The Current Status of the Disease Caused by Enterovirus 71 Infections: Epidemiology, Pathogenesis, Molecular Epidemiology, and Vaccine Development.

Ping-Chin Chang,Kow-Tong Chen,Shou-Chien Chen

doi:10.3390/ijerph13090890

Abstract

Enterovirus 71 (EV71) infections have a major public health impact in the Asia-Pacific region. We reviewed the epidemiology, pathogenesis, and molecular epidemiology of EV71 infection as well as EV71 vaccine development. Previous studies were found using the search terms “enterovirus 71” and “epidemiology” or “pathogenesis” or “molecular epidemiology” or “vaccine” in Medline and PubMed. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded from the review. The reported epidemiology of cases caused by EV71 infection varied from country to country; seasonal variations in incidence were observed. Most cases of EV71 infection that resulted in hospitalization for complications occurred in children less than five years old. The brainstem was the most likely major target of EV71 infection. The emergence of the EV71 epidemic in the Asia-Pacific region has been associated with the circulation of different genetic lineages (genotypes B3, B4, C1, C2, and C4) that appear to be undergoing rapid evolutionary changes. The relationship between the gene structure of the EV71 virus and the factors that ensure its survival, circulation, and evasion of immunity is still unknown. EV71 infection has emerged as an important global public health problem. Vaccine development, including the development of inactivated whole-virus live attenuated, subviral particles, and DNA vaccines, has been progressing.

Highlights

Hand, foot, and mouth disease (HFMD) is a common childhood disease caused by enteroviruses.A proportion of HFMD patients develop severe neurological complications and die [1]
Human enteroviruses are divided into four species, including human enterovirus A (HEV-A), HEV-B, HEV-C, and HEV-D, based on homology within the ribonucleic acid (RNA) region coding for the VP1 capsid protein
This study indicated that warmer temperatures and elevated humidity would lead to an increased rate of Enterovirus 71 (EV71) infection in Taiwan

Summary

Introduction

Foot, and mouth disease (HFMD) is a common childhood disease caused by enteroviruses. A proportion of HFMD patients develop severe neurological complications and die [1]. Human enteroviruses are divided into four species, including human enterovirus A (HEV-A), HEV-B, HEV-C, and HEV-D, based on homology within the RNA region coding for the VP1 capsid protein. EV71 was known to cause several large-scale outbreaks of severe complications in children involving the central nervous system (CNS). Because of the potential of the virus to cause severe neurologic disease, we need to understand the characteristics of EV71 infection. Relevant information was extracted and classified with respect to the basic science (epidemiology, virology), the clinical indicators (symptomatology, visits to the emergency department, and hospitalization), the information source (laboratory, and surveillance), the year of publication, and the study design. Eighty-five percent of the studies were retrospective studies, 10% were perspective studies, and 5% used other study designs

Epidemiology

Molecular Epidemiology

Vaccine Development

Findings

Conclusions