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

Wei Li,Cong Ma,Changwen Ke,Hui Li,Lina Yi,Yonghui Zhang,Jinyan Lin,Jing Lu,Hong Xiao,Juan Su,Wanly Zhang,Hanri Zeng,Dawei Guan,Ray Borrow

doi:10.1371/journal.pone.0080515

Wei Li, Cong Ma + Show 12 more

Open Access

https://doi.org/10.1371/journal.pone.0080515

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Abstract

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.

Highlights

Hand, foot and mouth disease (HFMD) is a common and highly infectious disease [1]
These results indicate Enterovirus 71 (EV71) was the major pathogen of HFMD in Guangdong during the 2010 epidemic
Our previous epidemiology studies indicated the majority of EV71 infection occurred in preschool-aged children with the HFMD epidemic peak appeared in May and June [21]

Summary

Introduction

Foot and mouth disease (HFMD) is a common and highly infectious disease [1]. Characterized by fever, mouth ulcers and rash on hands and feet, the HFMD as itself is usually mild and selflimited [2,3]. Enterovirus 71(EV71) and Coxsackie A16 (CA16) are commonly recognized as the cause of HFMD [6,7]. Compared to CA16, EV71 is more often associated with severe HFMD cases [8]. There are no specific therapies to treat severe HFMD cases [9]. An effective vaccine for EV71 at phase 3 trial has been reported in China [13]. Human 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

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