Abstract
BackgroundEnterovirus 71 (EV71) belongs to picornavirus family and could be classified phylogenetically into three major genogroups (A, B and C) including 11 genotypes (A, B1-B5 and C1-C5). Since 1997, EV71 has caused large-scale of epidemics with neurological complications in Asian children. In Taiwan, nationwide EV71 epidemics with different predominant genotypes have occurred cyclically since 1998. A nationwide EV71 epidemic occurred again in 2012. We conducted genetic and antigenic characterizations of the 2012 epidemic.MethodsChang Gung Memorial Hospital (CGMH) is a medical center in northern Taiwan. In CGMH, specimens were collected from pediatric inpatients with suspected enterovirus infections for virus isolation. Enterovirus isolates were serotyped and genotyped and sera from EV71 inpatients were collected for measuring neutralizing antibody titers.ResultsThere were 10, 16 and 99 EV71 inpatients identified in 2010, 2011 and 2012, respectively. There were 82 EV71 isolates genotyped, which identified 17 genotype C4a viruses and 65 genotype B5 viruses. The genotype B5 viruses were not detected until November 2011 and caused epidemics in 2012. Interestingly, the B5-2011 viruses were genetically distinguishable from the B5 viruses causing the 2008 epidemic and are likely introduced from China or Southeastern Asia. Based on antigenic analysis, minor antigenic variations were detected among the B5-2008, B5-2011, C4a-2008 and C4a-2012 viruses but these viruses antigenically differed from genotype A.ConclusionsGenotype B5 and C4a viruses antigenically differ from genotype A viruses which have disappeared globally for 30 years but have been detected in China since 2008. Enterovirus surveillance should monitor genetic and antigenic variations of EV71.
Highlights
Enterovirus 71 (EV71) was first described in California, USA, in 1969
The genotype B5 viruses were not detected until November 2011 and caused epidemics in 2012
Genotype B5 and C4a viruses antigenically differ from genotype A viruses which have disappeared globally for 30 years but have been detected in China since 2008
Summary
Enterovirus 71 (EV71) was first described in California, USA, in 1969. Since EV71 has been identified globally. Two patterns of EV71 outbreaks have been reported: small-scale outbreaks with low mortality and large-scale outbreaks with high mortality. The latter pattern occurred in Bulgaria in 1975, in Hungary in 1978, in Malaysia in 1997, in Taiwan in 1998, in Singapore in 2000, in Vietnam in 2005, in Brunei in 2006, in China since 2007, and recently in Cambodia in 2012[1, 4, 5]. Since the 1998 epidemic, Taiwan Centers for Disease Control has established national enterovirus surveillance system and EV71 has been detected as an endemic disease with cyclical nationwide epidemics every 3–4 years[1, 6, 7]. In Taiwan, nationwide EV71 epidemics with different predominant genotypes have occurred cyclically since 1998. We conducted genetic and antigenic characterizations of the 2012 epidemic
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