

Epidemiological characteristics of hand, foot and mouth disease reinfection in Guangzhou, Southern China from 2012 to 2017

Zhong

Wang

Chen

et al. 2019

Preprint

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Background: Hand, foot and mouth disease (HFMD) is a common infectious disease that occurs mostly in infants and children. Reinfection is not uncommon because of the limited cross-protection from infections of different enterovirus. This study was to investigate the epidemiological characteristics and its influential factors of HFMD reinfection in Guangzhou. Methods: Data on HFMD patients aged ≤5 years from 2012 to 2017 were extracted from surveillance system. Descriptive epidemiology method was adopted to analyze the characteristics of populations and time. Influential factors of reinfection were assessed using the logistic regression model. Results: Of 369,054 HFMD patients, 11,321 patients were classified as reinfection, corresponding to a rate of 3.07%. The reinfection rate in male was higher than in female (χ2=60.11, P<0.001). The reinfection rate in patients ≤1 year was 3.86%, which showed a downward trend with age (Z=37.37, Ptrend<0.001). The highest reinfection rate was observed in the scattered children (3.38%), followed by nursery care children and others (χ2=514.75, P<0.001). Besides, higher risk of reinfection was detected among those who were male, lower age group and other enteroviruses infection compared with their respective counterparts. Seasonality was illustrated according to the number of reinfections peaked from April to July. Time intervals curves revealed the number of reinfections gradually increased after 13 months from the initial infection. Conclusions: These results indicated that male ≤4 years, especially those lived scattered and infected with other enteroviruses were more likely to be reinfection. Administrations need to be alert to signs of HFMD reinfection. Effective interventions should be imposed on these high-risk children in time.

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Section: Discussionsupporting

confidence: 63%

Epidemiological characteristics of hand, foot and mouth disease reinfection in Guangzhou, Southern China from 2012 to 2017

Zhong

Wang

Chen

et al. 2019

Preprint

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“…Seroprevalence rates of enterovirus A71 (EV‐A71) infection in different age groups worldwide . The data of 26 studies were collected according to their age groups and geographic locations and represented by a green‐yellow‐red colour heatmap.…”

Section: Ev‐a71 Infection Is Common: Evidence From Seroepidemiology Smentioning

confidence: 99%

Immune responses against enterovirus A71 infection: Implications for vaccine success

Aw-Yong

NikNadia

Tan

et al. 2019

Reviews in Medical Virology

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Summary Enterovirus A71 (EV‐A71) from the Picornaviridae family is an important emerging pathogen causing hand, foot, and mouth disease (HFMD) outbreaks worldwide. EV‐A71 also caused fatal neurological complications in young children especially in Asia. On the basis of seroepidemiological studies from many Asian countries, EV‐A71 infection is very common. Children of very young age are particularly vulnerable. Large‐scale epidemics that occur every 3 to 4 years are associated with accumulation of an immunologically naive younger population. Capsid proteins especially VP1 with the presence of major B‐ and T‐cell epitopes are the most antigenic proteins. The nonstructural proteins mainly contribute to T‐cell epitopes that induce cross‐reactive immune responses against other enteroviruses. Dominant epitopes and their neutralization magnitudes differ in mice, rabbits, and humans. Neutralizing antibody is sufficient for immune protection, but poorer cellular immunity may lead to severe neurological complications and deaths. Some chemokines/cytokines are consistently found in severely ill patients, for example, IL‐6, IL‐10, IL‐17A, MCP‐1, IL‐8, MIG, IP‐10, IFN‐γ, and G‐CSF. An increase in white cell counts is a risk factor for severe HFMD. Recent clinical trials on EV‐A71 inactivated vaccine showed >90% efficacy and a robust neutralization response that was protective, indicating neutralizing antibody correlates for protection. No protection against other enteroviruses was observed. A comprehensive understanding of the immune responses to EV‐A71 infection will benefit the development of diagnostic tools, potential therapeutics, and subunit vaccine candidates. Future development of a multivalent enterovirus vaccine will require knowledge of correlates of protection, understanding of cross‐protection and memory T‐cell responses among enteroviruses.

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“…The median age of infection (50% seroprevalence) was about 3 years in southern Vietnam, which is much lower than that in Singapore (>17 years) and Taiwan (>15 years) but is higher than that in Cambodia (1.5 years) and similar to China (3.1 years) ( Table 1) [17][18][19][20][21]. In another study collecting sera after the 2005 epidemic in HCMC, seroprevalences of EV-A71 antibody were 5.6% at 1 years of age and 12.2% at 2 years of age [22], which indicate that more young children under 3 years of age were infected in the 2011 epidemic (15.8% at 1 years of age; 23.5% at 2 years of age) than in the 2005 epidemic (S2 Table) [ [22][23][24][25]. In contrast, seroprevalences of EV-A71 antibody in Singapore and Taiwan were much lower in recent years [17,19,23,25].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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Enterovirus-A71 (EV-A71) cyclically causes hand-foot-mouth disease (HFMD) epidemics in Asian children. An EV-A71 epidemic occurred in Southern Vietnam in 2011, but its scale is not clear. We collected residual sera from non-HFMD Vietnamese inpatients in 2012-2013 to determine seroprevalence of EV-A71 neutralizing antibodies, and measured cross-reactive neutralizing antibody titers against three EV-A71 genogroups. About 23.5% of 1-yearold children in Southern Vietnam has been infected by EV-A71, and the median age of infection was estimated to be 3 years. No significant antigenic variation could be detected among the three EV-A71 genogroups. The high seroprevalence of EV-A71 neutralizing antibody in children living in southern Vietnam indicates the necessity of introducing EV-A71 vaccines in southern Vietnam, particularly for children under 6 months of age. Moreover, it is critical to understand EV-A71 disease burden for formulating national vaccination policy. Author summaryEnterovirus-A71 (EV-A71), a member of the enterovirus genus, is a virulent pathogen causing neurological complications. EV-A71 mainly spreads through oral-fecal or oraloral transmission, as well as respiratory droplets. EV-A71 outbreaks have cyclically occurred throughout some Asian countries since 1997, with millions of people affected. The presence of serum neutralizing antibodies to EV-A71 can represent the prevalence of previous EV-A71 infections and seroprevalence studies are widely used to understand prevalence of infectious diseases. The results of our study demonstrate that about 50% of young children under 3 years of age were infected during the 2011 epidemic in southern Vietnam. The high seroprevalence of EV-A71 neutralizing antibody in children living in southern Vietnam indicates the necessity of introducing EV-A71 vaccines, particularly for children under 6 months of age. Moreover, it is critical to understand EV-A71 disease burden for formulating national vaccination policy in the future. PLOS NEGLECTED TROPICAL DISEASESPLOS Neglected Tropical Diseases | https://doi.

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Enterovirus 71 Neutralizing Antibodies Seroepidemiological Research among Children in Guangzhou, China between 2014 and 2015: A Cross-Sectional Study

Cited by 11 publications

References 16 publications

Epidemiological characteristics of hand, foot and mouth disease reinfection in Guangzhou, Southern China from 2012 to 2017

Epidemiological characteristics of hand, foot and mouth disease reinfection in Guangzhou, Southern China from 2012 to 2017

Immune responses against enterovirus A71 infection: Implications for vaccine success

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

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