Abstract
Infection of enterovirus 71 (EV71) and associated hand, foot, and mouth disease (HFMD) are recognized as emerging public health issues worldwide. Hundreds of thousands of children are annually infected with EV71 and develop HFMD in China alone. Studies of EV71 infection are critical to the treatment and prevention of the associated HFMD outbreaks. In this report, we studied an outbreak of 105 HFMD cases in Shawo Township of China between September to October 2012. More than 90% of cases were children younger than 9 years old, with over 50% of cases aged 3–6 years old. Laboratory studies detected a high prevalence of EV71 and suggested EV71 as the most common enterovirus causing HFMD in Shawo. Sequencing analysis showed that the EV71 strains from Shawo belong to the C4 subgenotype, and are phylogenetically more related to those from the distant city of Nanchang than those from the nearby city of Wuhan with distinct variations. More girls were found to be associated with EV71 in Shawo whereas more boys were associated with EV71 in Wuhan and Nanchang. Our studies further the understanding of the molecular epidemiological features of HFMD and infection by enteroviruses in China.
Highlights
Infection of enterovirus 71 (EV71) and associated hand, foot, and mouth disease (HFMD) are recognized as emerging public health issues worldwide
We performed laboratory procedures such as quantitative RT-PCR and virus isolating and culture to analyze the samples for the presence of human enteroviruses, including EV71 and coxsackievirus A16 (CVA16), which are among the most common causes of HFMD
24 of 30 HFMD cases that were EVU positive in Shawo Village were positive for EV71 while 3 of 3 HFMD cases that were EVU positive in Huangshan Village were EV71 positive (Table 2). These results suggested that EV71 represented the major cause of the enterovirus infections associated with HFMD cases in Shawo Township
Summary
Infection of enterovirus 71 (EV71) and associated hand, foot, and mouth disease (HFMD) are recognized as emerging public health issues worldwide. We studied an outbreak of 105 HFMD cases in Shawo Township of China between September to October 2012. Hundreds of thousands of children develop HFMD each year in addition to recent outbreaks in Shanghai and Zunyi, with over 2,000,000 and 6,000 cases spanning one year, respectively[1,2,3]. We reported enterovirus infection and HFMD in the Shawo Township of China from September to October 2012. We have recently reported the infection of enteroviruses and HFMD outbreaks in Wuhan and in northern Hubei Province[29] as well as in the city of Nanchang in the adjacent Jiangxi Province between 2010 and 201130. HFMD outbreaks and their associated enterovirus infections in Shawo have not been reported. Unknown is the nature of the HFMD outbreaks and enterovirus infection in Hubei Province after 2011
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