Seroepidemiology of human enterovirus71 and coxsackievirusA16 in Jiangsu province, China

Ji, Hong; Li, Liang; Liu, Yanming; Ge, Heng-Ming; Wang, Xushan; Hu, Jianli; Wu, Bin; Fu, Jianguang; Zhang, Zhenyu; Chen, XiaoQin; Zhang, Minglei; Ding, Qiang; Xu, Wenbo; Tang, Fenyang; Zhou, Minghao; Wang, Hua; Zhu, Fengcai

doi:10.1186/1743-422x-9-248

Cited by 41 publications

(50 citation statements)

References 30 publications

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“…This was in contrast to previous studies which found decreased EV71 GMT with age [25], [37]. The steady state of EV71 immune level may attribute to lasting EV71 circulation in mainland China since the 2008.…”

Section: Discussioncontrasting

confidence: 97%

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Seroprevalence of Human Enterovirus 71 and Coxsackievirus A16 in Guangdong, China, in Pre- and Post-2010 HFMD Epidemic Period

Liu

et al. 2013

PLoS ONE

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BackgroundHuman Enterovirus 71 and Coxsackie A16 have caused many outbreaks in the last decade in mainland China, resulting in thousands of fatal cases. Seroepidemiology which provides important information to document population immunity is rare in China.Methodology/Principal FindingsA cross sectional study of Enterovirus 71 (EV71) and Coxsackie A16 (CA16) seroprevalence was carried out in Guangdong, China, pre- and post- the 2010 hand, foot and mouth disease (HFMD) epidemic period. The levels of EV71 and CA16 specific antibodies were evaluated by a microneutralization test and the geometric mean titer (GMT) was calculated and compared. Our results indicated frequent infection by EV71 and CA16 in Guangdong before the 2010 epidemic. Only EV71 neutralizing antibody but not CA16 seroprevalence was significantly increased after the 2010 HFMD epidemic. Children less than 3 years old especially those aged 2 years showed the lowest positive rates for EV71 and CA16 NA before epidemic and the most significantly increased EV71 seroprevalence after epidemic. CA16 GMT values declined after the 2010 epidemic.ConclusionsThese results indicate EV71 was the major pathogen of HFMD in Guangdong during the 2010 epidemic. The infection occurs largely in children less than 3 years, who should have first priority to receive an EV71 vaccine.

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Section: Discussioncontrasting

confidence: 97%

“…The proportion of positive individuals identified in our results was slightly higher than the values observed in other cities in mainland China, including Lu’an, Shanghai and Jiangsu [19], [24], [25]. The difference might be related to the geographical difference in samples tested.…”

Section: Discussioncontrasting

confidence: 84%

Seroprevalence of Human Enterovirus 71 and Coxsackievirus A16 in Guangdong, China, in Pre- and Post-2010 HFMD Epidemic Period

Liu

et al. 2013

PLoS ONE

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“…2,19 As demonstrated here, EV71 antibody decreased between 0 to 4 months, remained at a low level until 10 months, and increased to a maximum at 36 months. The overall trends were consistent with those for another investigation conducted in the same region, 24 although, in our study, the seroprevalence between 4 and 10 months fluctuated somewhat. For neonates, the positive rate was higher than that for other areas.…”

Section: Discussionsupporting

confidence: 92%

“…This may be due to the presence of maternal antibody, for there is a strong correlation of neutralizing antibody in prenatal women and neonates. 2,19,24 Moreover, the low level of EV71 neutralizing antibody in children between 5 and 6 months of age showed that they were more likely to be infected, indicating the optimal time for vaccination. Nevertheless, application of these findings into strategies to improve the efficiency of control of HFMD remains to be determined.…”

Section: Discussionmentioning

confidence: 97%

Two models for changes of EV71 immunity in infants and young children

Wang

Zhu

et al. 2015

Human Vaccines & Immunotherapeutics

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Human enterovirus 71 (EV71) has been associated with outbreaks of hand-foot-and-mouth disease (HFMD) in China. Susceptibility to EV71 is associated with age, but few studies have been accomplished to measure such a relationship. A better understanding of the connection between susceptibility and age is necessary to develop strategies for control of HFMD. In 2010, a survey of an epidemic of EV71 was conducted in a northern city of Jiangsu Province in China. Samples were tested serologically to identify the EV71 neutralizing antibody. Two different mathematical models have now been employed to describe how this antibody varied with age, and parameters in the model were estimated from survey data. Both models depicted the variations in EV71-neutralizing antibody. Seroprevalence was high for neonates but decreased to near zero at 5 months of age. Subsequently, the EV71 antibody levels increased and then remained stable after about 36 months. For models 1 and 2, values for the coefficient of determination (R(2)) were 0.9458 and 0.9576, and values for root mean square error (RMSE) were 0.0755 and 0.0752, respectively. Model 2, formulated from the characteristics of development of the immune system, was more reliable than model 1, formulated from survey data, because the impact of the survey on the structure of the model was removed. Moreover, model 2 provided the possibility to define the parameters in a biological sense.

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“…Our meta-analysis showed that, on average, 78% of neonates in China investigated were seropositive (Figure 3, Appendix Figure 1), somewhat higher than reported in studies conducted in Viet Nam, Thailand and Singapore (ranging from 44–67%) [61–63], suggesting a high level of maternal antibody against EV71 infection in China, perhaps due to higher historical incidence of infections among adults [17, 29, 41, 64]. In general, the titer and duration of maternal immunity of infants are associated with the level of mother’s immunity [32].…”

Section: Discussionmentioning

confidence: 69%

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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Seroepidemiology of human enterovirus71 and coxsackievirusA16 in Jiangsu province, China

Cited by 41 publications

References 30 publications

Seroprevalence of Human Enterovirus 71 and Coxsackievirus A16 in Guangdong, China, in Pre- and Post-2010 HFMD Epidemic Period

Seroprevalence of Human Enterovirus 71 and Coxsackievirus A16 in Guangdong, China, in Pre- and Post-2010 HFMD Epidemic Period

Two models for changes of EV71 immunity in infants and young children

Seroprevalence of Enterovirus 71 Antibody Among Children in China

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