Global Spatiotemporal Transmission Patterns of Human Enterovirus 71 from 1963 to 2019

ABSTRACT EV71 can cause large outbreaks of HFMD and severe neurological diseases, which is regarded as a major threat to public health especially in Asia-Pacific regions. However, the global spatiotemporal spread of this virus has not been identified. In this study, we used large sequence datasets and a Bayesian phylogenetic approach to compare the molecular epidemiology and geographical spread patterns of different EV71 subgroups globally. The study found that subgroups of HFMD presented global spatiotemporal variation, subgroups B0, B1 and B2, have caused early infections in Europe and America, and then subgroups C1, C2, C3, C4 replaced B0-B2 as the predominant genotypes especially in Asia-Pacific countries. The dispersal patterns of genotype B and subgroup C4 showed the complicated routes in Asia and the source might in some Asia countries, while subgroups C1 and C2 displayed more strongly support pathways globally especially in Europe. This study found the predominant subgroup of EV71 and its global spatiotemporal transmission patterns, which may be beneficial to reveal the long term global spatiotemporal transmission patterns of human enterovirus 71 and carry out the HFMD vaccine development.

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Human enterovirus 71 and hand, foot and mouth disease

Epidemiology and Infection ◽

10.1017/s0950268809991555 ◽

2010 ◽

Vol 138 (8) ◽

pp. 1071-1089 ◽

Cited By ~ 178

Author(s):

S. S. Y. WONG ◽

C. C. Y. YIP ◽

S. K. P. LAU ◽

K. Y. YUEN

Keyword(s):

Vaccine Development ◽

Enterovirus 71 ◽

Foot And Mouth Disease ◽

Mouth Disease ◽

Asia Pacific ◽

Human Enterovirus ◽

Human Enterovirus 71 ◽

Asian Pacific Region ◽

Route Of Transmission ◽

Foot And Mouth

SUMMARYHand, foot and mouth disease (HFMD) is generally a benign febrile exanthematous childhood disease caused by human enteroviruses. The route of transmission is postulated to be faeco-oral in developing areas but attributed more to respiratory droplet in developed areas. Transmission is facilitated by the prolonged environmental survival of these viruses and their greater resistance to biocides. Serious outbreaks with neurological and cardiopulmonary complications caused by human enterovirus 71 (HEV-71) seem to be commoner in the Asian Pacific region than elsewhere in the world. This geographical predilection is unexplained but could be related to the frequency of intra- and inter-typic genetic recombinations of the virus, the host populations' genetic predisposition, environmental hygiene, and standard of healthcare. Vaccine development could be hampered by the general mildness of the illness and rapid genetic evolution of the virus. Antivirals are not readily available; the role of intravenous immunoglobulin in the treatment of serious complications should be investigated. Monitoring of this disease and its epidemiology in the densely populated Asia Pacific epicentre is important for the detection of emerging epidemics due to enteroviruses.

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Hand, Foot and Mouth Disease (HFMD): An Update

Bangladesh Journal of Child Health ◽

10.3329/bjch.v40i2.31567 ◽

2017 ◽

Vol 40 (2) ◽

pp. 115-119 ◽

Cited By ~ 4

Author(s):

Probir Kumar Sarkar ◽

Nital Kumar Sarker ◽

Md Abu Tayab

Keyword(s):

Enterovirus 71 ◽

Foot And Mouth Disease ◽

Mouth Disease ◽

Coxsackie Virus ◽

Asia Pacific ◽

Human Enterovirus ◽

Small Scale ◽

Human Enterovirus 71 ◽

Mild Disease ◽

Foot And Mouth

Hand, foot, and mouth disease (HFMD) also known as vesicular stomatitis with exanthema, first reported in New Zealand in 1957 is caused by Coxsackie virus A16 (CVA16), human enterovirus 71 (HEV71) and occasionally by other HEV-A serotypes, such as Coxsackie virus A6 and Coxsackie virus A10, are also associated with HFMD and herpangina. While all these viruses can cause mild disease in children, EV71 has been associated with neurological disease and mortality in large outbreaks in the Asia Pacific region over the last decade. It is highly contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. This is characterized by erythrematous papulo vesicular eruptions over hand, feet, perioral area, knee, buttocks and also intra-orally mostly in children, typically occurs in small epidemics usually during the summer and autumn months. HFMD symptoms are usually mild and resolve on their own in 7 to 10 days. Treatment is symptomatic but good hygiene during and after infection is very important in preventing the spread of the disease. Though only small scale outbreaks have been reported from United States, Europe, Australia Japan and Brazil for the first few decade, since 1997 the disease has conspicuously changed its behavior as noted in different Southeast Asian countries. There was sharp rise in incidence, severity, complications and even fatal outcomes that were almost unseen before that period. There are reports of disease activity in different corners of India since 2004, and the largest outbreak of HFMD occurred in eastern part of India in and around Kolkata in 2007and Bhubaneswar, Odisha in 2009. In recent years there are cases of HFMD have been seen in Bangladesh also. Although of milder degree, continuous progress to affect larger parts of the neighboring may indicate vulnerability of Bangladesh from possible future outbreaks.Bangladesh J Child Health 2016; VOL 40 (2) :115-119

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Molecular Epidemiology of Human Enterovirus 71 Strains and Recent Outbreaks in the Asia-Pacific Region: Comparative Analysis of the VP1 and VP4 Genes

Emerging Infectious Diseases ◽

10.3201/eid0904.020395 ◽

2003 ◽

Vol 9 (4) ◽

pp. 461-468 ◽

Cited By ~ 192

Author(s):

Mary Jane Cardosa ◽

David Perera ◽

Betty A. Brown ◽

Doosung Cheon ◽

Hung Ming Chan ◽

...

Keyword(s):

Comparative Analysis ◽

Molecular Epidemiology ◽

Enterovirus 71 ◽

Asia Pacific ◽

Human Enterovirus ◽

Pacific Region ◽

Asia Pacific Region ◽

Human Enterovirus 71

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First seroepidemiological investigation of human enterovirus 71 in Iran

Iranian Journal of Microbiology ◽

10.18502/ijm.v13i4.6975 ◽

2021 ◽

Author(s):

Mahsa Javadi ◽

Ahmad Nejati ◽

Maryam Yousefi ◽

Mahmood Mahmoodi ◽

Zabihollah Shoja ◽

...

Keyword(s):

Neutralizing Antibodies ◽

Neurological Diseases ◽

Age Groups ◽

Enterovirus 71 ◽

Neutralizing Antibody ◽

Human Enterovirus ◽

Healthy Individuals ◽

Serum Samples ◽

Cross Sectional ◽

Human Enterovirus 71

Background and Objectives: Human Enterovirus 71 (EV-A71) is the causative agent for many dermal to neurological diseases especially polio-like paralysis outbreaks around the world. This study, the first of this kind in Iran, aimed to find neu- tralizing antibodies against EV-A71 in serum of healthy individuals in different age groups based on neutralization test (NT). Materials and Methods: In this cross-sectional study, 547 serum samples were collected from healthy individuals who were referring for routine checkup tests (aged from under 6 months to over 31 years old) to Imam-Khomeini Hospital in Tehran during January-December 2015. Serum samples were examined by NT in cell culture to detect neutralizing antibodies against EV-A71. In the next step, some of the positive samples were subjected to complete titration to determine the exact titer of anti-EV-A71 antibodies. Results: Of 547 samples, 310 (56.7%) were positive for EV-A71 neutralizing antibody. The presence of the antibody in- creased with age (p<0.001), and there was a significant statistical relationship between sex and the presence of antibody (p=0.009). Conclusion: Our results demonstrated an apparent but limited circulation of EV-A71 in our society. After the worldwide eradication of poliovirus, EV-A71 which can cause polio-likes syndrome, might be the new challenge for our health care system as regard more in depth research is however needed.

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