1
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Gao F, Liu P, Huo Y, Bian L, Wu X, Liu M, Wang Q, He Q, Dong F, Wang Z, Xie Z, Zhang Z, Gu M, Xu Y, Li Y, Zhu R, Cheng T, Wang T, Mao Q, Liang Z. A screening study on the detection strain of Coxsackievirus A6: the key to evaluating neutralizing antibodies in vaccines. Emerg Microbes Infect 2024; 13:2322671. [PMID: 38390796 PMCID: PMC10906128 DOI: 10.1080/22221751.2024.2322671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/20/2024] [Indexed: 02/24/2024]
Abstract
The increasing incidence of diseases caused by Coxsackievirus A6 (CV-A6) and the presence of various mutants in the population present significant public health challenges. Given the concurrent development of multiple vaccines in China, it is challenging to objectively and accurately evaluate the level of neutralizing antibody response to different vaccines. The choice of the detection strain is a crucial factor that influences the detection of neutralizing antibodies. In this study, the National Institutes for Food and Drug Control collected a prototype strain (Gdula), one subgenotype D1, as well as 13 CV-A6 candidate vaccine strains and candidate detection strains (subgenotype D3) from various institutions and manufacturers involved in research and development. We evaluated cross-neutralization activity using plasma from naturally infected adults (n = 30) and serum from rats immunized with the aforementioned CV-A6 strains. Although there were differences between the geometric mean titer (GMT) ranges of human plasma and murine sera, the overall trends were similar. A significant effect of each strain on the neutralizing antibody test (MAX/MIN 48.0 ∼16410.3) was observed. Among all strains, neutralization of the S112 strain by 15 different sera resulted in higher neutralizing antibody titers (GMTS112 = 132.0) and more consistent responses across different genotypic immune sera (MAX/MIN = 48.0). Therefore, S112 may serve as a detection strain for NtAb testing in various vaccines, minimizing bias and making it suitable for evaluating the immunogenicity of the CV-A6 vaccine.
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Affiliation(s)
- Fan Gao
- School of Life Sciences, Tianjin University, Tianjin, People’s Republic of China
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Pei Liu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Yaqian Huo
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
- Department of Research & Development, Shanghai Institute of Biological Products Co., Ltd, Shanghai, People’s Republic of China
| | - Lianlian Bian
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Xing Wu
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Mingchen Liu
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Qian Wang
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Qian He
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Fangyu Dong
- Department of Research & Development, Taibang Biologic Group, Beijing, People’s Republic of China
| | - Zejun Wang
- Department of R&D, Wuhan Institute of Biological Products Co., LTD, Wuhan, People’s Republic of China
| | - Zhongping Xie
- Department of Production Management, Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, People’s Republic of China
| | - Zhongyang Zhang
- The Second Research Laboratory, National Vaccine and Serum Institute, Beijing, People’s Republic of China
| | - Meirong Gu
- R&D Center, Minhai Biotechnology Co., LTD, Beijing, People’s Republic of China
| | - Yingzhi Xu
- R&D Center, Minhai Biotechnology Co., LTD, Beijing, People’s Republic of China
| | - Yajing Li
- R&D Center, Sinovac Biotech Co., LTD, Beijing, People’s Republic of China
| | - Rui Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, People’s Republic of China
| | - Tong Cheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, People’s Republic of China
| | - Tao Wang
- School of Life Sciences, Tianjin University, Tianjin, People’s Republic of China
| | - Qunying Mao
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
| | - Zhenglun Liang
- Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of China
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2
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Roux H, Touret F, Coluccia A, Khoumeri O, Di Giorgio C, Majdi C, Sciò P, Silvestri R, Vanelle P, Roche M. New potent EV-A71 antivirals targeting capsid. Eur J Med Chem 2024; 276:116658. [PMID: 39088999 DOI: 10.1016/j.ejmech.2024.116658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 08/03/2024]
Abstract
The enterovirus is a genus of single-stranded, highly diverse positive-sense RNA viruses, including Human Enterovirus A-D and Human Rhinovirus A-C species. They are responsible for numerous diseases and some infections can progress to life-threatening complications, particularly in children or immunocompromised patients. To date, there is no treatment against enteroviruses on the market, except for polioviruses (vaccine) and EV-A71 (vaccine in China). Following a decrease in enterovirus infections during and shortly after the (SARS-Cov2) lockdown, enterovirus outbreaks were once again detected, notably in young children. This reemergence highlights on the need to develop broad-spectrum treatment against enteroviruses. Over the last year, our research team has identified a new class of small-molecule inhibitors showing anti-EV activity. Targeting the well-known hydrophobic pocket in the viral capsid, these compounds show micromolar activity against EV-A71 and a high selectivity index (SI) (5h: EC50, MRC-5 = 0.57 μM, CC50, MRC-5 >20 μM, SI > 35; EC50, RD = 4.38 μM, CC50, RD > 40 μM, SI > 9; 6c: EC50, MRC-5 = 0.29 μM, CC50, MRC-5 >20 μM, SI > 69; EC50, RD = 1.66 μM, CC50, RD > 40 μM, SI > 24; Reference: Vapendavir EC50, MRC-5 = 0.36 μM, CC50, MRC-5 > 20 μM, EC50, RD = 0.53 μM, CC50, RD > 40 μM, SI > 63). The binding mode of these compounds in complex with enterovirus capsids was analyzed and showed a series of conserved interactions. Consequently, 6c and its derivatives are promising candidates for the treatment of enterovirus infections.
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Affiliation(s)
- Hugo Roux
- Aix-Marseille Université, CNRS, ICR UMR 7273, PCR, Faculté de Pharmacie, 13005 Marseille, France
| | - Franck Touret
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), France
| | - Antonio Coluccia
- Laboratory affiliated with the Institute Pasteur Italy - Cenci Bolognetti Foundation, Department of Drug Chemistry and Technologies (M.B., A.C., R.S.), Sapienza University of Rome, Piazzale Aldo Moro 5, Roma 00185, Italy
| | - Omar Khoumeri
- Aix-Marseille Université, CNRS, ICR UMR 7273, PCR, Faculté de Pharmacie, 13005 Marseille, France
| | - Carole Di Giorgio
- Aix-Marseille Université, Avignon Université, CNRS, IRD, IMBE, Faculty of Pharmacy, Service of Environmental Mutagenesis, Marseille, France
| | - Chaimae Majdi
- Aix-Marseille Université, CNRS, ICR UMR 7273, PCR, Faculté de Pharmacie, 13005 Marseille, France
| | - Pietro Sciò
- Laboratory affiliated with the Institute Pasteur Italy - Cenci Bolognetti Foundation, Department of Drug Chemistry and Technologies (M.B., A.C., R.S.), Sapienza University of Rome, Piazzale Aldo Moro 5, Roma 00185, Italy
| | - Romano Silvestri
- Laboratory affiliated with the Institute Pasteur Italy - Cenci Bolognetti Foundation, Department of Drug Chemistry and Technologies (M.B., A.C., R.S.), Sapienza University of Rome, Piazzale Aldo Moro 5, Roma 00185, Italy
| | - Patrice Vanelle
- Aix-Marseille Université, CNRS, ICR UMR 7273, PCR, Faculté de Pharmacie, 13005 Marseille, France.
| | - Manon Roche
- Aix-Marseille Université, CNRS, ICR UMR 7273, PCR, Faculté de Pharmacie, 13005 Marseille, France.
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Wang J, Wu W, Wang W, Zhang J, Xiao J, Cai M, Guo J, Li R, Zhu S, Zhang W, Chen M, Teng Z. Seroprevalence of neutralizing antibodies against HFMD associated enteroviruses among healthy individuals in Shanghai, China, 2022. Virol Sin 2024; 39:694-698. [PMID: 38801978 DOI: 10.1016/j.virs.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Jiayu Wang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Wencheng Wu
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Wei Wang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Jingyi Zhang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Jianwei Xiao
- Microbiology Department, Yangpu Municipal Center for Disease Control and Prevention, Shanghai, 200090, China
| | - Mingyi Cai
- Microbiology Department, Jing'an Municipal Center for Disease Control and Prevention, Shanghai, 200070, China
| | - Jiaying Guo
- Microbiology Department, Changning Municipal Center for Disease Control and Prevention, Shanghai, 200050, China
| | - Run Li
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Wanju Zhang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Min Chen
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Zheng Teng
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China.
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Wang Y, Gao F, Liang Z, Sun H, Wang J, Mao Q. Establishment of the 1st Chinese national standard for CA6 neutralizing antibody. Hum Vaccin Immunother 2023; 19:2164140. [PMID: 36600518 PMCID: PMC9980696 DOI: 10.1080/21645515.2022.2164140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Coxsackievirus A6 (CA6) is one of the major causative agents of herpangina and hand-foot-mouth disease (HFMD). Since 2008, CA6 has circulated widely around the world. Especially in Asia-Pacific region CA6 had even replaced enterovirus A71 (EV71) and coxsackievirus A16 (CA16) as the main prevalent strain of HFMD. In the recent 10 years, monovalent and multivalent vaccines against CA6 have been researched and developed by manufacturers from China, Korea, and the USA. The neutralizing antibody titer is a key indicator for accurately evaluating immunogenicity of vaccine. However, so far, the World Health Organization international standard for CA6 neutralizing antibody has not been available. In order to meet the needs of evaluating the immunogenicity of vaccines against CA6, the first Chinese national standard for CA6 neutralizing antibody was established, which was conducted to ensure that methods used to measure the neutralizing antibody titers against CA6 are accurate, reliable, and comparable. Three lyophilized candidate standards (29#, 39# and 44#) were produced with 0.40 ml/vial from plasma samples donated by healthy individuals. The collaborative study showed that the 29# candidate standard could effectively minimize the variability in neutralization titers between labs and across challenging viruses of different genotypes (A, D1, and D3). Therefore, the 29# candidate sample was established as the first Chinese national standard for CA6 neutralizing antibody test. This standard has good long-term stability and was assigned a potency of 150 units per milliliter (U/ml) of CA6 neutralizing antibody. It will contribute to ensure uniformity of potency or activity of vaccines and potentially therapeutic antibody preparations.
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Affiliation(s)
- Yiping Wang
- National Institutes for Food and Drug Control, Beijing, China
| | - Fan Gao
- National Institutes for Food and Drug Control, Beijing, China
| | - Zhenglun Liang
- National Institutes for Food and Drug Control, Beijing, China
| | | | - Junzhi Wang
- National Institutes for Food and Drug Control, Beijing, China
| | - Qunying Mao
- National Institutes for Food and Drug Control, Beijing, China
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5
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Zhang T, Zhang Z, Yu Z, Huang Q, Gao D. Effects of behaviour change on HFMD transmission. JOURNAL OF BIOLOGICAL DYNAMICS 2023; 17:2244968. [PMID: 37581613 DOI: 10.1080/17513758.2023.2244968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/01/2023] [Indexed: 08/16/2023]
Abstract
We propose a hand, foot and mouth disease (HFMD) transmission model for children with behaviour change and imperfect quarantine. The symptomatic and quarantined states obey constant behaviour change while others follow variable behaviour change depending on the numbers of new and recent infections. The basic reproduction number R 0 of the model is defined and shown to be a threshold for disease persistence and eradication. Namely, the disease-free equilibrium is globally asymptotically stable if R 0 ≤ 1 whereas the disease persists and there is a unique endemic equilibrium otherwise. By fitting the model to weekly HFMD data of Shanghai in 2019, the reproduction number is estimated at 2.41. Sensitivity analysis for R 0 shows that avoiding contagious contacts and implementing strict quarantine are essential to lower HFMD persistence. Numerical simulations suggest that strong behaviour change not only reduces the peak size and endemic level dramatically but also impairs the role of asymptomatic transmission.
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Affiliation(s)
- Tongrui Zhang
- Department of Mathematics, Shanghai Normal University, Shanghai, People's Republic of China
| | - Zhijie Zhang
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, People's Republic of China
| | - Zhiyuan Yu
- Department of Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Qimin Huang
- Department of Mathematical and Computational Sciences, The College of Wooster, Wooster, OH, USA
| | - Daozhou Gao
- Department of Mathematics, Shanghai Normal University, Shanghai, People's Republic of China
- Department of Mathematics and Statistics, Cleveland State University, Cleveland, OH, USA
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6
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Zhou X, Qian K, Zhu C, Yi L, Tu J, Yang S, Zhang Y, Zhang Y, Xia W, Ni X, Xu T, He F, Li H. Surveillance, epidemiology, and impact of the coronavirus disease 2019 interventions on the incidence of enterovirus infections in Nanchang, China, 2010-2022. Front Microbiol 2023; 14:1251683. [PMID: 37920267 PMCID: PMC10618362 DOI: 10.3389/fmicb.2023.1251683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction Pathogen spectrum of Hand, foot and mouth disease (HFMD) has substantially changed in the past decade in China. Growing evidence has indicated that anti-COVID-19 nonpharmaceutical interventions (NPIs) can support control of various infectious diseases, including intestinal diseases. Methods In this study, HFMD cases were enrolled from sentinel hospitals of Nanchang, Jiangxi province, and enteroviruses were genotyped using specific real time RT-PCR. We systematically characterized the epidemiology of HFMD based on the continuous molecular surveillance and estimated the impact of COVID-19 intervention on HFMD incidence using seasonal autoregressive integrated moving average (ARIMA) models. Results A total of 10247 HFMD cases were included during 2010-2022, of which 6121 enterovirus (EV)-positive cases (59.7%) were identified by real-time RT-PCR. Over 80% cases were associated with EV-A71 and coxsackievirus A16 (CVA16) during 2010-2012, while the type distribution significantly changed as CVA6 emerged to be dominant, accounting for 22.6%-59.6% during 2013-2022. It was observed that the prevalence patterns of EV-A71 and CVA16 were similar and both of them peaked in the second quarter and then leveled off. However, CVA6 was generally prevalent around the fourth quarter, demonstrating a staggered prevalence during 2010-2019. During the COVID-19 epidemic, the seasonal HFMD epidemic peak was restrained, and the ARIMA analysis indicated that the COVID-19 intervention had mitigated EV transmission during the first COVID-19 outbreak in early 2020. In addition, bivariate Spearman's cross-correlation coefficients were estimated for the major types CVA6, CVA16 and EV-A71. Our analyses indicated the possible existence of correlations among CVA6, CVA16 and EV-A71 prevalence in the epidemiological level. Discussion Taken together, the type distribution of HFMD has substantially changed over the last decade and CVA6 and CVA16 are currently the most predominant types co-circulating in Nanchang. The anti-COVID-19 NPIs significantly reduced the incidence of EV infections.
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Affiliation(s)
- Xianfeng Zhou
- Cancer Research Center, Jiangxi University of Chinese Medicine, Nanchang, China
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Ke Qian
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Chunlong Zhu
- Clinical Laboratory, Third Hospital of Nanchang, Nanchang, China
| | - Liu Yi
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Junling Tu
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Shu Yang
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Yanxia Zhang
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Yanglin Zhang
- Clinical Laboratory, Third Hospital of Nanchang, Nanchang, China
| | - Wen Xia
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Xiansheng Ni
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Tielong Xu
- School of Life Science, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Fenglan He
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Hui Li
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
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7
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Song JM. Experimental animal models for development of human enterovirus vaccine. Clin Exp Vaccine Res 2023; 12:291-297. [PMID: 38025911 PMCID: PMC10655152 DOI: 10.7774/cevr.2023.12.4.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 08/26/2023] [Accepted: 08/26/2023] [Indexed: 12/01/2023] Open
Abstract
Enterovirus infections induce infectious diseases in young children, such as hand, foot, and mouth disease which is characterized by highly contagious rashes or blisters around the hands, feet, buttocks, and mouth. This predominantly arises from enterovirus A71 or coxsackievirus A16 infections and in severe cases, they can lead to encephalitis, paralysis, pulmonary edema, or even fatality, representing a global health threat. Due to the absence of effective therapeutic strategies for these infections, various experimental animal models are being investigated for the development of vaccines. During the early stages of research on enterovirus infections, non-human primate infections exhibited symptoms like those in humans, leading to their utilization as model animals. However, due to economic and ethical considerations, their current usage is limited. While enterovirus infections do not readily occur in mice, an infection model with mouse-adapted strain in neonatal mice has been employed. Cellular receptors have been identified in human cells, and genetically modified mice expressing these receptors have been used. Most recently, the utilization of Mongolian gerbil model is actively being considered and should be pursued for further animal model development. So, herein, we provide a summarized overview of the current portfolio of available enterovirus infection models, emphasizing their respective advantages and limitations.
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Affiliation(s)
- Jae Min Song
- School of Biopharmaceutical and Medical Sciences, Sungshin Women’s University, Seoul, Korea
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8
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Wang L, Xu C, Wang J, Qiao J, Wu N, Li L. Spatiotemporal associations between hand, foot and mouth disease and meteorological factors over multiple climate zones. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1493-1504. [PMID: 37458818 DOI: 10.1007/s00484-023-02519-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 05/25/2023] [Accepted: 07/05/2023] [Indexed: 08/17/2023]
Abstract
Prior studies of hand, foot, and mouth disease (HFMD) have often observed inconsistent results regarding meteorological factors. We propose the hypothesis that these meteorological associations vary in regions because of the heterogeneity of their geographical characteristics. We have tested this hypothesis by applying a geographical detector and Bayesian space-time hierarchy model to measure stratified spatiotemporal heterogeneity and local associations between meteorological factors and HFMD risk in five climate zones in China from January 2016 to December 2017. We found a significant spatial stratified heterogeneity in HFMD risk and climate zone explained 15% of the spatial stratified heterogeneity. Meanwhile, there was a significant temporal stratified heterogeneity of 14% as determined by meteorological factors. Average temperatures and relative humidity had a significant positive effect on HFMD in all climate zones, they were the most obvious in the southern temperate zone. In northern temperate, southern temperate, northern subtropics, middle subtropics and southern subtropics climate zone, a 1 °C rise in temperature was related to an increase of 3.99%, 13.76%, 4.38%, 3.99%, and 7.74% in HFMD, and a 1% increment in relative humidity was associated with a 1.51%, 5.40%, 2.21%, 3.44%, and 4.78% increase, respectively. These findings provide strong support for our hypotheses that HFMD incidence has a significant spatiotemporal stratified heterogeneity and different climate zones have distinct influences on the disease. These findings provide strong support for our hypotheses: HFMD incidence had significant spatiotemporal stratified heterogeneity and different climate zones had distinct influences on it. The study suggested that HFMD prevention and policy should be made according to meteorological variation in each climate zone.
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Affiliation(s)
- Li Wang
- College of Geography and Environmental Science, Henan University, Kaifeng, China
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Kaifeng, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China.
- University of Chinese Academy of Sciences, Beijing, China.
| | - Jiajun Qiao
- College of Geography and Environmental Science, Henan University, Kaifeng, China.
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Kaifeng, China.
| | - Nalin Wu
- College of Geography and Environmental Science, Henan University, Kaifeng, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Kaifeng, China
| | - Li Li
- Key Laboratory of Ecosystem Network Observation and Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
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9
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Wu W, Li B, Xie T. Children with severe enterovirus A71 infection. BMC Pediatr 2023; 23:172. [PMID: 37055743 PMCID: PMC10100469 DOI: 10.1186/s12887-023-03980-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/30/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND There are few reports on the timing of onset and the symptoms of enterovirus A71 (EV-A71) infection, which can easily be misdiagnosed. This study aimed to explore the clinical characteristics of children with severe EV-A71 infection. METHODS This retrospective observational study included children with severe EV-A71 infection admitted to Hebei Children's Hospital between January 2016 and January 2018. RESULTS A total of 101 patients were included: 57 males (56.4%) and 44 females (43.6%). They were 1-13 years of age. The symptoms were fever in 94 patients (93.1%), rash in 46 (45.5%), irritability in 70 (69.3%), and lethargy in 56 (55.4%). There were 19 (59.3%) patients with abnormal neurological magnetic resonance imaging [pontine tegmentum (n = 14, 43.8%), medulla oblongata (n = 11, 34.4%), midbrain (n = 9, 28.1%), cerebellum and dentate nucleus (n = 8, 25.0%), basal ganglia (n = 4, 12.5%), cortex (n = 4, 12.5%), spinal cord (n = 3, 9.3%), and meninges (n = 1, 3.1%)]. There was a positive correlation between the ratio of neutrophil count and white blood cell count in cerebrospinal fluid in the first 3 days of the disease (r = 0.415, P < 0.001). CONCLUSION The clinical symptoms of EV-A71 infection are fever and/or skin rash, irritability, and lethargy. Some patients have abnormal neurological magnetic resonance imaging. The white blood cell count in the cerebrospinal fluid of children with EV-A71 infection may increase alongside neutrophil counts.
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Affiliation(s)
- Wenjuan Wu
- Department of Neurology, Hebei Children's Hospital, Hebei Children's Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Pediatric Epilepsy and Neurological Diseases, 133 Jianhua Nan street, Shijiazhuang, 050031, China
| | - Baoguang Li
- Department of Neurology, Hebei Children's Hospital, Hebei Children's Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Pediatric Epilepsy and Neurological Diseases, 133 Jianhua Nan street, Shijiazhuang, 050031, China.
| | - Tao Xie
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
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10
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Shi Y, Chen P, Bai Y, Xu X, Liu Y. Seroprevalence of coxsackievirus A6 and enterovirus A71 infection in humans: a systematic review and meta-analysis. Arch Virol 2023; 168:37. [PMID: 36609748 PMCID: PMC9825098 DOI: 10.1007/s00705-022-05642-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/25/2022] [Indexed: 01/09/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is a common infectious disease in children. Enterovirus A71 (EV-A71) is one of the main pathogens, and coxsackievirus A6 (CVA6) has gradually become the dominant pathogen of HFMD in recent years. This study was conducted mainly to assess the serological prevalence of EV-A71 and CVA6 antibodies in people of different ages, sexes, and regions through a systematic review and meta-analysis. A comprehensive study was performed based on the EV-A71 and CVA6 serological literature published before May 2022. Heterogeneity analysis (Cochrane's Q test and the I2 statistic) and random effect models were adopted. Subgroup and meta-regression analyses were used to identify potential sources of heterogeneity in the data, and all analysis was performed using STATA version 16.0. This study included 71 studies involving 55,176 people from 13 countries that met the inclusion criteria. The serological prevalence of EV-A71 antibody in different studies was 4.31-88.8%, and that of CVA6 antibody was 40.8-80.9%. Meta-analysis results showed that the serum positive rate for EV-A71 antibody was 45.9% (95% CI: 37.6-54.1%). The rate in the Chinese population was 47.8% (95% CI: 42.4-53.2%), and in the other countries, it was 38% (95% CI: 23-55%). The serum positive rate for CVA6 antibody was 58.3% (95% CI: 46.5-70.2%). The rate in the Chinese population was 49.1% (95% CI: 38.3-59.9%), and in the other countries, it was 68% (95% CI: 51-83%). Subgroup analysis was also conducted. The seroprevalence of EV-A71 and CVA6 antibodies is related to age rather than gender or region. The rates of EV-A71 and CVA6 seropositivity are considerably lower in children younger than five years of age. However, the rates gradually increase with age. The findings of this study suggest that children under five years of age may be susceptible to EV-A71 and CVA6. Thus, safety education and vaccination should be strengthened accordingly. This study provides a basis for understanding the risk factors for EV-A71 and CVA6 infection in China and for deciding how to formulate standard preventive measures to prevent the spread of the virus.
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Affiliation(s)
- Yingying Shi
- grid.411854.d0000 0001 0709 0000Department of Immunology, School of Medicine, Jianghan University, Wuhan, Hubei China
| | - Peiqing Chen
- grid.411854.d0000 0001 0709 0000Department of Immunology, School of Medicine, Jianghan University, Wuhan, Hubei China
| | - Yijing Bai
- grid.411854.d0000 0001 0709 0000Department of Immunology, School of Medicine, Jianghan University, Wuhan, Hubei China
| | - Xuan Xu
- grid.411854.d0000 0001 0709 0000Department of Immunology, School of Medicine, Jianghan University, Wuhan, Hubei China
| | - Yongjuan Liu
- Department of Central Laboratory, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, 222000, Jiangsu, China.
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11
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Song J, Liu Y, Guo Y, Qu Z, Liu P, Li F, Yang C, Fan F, Chen Z. TMEM173 rs7447927 genetic polymorphism and susceptibility to severe enterovirus 71 infection in Chinese children. Immun Inflamm Dis 2022; 10:e742. [PMID: 36444630 PMCID: PMC9695089 DOI: 10.1002/iid3.742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/01/2022] [Accepted: 11/06/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION This study was designed to explore the association between the TMEM173 polymorphism (rs7447927) and the severity of enterovirus 71 (EV71) infection among Chinese children. METHODS The TMEM173 polymorphism was identified in EV71-infected patients (n = 497) and healthy controls (n = 535) using the improved multiplex ligation detection reaction (iMLDR). The interferon-α (IFN-α) serum levels were detected using enzyme linked immunosorbent assay (ELISA). RESULTS The frequencies of the GG genotype and G allele of TMEM173 rs7447927 in the mild EV71 infection and severe EV71 infection groups were markedly higher than those in the control group. The GG genotype and G allele frequencies in severely infected EV71 patients were significantly higher than those in mildly infected EV71 patients. Severely infected EV71 patients with the GG genotype had higher white blood cell counts (WBC), and C-reactive proteins (CRP), and blood glucose (BG) levels, longer fever duration, higher vomiting frequency, spirit changes, and electroencephalography (EEG) abnormalities. IFN-α serum concentration in severely infected patients was significantly higher than in the mildly infected group. The IFN-α concentration in the GG genotype was significantly higher compared with those in the GC and CC genotypes in severe cases. CONCLUSIONS The TMEM173 rs7447927 polymorphism was associated with EV71 infection susceptibility and severity. The G allele and GG genotype are susceptibility factors in the development of severe EV71 infection in Chinese children.
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Affiliation(s)
- Jie Song
- Department of PediatricsThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - Yedan Liu
- Department of PediatricsThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - Ya Guo
- Department of PediatricsShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Zhenghai Qu
- Department of PediatricsThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - Peipei Liu
- Department of PediatricsThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - Fei Li
- Department of PediatricsThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - Chengqing Yang
- Department of PediatricsThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - Fan Fan
- Department of Pharmacology and ToxicologyUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Zongbo Chen
- Department of PediatricsThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
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12
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The spatial-temporal distribution and etiological characteristics of hand-foot-and-mouth disease before and after EV‑A71 vaccination in Kunming, China, 2017-2020. Sci Rep 2022; 12:17028. [PMID: 36220850 PMCID: PMC9552732 DOI: 10.1038/s41598-022-21312-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 09/26/2022] [Indexed: 12/29/2022] Open
Abstract
After vaccination with enterovirus 71 (EV-A71), the prevalence of hand-foot-and-mouth disease (HFMD) remained high, and the spatial-temporal distribution of enteroviruses changed. Therefore, it is essential to define the temporal features, spatial distributions, and epidemiological and etiological characteristics of HFMD in Kunming. Between 2017 and 2020, a total of 36,540 children were diagnosed with HFMD in Kunming, including 32,754 children with enterovirus-positive clinical samples. Demographic, geographical, epidemiological and etiological data of the cases were acquired and analyzed. Other enteroviruses replaced EV-A71, and the incidence of EV-A71 decreased dramatically, whereas coxsackievirus A6 (CV-A6) and coxsackievirus A16 (CV-A16) had substantial outbreaks in 2018 and 2019, respectively. The major and minor peaks all extended for 2-4 months compared to before vaccination with the EV-A71 vaccine. From 2019 to 2020, CV-A6, as the predominant serotype, showed only a single peak. Although a high incidence of HFMD was observed in Guandu, Chenggong and Xishan, the annual incidence of different enterovirus serotypes was different in different regions. In 2017, other enteroviruses were most prevalent in Shilin. In 2018, CV-A16 and CV-A6 were most prevalent in Luquan and Shilin, respectively. In 2019, CV-A16 was most prevalent in Jinning. In 2020, CV-A6 and coxsackievirus A10 (CV-A10) were most prevalent in Luquan and Shilin, respectively. Meanwhile, the epidemic cycle of CV-A6 and CV-A16 was only 1 year, and CV-A10 and other enteroviruses were potential risk pathogens. The spatial and temporal distribution of HFMD varies at different scales, and the incidence of HFMD associated with different pathogens has obvious regional differences and seasonal trends. Therefore, research on multivalent combined vaccines is urgently needed, and proper preventive and protective measures could effectively control the incidence of HFMD-like diseases.
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13
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Wang J, Ding S, Xie W, Wang T, Qin Y, Zheng J, Yang X, Zhao H, Peng Z, Ma T. Epidemiological and etiological characteristics of mild hand, foot and mouth disease in children under 7 years old, Nanjing, China, 2010-2019. Arch Public Health 2022; 80:220. [PMID: 36209145 PMCID: PMC9548167 DOI: 10.1186/s13690-022-00974-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022] Open
Abstract
Background Mild hand, foot and mouth disease (HFMD) cases make up a relatively high proportion of HFMD while have often been overlooked. This study aimed to investigate the epidemiological and etiological characteristics of mild HFMD in Nanjing. Methods Data on mild HFMD cases, during 2010–2019 in Nanjing, were collected from the China Information System for Disease Control and Prevention. This study mainly focused on mild cases aged < 7 years. Descriptive analysis was used to summarize epidemiological and etiological characteristics of mild cases. Flexible spatial scan statistic was used to detect spatial clusters of mild cases. Results A total of 175,339 mild cases aged < 7 years were reported, accounting for 94.4% of all mild cases. There was a higher average annual incidence of mild HFMD in children aged < 7 years (4,428 cases/100,000) compared with children aged ≥ 7 years (14 cases/100,000, P < 0.001), and especially children aged 1-year-old (7,908 cases/100,000). Mild cases showed semi-annual peaks of activity, including a major peak (April to July) and a minor peak (September to November). The average annual incidence was higher in males (5,040 cases/100,000) than females (3,755 cases/100,000). Based on the cumulative reported cases, the most likely cluster was detected, including Yuhuatai District, Jiangning District, Jiangbei new Area, and Pukou District. The annual distribution of enterovirus serotypes showed a significant difference. During 2010–2016, Enterovirus 71 (EV71), Coxsackievirus A16 (Cox A16), and other non-EV71/Cox A16 EVs, accounted for 29.1%, 34.6%, 36.3% of all the enterovirus test positive cases, respectively. Moreover, during 2017–2019, Cox A6, Cox A16, EV71, and other non-EV71/Cox A16/Cox A6 EVs, accounted for 47.3%, 32.5%, 10.7%, 9.5%, respectively. Conclusions Children under 7 years old are at higher risk of mild HFMD. Regions with high risk are mainly concentrated in the areas surrounding central urban areas. Cox A16 and Cox A6 became the dominant serotypes and they alternated or were co-epidemic. Our findings could provide valuable information for improving the regional surveillance, prevention and control strategies of HFMD. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00974-4.
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Affiliation(s)
- Junjun Wang
- grid.508377.eNanjing Municipal Center for Disease Control and Prevention, No. 2 Zizhulin, Nanjing, 210003 Jiangsu China ,grid.198530.60000 0000 8803 2373Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 China ,grid.198530.60000 0000 8803 2373Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Songning Ding
- grid.508377.eDepartment of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, No. 2 Zizhulin, Nanjing, 210003 Jiangsu China
| | - Weijia Xie
- grid.410570.70000 0004 1760 6682Department of Epidemiology, College of Preventive Medicine, Army Medical University, Chongqing, China
| | - Taiwu Wang
- Center for Disease Control and Prevention of Eastern Theatre Command, Nanjing, Jiangsu China
| | - Ying Qin
- grid.198530.60000 0000 8803 2373Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 China
| | - Jiandong Zheng
- grid.198530.60000 0000 8803 2373Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 China
| | - Xiaokun Yang
- grid.198530.60000 0000 8803 2373Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 China
| | - Hongting Zhao
- grid.198530.60000 0000 8803 2373Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 China
| | - Zhibin Peng
- grid.198530.60000 0000 8803 2373Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 China
| | - Tao Ma
- grid.508377.eDepartment of Acute Infectious Diseases Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, No. 2 Zizhulin, Nanjing, 210003 Jiangsu China
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14
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Cui Y, Yang YN, Zheng RR, Xie MZ, Zhang WX, Chen LY, Du J, Yang Y, Xi L, Li H, Li HJ, Lu QB. Epidemiological characteristics of hand, foot, and mouth disease clusters during 2016-2020 in Beijing, China. J Med Virol 2022; 94:4934-4943. [PMID: 35655366 DOI: 10.1002/jmv.27906] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/27/2022] [Accepted: 05/31/2022] [Indexed: 12/19/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is an infectious disease that usually occurs in children under 5 years and is caused by a group of enteroviruses. This study aimed to investigate the epidemiological characteristics of HFMD clusters from 2016 to 2020 in Tongzhou, Beijing, and explored the genetic evolution of CV-A6. The HFMD case information came from the Information System of China Center for Disease Control and Prevention (CDC), as well as the clusters information verification and on-site investigation by Tongzhou CDC. ARIMA model was applied to forecast HFMD clusters in 2020. Totally 440 HFMD clusters were reported during 2016-2020. The large peak of the clusters occurred in April-July, followed by a smaller peak in October-November during 2016-2019. However, in 2020, the two peaks disappeared. The main site of HFMD clusters was childcare facilities (65.0%) and mostly occurred in urban areas (46.1%). The detection rate of CV-A6 was the highest (36.1%), and cases with CV-A6 infection had the highest proportion of fever. The phylogenetic analysis based on CV-A6 VP1 gene showed that the predominant strains mainly located in Group F during 2016-2017, while changed into Group A during 2018-2020. HFMD clusters presented seasonality, mainly located in childcare facilities and urban areas, and CV-A6 was the major causative agent. Targeted prevention and control measures should be taken to reduce HFMD clusters.
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Affiliation(s)
- Yan Cui
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, China
| | - Yan-Na Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, China
| | - Ran-Ran Zheng
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, China
| | - Ming-Zhu Xie
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
| | - Wan-Xue Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
| | - Lin-Yi Chen
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
| | - Yang Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Lu Xi
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, China
| | - Hua Li
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, China
| | - Hong-Jun Li
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Diseases Prevention and Control, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China.,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
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15
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Duan X, Zhang C, Wang X, Ren X, Peng H, Tang X, Zhang L, Chen Z, Ye Y, Zheng M, Zhong W, Chen X, Zeng Y, Yuan P, Long L. Molecular epidemiology and clinical features of hand, foot and mouth disease requiring hospitalization after the use of enterovirus A71 inactivated vaccine in Chengdu, China, 2017-2022: a descriptive study. Emerg Microbes Infect 2022; 11:2510-2519. [PMID: 36103331 PMCID: PMC9621254 DOI: 10.1080/22221751.2022.2125346] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Three inactivated enterovirus A71 (EV-A71) vaccines have been widely vaccinated among children in the targeted age group in mainland China since mid-2016. However, comprehensive virological surveillance of hand, foot and mouth disease (HFMD) over multiple years after the use of EV-A71 vaccines has rarely been conducted. Using long-term data extracted from the Public Health and Clinical Center of Chengdu, we described the clinical, aetiological, and epidemiological characteristics of HFMD inpatients after the use of EV-A71 vaccines from 2017 through 2022. A total of 5115 patients were selected for analysis with a male-to-female ratio of 1.63:1 and were mostly under 5 years of age (97.6%). Among these cases, 4.3% presented with severe symptoms, and 4.1% of severe cases experienced significant complications. EV-A71 was no longer the major serotype for laboratory-confirmed HFMD, responsible for 15.6% of severe cases and 1.2% of mild cases. A significant downwards trend of EV-A71 infections was observed after the use of EV-A71 vaccines (P for trend < 0.001). Coxsackievirus A6 was the predominant pathogen, accounting for 63.5% of mild cases and 36.2% of severe cases. Coxsackievirus A10 (CV-A10) and A16 were sporadically detected, and an upwards trend was observed in the proportion of CV-A10 infections. This study provides baseline molecular epidemiology for the evaluation of EV-A71 vaccination impact and potential serotype replacement based on HFMD inpatients. Additional nationwide and population-based epidemiologic and serologic studies are essential to elucidate HFMD dynamics after the use of EV-A71 vaccines, and to inform public health authorities to introduce optimized intervention strategies.
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Affiliation(s)
- Xiaoxia Duan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Chaoyong Zhang
- Public Health Clinical Center of Chengdu, Sichuan, China
| | - Xiao Wang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Xueling Ren
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Hongxia Peng
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Xueqin Tang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Liangzhi Zhang
- Department of Immunization Program, Chengdu Municipal Center for Disease Control and Prevention, Sichuan, China
| | - Zhenhua Chen
- Department of Microbiology Laboratory, Chengdu Municipal Center for Disease Control and Prevention, Sichuan, China
| | - Yan Ye
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Mengmou Zheng
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Wanzhen Zhong
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Xiyue Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Yilan Zeng
- Public Health Clinical Center of Chengdu, Sichuan, China
| | - Ping Yuan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Lu Long
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
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16
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Cheng Q, Collender PA, Heaney AK, McLoughlin A, Yang Y, Zhang Y, Head JR, Dasan R, Liang S, Lv Q, Liu Y, Yang C, Chang HH, Waller LA, Zelner J, Lewnard JA, Remais JV. Optimizing laboratory-based surveillance networks for monitoring multi-genotype or multi-serotype infections. PLoS Comput Biol 2022; 18:e1010575. [PMID: 36166479 PMCID: PMC9543988 DOI: 10.1371/journal.pcbi.1010575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 10/07/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022] Open
Abstract
With the aid of laboratory typing techniques, infectious disease surveillance networks have the opportunity to obtain powerful information on the emergence, circulation, and evolution of multiple genotypes, serotypes or other subtypes of pathogens, informing understanding of transmission dynamics and strategies for prevention and control. The volume of typing performed on clinical isolates is typically limited by its ability to inform clinical care, cost and logistical constraints, especially in comparison with the capacity to monitor clinical reports of disease occurrence, which remains the most widespread form of public health surveillance. Viewing clinical disease reports as arising from a latent mixture of pathogen subtypes, laboratory typing of a subset of clinical cases can provide inference on the proportion of clinical cases attributable to each subtype (i.e., the mixture components). Optimizing protocols for the selection of isolates for typing by weighting specific subpopulations, locations, time periods, or case characteristics (e.g., disease severity), may improve inference of the frequency and distribution of pathogen subtypes within and between populations. Here, we apply the Disease Surveillance Informatics Optimization and Simulation (DIOS) framework to simulate and optimize hand foot and mouth disease (HFMD) surveillance in a high-burden region of western China. We identify laboratory surveillance designs that significantly outperform the existing network: the optimal network reduced mean absolute error in estimated serotype-specific incidence rates by 14.1%; similarly, the optimal network for monitoring severe cases reduced mean absolute error in serotype-specific incidence rates by 13.3%. In both cases, the optimal network designs achieved improved inference without increasing subtyping effort. We demonstrate how the DIOS framework can be used to optimize surveillance networks by augmenting clinical diagnostic data with limited laboratory typing resources, while adapting to specific, local surveillance objectives and constraints.
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Affiliation(s)
- Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Philip A. Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Alexandra K. Heaney
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Aidan McLoughlin
- Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Yang Yang
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Yuzi Zhang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Jennifer R. Head
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Rohini Dasan
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Song Liang
- Department of Environmental and Global Health College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Qiang Lv
- Institute of Health Informatics, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Yaqiong Liu
- Institute of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Changhong Yang
- Division of Business Management and Quality Control, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Jon Zelner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
- Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Joseph A. Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Justin V. Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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17
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Zhou Y, Zhou J, Yang J, Qiu Q, Wang L, Yang J, Li Y, Liang L, Cui P, Cheng Y, Zheng W, Shi H, Gong H, Wang K, Zhou C, Chu JJH, Yu H. Comparison of Neutralizing Antibody Response Kinetics in Patients with Hand, Foot, and Mouth Disease Caused by Coxsackievirus A16 or Enterovirus A71: A Longitudinal Cohort Study of Chinese Children, 2017-2019. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 209:280-287. [PMID: 35777850 DOI: 10.4049/jimmunol.2200143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Hand, foot, and mouth disease (HFMD), which is mainly caused by coxsackievirus A16 (CVA16) or enterovirus A71 (EV-A71), poses a serious threat to children's health. However, the long-term dynamics of the neutralizing Ab (NAb) response and ideal paired-serum sampling time for serological diagnosis of CVA16-infected HFMD patients were unclear. In this study, 336 CVA16 and 253 EV-A71 PCR-positive HFMD inpatients were enrolled and provided 452 and 495 sera, respectively, for NAb detection. Random-intercept modeling with B-spline was conducted to characterize NAb response kinetics. The NAb titer of CVA16 infection patients was estimated to increase from negative (2.1, 95% confidence interval [CI]: 1.4-3.3) on the day of onset to a peak of 304.8 (95% CI: 233.4-398.3) on day 21 and then remained >64 until 26 mo after onset. However, the NAb response level of EV-A71-infected HFMD patients was much higher than that of CVA16-infected HFMD patients throughout. The geometric mean titer was significantly higher in severe EV-A71-infected patients than in mild patients, with a 2.0-fold (95% CI: 1.4-3.2) increase. When a 4-fold rise in titer was used as the criterion for serological diagnosis of CVA16 and EV-A71 infection, acute-phase serum needs to be collected at 0-5 d, and the corresponding convalescent serum should be respectively collected at 17.4 (95% CI: 9.6-27.4) and 24.4 d (95% CI: 15.3-38.3) after onset, respectively. In conclusion, both CVA16 and EV-A71 infection induce a persistent humoral immune response but have different NAb response levels and paired-serum sampling times for serological diagnosis. Clinical severity can affect the anti-EV-A71 NAb response.
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Affiliation(s)
- Yonghong Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiaxin Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jianli Yang
- Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Qi Qiu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Lili Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Junmei Yang
- Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lu Liang
- West China School of Public Health, Sichuan University, Sichuan, China; and
| | - Peng Cui
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yibing Cheng
- Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Wen Zheng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Huilin Shi
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Hui Gong
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Kai Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Chongchen Zhou
- Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Justin Jang Hann Chu
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology and Infectious Disease Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China;
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Song J, Liu Y, Guo Y, Liu P, Li F, Yang C, Pan X, Yi L, Fan F, Zhao H, Chen Z. Association of the IRAK4 rs4251545 genetic polymorphism with severity of enterovirus-71 infection in Chinese children. Immun Inflamm Dis 2022; 10:e614. [PMID: 35478439 PMCID: PMC9017637 DOI: 10.1002/iid3.614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION This study aimed to explore the association between the IRAK4 polymorphism rs4251545 and the severity of enterovirus 71 (EV71) infection in Chinese children. METHODS We analyzed the IRAK4 polymorphism rs4251545 in 617 EV71-infected patients and 410 controls using the improved multiplex ligation detection reaction. IRAK4 mRNA expression was tested by qRT-PCR. Serum concentrations of IL-6 and NF-κB were detected using ELISA. RESULTS The frequencies of the GA + AA genotype and A allele in the mild EV71 infection group and in the severe EV71 infection group were significantly higher than those in the normal control group. The frequency of the GA + AA genotype and A allele in severely infected EV71 patients was markedly higher than that in mildly infected EV71 patients. IRAK4 mRNA expression in mildly infected EV71 patients and severely infected patients was significantly higher than that in the control group. IRAK4 mRNA expression in GA + AA genotypes in both mild and severe EV71 infection groups was significantly higher than that in patients with the GG genotype. IL-6 concentration and the ratio of IL-6/NF-κB in severe EV71 cases were significantly lower in patients with the GA + AA genotype than in those with the GG genotype. The ratio of IL-6/NF-κB was distinctly higher in severely infected EV71 patients than in mildly infected and control subjects. CONCLUSIONS The IRAK4 polymorphism rs4251545 was associated with the susceptibility and severity of EV71 infection. The A allele is a susceptible factor in the development of severe EV71 infection in Chinese children.
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Affiliation(s)
- Jie Song
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yedan Liu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Ya Guo
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Peipei Liu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Fei Li
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Chengqing Yang
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaoyu Pan
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Liping Yi
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Fan Fan
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Han Zhao
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Zongbo Chen
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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He F, Rui J, Deng Z, Zhang Y, Qian K, Zhu C, Yu S, Tu J, Xia W, Zhu Q, Chen S, Chen T, Zhou X. Surveillance, Epidemiology and Impact of EV-A71 Vaccination on Hand, Foot, and Mouth Disease in Nanchang, China, 2010-2019. Front Microbiol 2022; 12:811553. [PMID: 35069515 PMCID: PMC8770912 DOI: 10.3389/fmicb.2021.811553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/14/2021] [Indexed: 12/22/2022] Open
Abstract
After the first national-scale outbreak of Hand, foot, and mouth disease (HFMD) in China, a national surveillance network was established. Here we described the epidemiology and pathogenic profile of HFMD and the impact of EV-A71 vaccination on pathogen spectrum of enteroviruses in the southeastern Chinese city of Nanchang during 2010–2019. A total of 7,951 HFMD cases from sentinel hospitals were included, of which 4,800 EV-positive cases (60.4%) were identified by real-time RT-PCR. During 2010–2012, enterovirus 71 (EV-A71) was the main causative agent of HFMD, causing 63.1% of cases, followed by 19.3% cases associated with coxsackievirus A16 (CV-A16). Since 2013, the proportion of other enteroviruses has increased dramatically, with the sub genotype D3 strain of Coxsackievirus A6 (CV-A6) replacing the dominance of EV-A71. These genetically diverse native strains of CV-A6 have co-transmitted and co-evolved in Nanchang. Unlike EV-A71 and CV-A16, most CV-A6 infections were concentrated in autumn and winter. The incidence of EV-A71 infection negatively correlated with EV-A71 vaccination (r = −0.990, p = 0.01). And severe cases sharply declined as the promotion of EV-A71 vaccines. After 2-year implementation of EV-A71 vaccination, EV-A71 is no longer detected from the reported HFMD cases in Nanchang. In conclusion, EV-A71 vaccination changed the pattern of HFMD epidemic, and CV-A6 replaced the dominance of EV-A71 over time.
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Affiliation(s)
- Fenglan He
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Zhiqiang Deng
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Yanxia Zhang
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Ke Qian
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Chunhui Zhu
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Shanshan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Junling Tu
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Wen Xia
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Qingxiong Zhu
- Department of Pediatrics, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Shengen Chen
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xianfeng Zhou
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Nanchang Center for Disease Control and Prevention, Nanchang, China
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Wang J, Liu J, Fang F, Wu J, Ji T, Yang Y, Liu L, Li C, Zhang W, Zhang X, Teng Z. Genomic surveillance of coxsackievirus A10 reveals genetic features and recent appearance of genogroup D in Shanghai, China, 2016–2020. Virol Sin 2022; 37:177-186. [PMID: 35234621 PMCID: PMC9170976 DOI: 10.1016/j.virs.2022.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
Coxsackievirus A10 (CVA10) is one of the major causative agents of hand, foot and mouth disease (HFMD). To investigate the epidemiological characteristics as well as genetic features of CVA10 currently circulating in Shanghai, China, we collected a total of 9,952 sporadic HFMD cases from January 2016 to December 2020. In the past five years, CVA10 was the fourth prevalent causatives associated with HFMD in Shanghai and the overall positive rate was 2.78%. The annual distribution experienced significant fluctuations over the past five years. In addition to entire VP1 sequencing, complete genome sequencing and recombination analysis of CVA10 isolates in Shanghai were further performed. A total of 64 near complete genomes and 11 entire VP1 sequences in this study combined with reference sequences publicly available were integrated into phylogenetic analysis. The CVA10 sequences in this study mainly belonged to genogroup C and presented 91%–100% nucleotide identity with other Chinese isolates based on VP1 region. For the first time, our study reported the appearance of CVA10 genogroup D in Chinese mainland, which had led to large-scale outbreaks in Europe previously. The recombination analysis showed the recombination break point located between 5,100 nt and 6,700 nt, which suggesting intertypic recombination with CVA16 genogroup D. To conclusion, CVA10 genogroup C was the predominant genogroup in Shanghai during 2016–2020. CVA10 recombinant genogroup D was firstly reported in circulating in Chinese mainland. Continuous surveillance is needed to better understand the evolution relationships and transmission pathways of CVA10 to help to guide disease control and prevention. Systematic profiles of genetic features of CVA10 near complete genome. First report of the appearance of CVA10 genogroup D in Chinese mainland. Genomic comparisons indicate the potential recombinant origin of CVA10 genogroup D.
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21
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Jiang L, Jiang H, Tian X, Xia X, Huang T. Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008-2019. BMC Infect Dis 2021; 21:751. [PMID: 34348655 PMCID: PMC8336324 DOI: 10.1186/s12879-021-06462-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/25/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province. METHODS Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination. RESULTS A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province. CONCLUSIONS Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.
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Affiliation(s)
- Li Jiang
- Kunming Children's Hospital, Kunming, Yunnan, People's Republic of China
| | - Hongchao Jiang
- Kunming Children's Hospital, Kunming, Yunnan, People's Republic of China
| | - Xin Tian
- Kunming Children's Hospital, Kunming, Yunnan, People's Republic of China
| | - Xueshan Xia
- Kunming University of Science and Technology, Kunming, Yunnan, People's Republic of China
| | - Tian Huang
- Yunnan Provincial Center for Disease Control and Prevention, 158 Dongsi Street, Kunming, Yunnan, 650022, People's Republic of China.
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刘 立, 刘 志, 张 良, 李 宁, 方 挺, 张 栋, 许 国, 詹 思. [Epidemiological and etiological characteristics of hand, foot and mouth disease among children aged 5 years and younger in Ningbo (2016 to 2019)]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:491-497. [PMID: 34145850 PMCID: PMC8220059 DOI: 10.19723/j.issn.1671-167x.2021.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To describe the epidemiological and etiological characteristics of hand, foot and mouth disease (HFMD) among children aged 5 years and younger in Ningbo after the access of entero-virus-A71 vaccine (2016 to 2019). METHODS A retrospective cohort study were performed in children aged 5 years and younger in Ningbo from 2016 to 2019. Data for incidence of HFMD was collected from the National Notifiable Disease Surveillance Reporting System and the Electronic Medical Records (EMRs) System, while the demographic information was derived from the Immunization Information System. Speci-mens were detected by real-time fluorescence quantitative PCR and the Wilson method was used to estimate the incidence rate and 95% confidence interval. RESULTS From 2016 to 2019, a total of 1 044 800 residential children were observed in this population-based cohort. In the study, 102 471 cases of HFMD were diagnosed in 2 651 081 person-years, revealing an overall incidence density of 3 865.25/100 000 person-years. There was no significant decline in the number of the cases after the vaccine was available. The number of the patients of hand foot mouth disease during the four years was 93 421, of whom 84 875 (90.85%) had only one incident record, while 8 946 (9.15%) had 2 or more cases in this period; there were 69 771 (66.06%) patients who only needed to see a doctor once for each disease, 19.92% of the patients needed to be treated twice, and 14 801 (14.02%) patients needed to go to the hospital or clinic three times or more. The incidence of HFMD showed obvious seasonality and periodicity, which mainly concentrated in April to July each year, and the epidemic cycle was 2 years; most of the cases were 1 to 3-year old children, with more cases in male. The incidence density varied across the region, with the highest density observed in Ninghai (4 524.76/100 000 person-years), followed by Xiangshan (3 984.22/100 000 person-years). In 3 748 library-conformed cases, 2 834(75.61%) were detected positive, among which enterovirus-A71, Cox-A16 and other enteroviruses accounted for 9.03%, 31.55% and 59.42%, respectively. During the study period, the cumulative coverage of enterovirus-A71 vaccine increased year by year, with the proportion of enterovirus-A71 and severe cases both gradually decreasing. CONCLUSION The current status of hand, foot and mouth disease in Ningbo is still serious. Children under 3-year old (especially male children aged 1 year) were the key population for prevention and control. Vaccination might lead to changes in major pathogenic virus type, of which more attention should be paid to the potential impact on disease surveillance, prevention and control.
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Affiliation(s)
- 立立 刘
- 北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 志科 刘
- 北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 良 张
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 宁 李
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 挺 方
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 栋梁 张
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 国章 许
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 思延 詹
- 北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
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23
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刘 立, 刘 志, 张 良, 李 宁, 方 挺, 张 栋, 许 国, 詹 思. [Epidemiological and etiological characteristics of hand, foot and mouth disease among children aged 5 years and younger in Ningbo (2016 to 2019)]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:491-497. [PMID: 34145850 PMCID: PMC8220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To describe the epidemiological and etiological characteristics of hand, foot and mouth disease (HFMD) among children aged 5 years and younger in Ningbo after the access of entero-virus-A71 vaccine (2016 to 2019). METHODS A retrospective cohort study were performed in children aged 5 years and younger in Ningbo from 2016 to 2019. Data for incidence of HFMD was collected from the National Notifiable Disease Surveillance Reporting System and the Electronic Medical Records (EMRs) System, while the demographic information was derived from the Immunization Information System. Speci-mens were detected by real-time fluorescence quantitative PCR and the Wilson method was used to estimate the incidence rate and 95% confidence interval. RESULTS From 2016 to 2019, a total of 1 044 800 residential children were observed in this population-based cohort. In the study, 102 471 cases of HFMD were diagnosed in 2 651 081 person-years, revealing an overall incidence density of 3 865.25/100 000 person-years. There was no significant decline in the number of the cases after the vaccine was available. The number of the patients of hand foot mouth disease during the four years was 93 421, of whom 84 875 (90.85%) had only one incident record, while 8 946 (9.15%) had 2 or more cases in this period; there were 69 771 (66.06%) patients who only needed to see a doctor once for each disease, 19.92% of the patients needed to be treated twice, and 14 801 (14.02%) patients needed to go to the hospital or clinic three times or more. The incidence of HFMD showed obvious seasonality and periodicity, which mainly concentrated in April to July each year, and the epidemic cycle was 2 years; most of the cases were 1 to 3-year old children, with more cases in male. The incidence density varied across the region, with the highest density observed in Ninghai (4 524.76/100 000 person-years), followed by Xiangshan (3 984.22/100 000 person-years). In 3 748 library-conformed cases, 2 834(75.61%) were detected positive, among which enterovirus-A71, Cox-A16 and other enteroviruses accounted for 9.03%, 31.55% and 59.42%, respectively. During the study period, the cumulative coverage of enterovirus-A71 vaccine increased year by year, with the proportion of enterovirus-A71 and severe cases both gradually decreasing. CONCLUSION The current status of hand, foot and mouth disease in Ningbo is still serious. Children under 3-year old (especially male children aged 1 year) were the key population for prevention and control. Vaccination might lead to changes in major pathogenic virus type, of which more attention should be paid to the potential impact on disease surveillance, prevention and control.
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Affiliation(s)
- 立立 刘
- 北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 志科 刘
- 北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - 良 张
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 宁 李
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 挺 方
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 栋梁 张
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 国章 许
- 宁波市疾病控制与预防中心,浙江宁波 315010Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, Zhejiang, China
| | - 思延 詹
- 北京大学公共卫生学院流行病与卫生统计学系,北京 100191Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
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Chen GP, Xiang K, Sun L, Shi YL, Meng C, Song L, Liu RS, Li WD, Pan HF. TLR3 polymorphisms are associated with the severity of hand, foot, and mouth disease caused by enterovirus A71 in a Chinese children population. J Med Virol 2021; 93:6172-6179. [PMID: 34061379 DOI: 10.1002/jmv.27115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 04/15/2021] [Accepted: 05/29/2021] [Indexed: 11/07/2022]
Abstract
Hand, foot, and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is a contagious viral disease, and toll-like receptors (TLRs) play essential roles in resisting the pathogen. The aim of this study was to assess the potential relationship between several TLRs polymorphisms and the HFMD severity in a Chinese children population. A total of 328 Chinese children with HFMD were included in the present study. The polymorphisms of TLR3 (rs3775290, rs3775291, rs3775296, rs1879026, rs5743312, rs5743313, rs5743303, rs13126816, and rs3775292), TLR4 (rs4986790, rs4986791, rs2149356, rs11536889, and rs41426344), TLR7 (rs179009, rs179010, rs179016, rs3853839, rs2302267, rs1634323, and rs5741880), and TLR8 (rs3764880, rs2159377, rs2407992, rs5744080, rs3747414, rs3764879, and rs5744069) genes were selected. The study indicated that individuals with the GG genotype of TLR3 single-nucleotide polymorphism rs1879026 had a higher risk of developing severe cases (GG vs. GT: OR = 1.875; 95% CI, 1.183-2.971; p = .007). Meanwhile, TLR3 rs3775290 CC genotype and C allele were associated with lower disease severity in females (CC vs. CT: OR = 0.350; 95% CI, 0.163-0.751; p = .006; C vs. T: OR = 0.566; 95% CI, 0.332-0.965; p = .036). TLR3 rs3775291 CC genotype showed 2.537 folds higher risk of developing severe cases in females (CC vs. CT: OR = 2.537; 95% CI, 1.108-5.806; p = .026). Moreover, TLR3 rs1879026 GG genotype was found to be related to increased risk of severe cases in males (GG vs. GT: OR = 2.076; 95% CI, 1.144-3.768; p = .016). The current findings show that the genetic variants of TLR3 rs1879026, rs3775290, and rs3775291 are associated with the severity of EV-A71-associated HFMD in a Chinese children population.
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Affiliation(s)
- Guo-Ping Chen
- Department of Infectious Diseases, Anhui Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Kun Xiang
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Liang Sun
- Department of Infectious Diseases, Fuyang Center for Disease Control and Prevention, Fuyang, Anhui, China
| | - Yong-Lin Shi
- Department of Infectious Diseases, Anhui Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Can Meng
- Department of Infectious Diseases, Anhui Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Lv Song
- Department of Infectious Diseases, Anhui Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Rui-Shan Liu
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Wei-Dong Li
- Department of Infectious Diseases, Anhui Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
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The changes in the epidemiology of hand, foot, and mouth disease after the introduction of the EV-A71 vaccine. Vaccine 2021; 39:3319-3323. [PMID: 33994239 DOI: 10.1016/j.vaccine.2021.05.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/25/2021] [Accepted: 05/03/2021] [Indexed: 12/22/2022]
Abstract
Three inactive monovalent EV-A71 vaccines have been launched in China since 2016, which may change the HFMD pathogen spectrum and epidemiological trend. Using notifications from the national surveillance system, we analyzed the epidemiological character profiles and the possible pathogen replacement. The proportion of HFMD cases aged 0-12 months decreased from 23.0% to 15.3% between 2013-2015 and 2017-2019 (p < 0.01). EV-A71 among laboratory-confirmed severe cases in 2013-2015 (62.8%) transformed to other EVs (67.2%) in 2017-2019. The age distribution of EV-A71 infection shifted to the older. The cumulative coverage of the EV-A71 vaccine for children aged six months to five years in Guangxi has increased, while in severe cases, the positive rate declined. After gradually expanded vaccination, EV-A71 associated incidence rate, case-severity rate has decreased, and other serotypes are becoming dominant. Thus, bivalent even polyvalent vaccines are urgently needed to control HFMD.
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26
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Novel capsid binder and PI4KIIIbeta inhibitors for EV-A71 replication inhibition. Sci Rep 2021; 11:9719. [PMID: 33958691 PMCID: PMC8102518 DOI: 10.1038/s41598-021-89271-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 04/16/2021] [Indexed: 11/22/2022] Open
Abstract
The Hand, Foot and Mouth Disease (HFMD) is a highly contagious viral illness generally manifests as a mild disease in young children and immunocompromised adults. It has however emerged as a significant public health threat in recent years as outbreaks have been occurring regularly, especially in the Asia–Pacific. The disease can result from infections by a wide variety of human enteroviruses, particularly, Enterovirus A71 (EV-A71) has garnered more attention due to its association with severe disease in infected patients. Despite the potential to result severe neurological complications or even fatality, there is currently no effective antiviral for treatment of EV-A71 infections and the only vaccines available are restricted to distribution in China. In this study, we report the in vitro and in vivo evaluation of two candidate antiviral compounds active against EV-A71, a viral capsid inhibitor (G197) and a novel host-targeting phosphatidylinositol 4-kinase III beta inhibitor (N373) which, especially when used in combination, can significantly improve the survival and pathology of infected mice.
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Incidence of Infection of Enterovirus 71 and Coxsackieviruses A6 and A16 among Household Contacts of Index Cases in Dong Thap Province, Southern Vietnam. BIOMED RESEARCH INTERNATIONAL 2021; 2020:9850351. [PMID: 33274234 PMCID: PMC7695493 DOI: 10.1155/2020/9850351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/03/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Abstract
Background Scarce information exists about immunity to hand, foot, and mouth disease (HFMD) among household contacts of index cases in Vietnam and what that means for reducing ongoing HFMD transmission in the community. Methods We analyzed neutralizing antibodies (NT) and the incidence of enterovirus (EVs) infection among household contacts of index cases in a province where HFMD remains endemic. Throat swab and 2 mL blood samples from household contacts were collected at enrollment, during and after 2 weeks follow-up. Results The incidence of EV-A71 infection among household contacts was 40/84 (47.6%, 95% Cl: 36.9-58.3%), compared with 106/336 (31.5%, 95% Cl: 26.6-36.5%) for CV-A6 and 36/107 (33.6%, 95% Cl: 24.7-42.6%) for CV-A16. The incidence of CV-A6 infection was fairly constant across ages; in contrast, CV-A71 and CV-A16 had some variation across ages. At baseline, higher geometric mean titer (GMT) of EV-A71, CV-A6, and CV-A16 antibody titers was found for 25-34-year groups (range 216.3 to 305.0) compared to the other age groups. There was a statistically significant difference in GMT values of CV-A6 and CV-A16 between those who had an infection or did not have infection among households with an index case of these serotypes. Conclusions Our results indicated that adults were becoming infected with HFMD and could be contributing to the transmission. There is, therefore, a need for considering the household setting as an additional target for intervention programs for HFMD.
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Xie J, Yang X, Duan L, Chen K, Liu P, Zhan W, Zhang C, Zhao H, Wei M, Tang Y, Luo M. One-Step Reverse-Transcription Recombinase Polymerase Amplification Using Lateral Flow Strips for the Detection of Coxsackievirus A6. Front Microbiol 2021; 12:629533. [PMID: 33613499 PMCID: PMC7889601 DOI: 10.3389/fmicb.2021.629533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/14/2021] [Indexed: 11/13/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common infectious disease affecting mainly children under 5 years of age. Coxsackievirus A6 (CVA-6), a major causative pathogen of HFMD, has caused outbreaks in recent years. Currently, no effective vaccine or antiviral treatments are available. In this study, one-step reverse-transcription recombinase polymerase amplification (RT-RPA), combined with a disposable lateral flow strip (LFS) assay, was developed to detect CVA-6. This assay can be performed in less than 35 min at 37°C without expensive instruments, and the result can be observed directly with the naked eye. The sensitivity of the RT-RPA-LFS was 10 copies per reaction, which was comparable to that of the conventional real-time quantitative polymerase chain reaction (qPCR) assays. Moreover, the assay specificity was 100%. The clinical performance of the RT-RPA-LFS assay was evaluated using 142 clinical samples, and the coincidence rate between RT-RPA-LFS and qPCR was 100%. Therefore, our RT-RPA-LFS assay provides a simple and rapid approach for point-of-care CVA-6 diagnosis.
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Affiliation(s)
- Jia Xie
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xiaohan Yang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, China
| | - Lei Duan
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Keyi Chen
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, China
| | - Pan Liu
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, China
| | - Wenli Zhan
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, China
| | - Changbin Zhang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, China
| | - Hongyu Zhao
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, China
| | - Mengru Wei
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yuan Tang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Mingyong Luo
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, China
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29
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Lin S, Yang L, Wang S, Weng B, Lin M. Bioinformatics Analysis of Key micro-RNAs and mRNAs under the Hand, Foot, and Mouth Disease Virus Infection. Pol J Microbiol 2021; 69:479-490. [PMID: 33574876 PMCID: PMC7812361 DOI: 10.33073/pjm-2020-052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
To clarify crucial key micro-RNAs and mRNAs associated with hand, foot, and mouth disease (HFMD) virus infection, we conducted this bioinformatics analysis from four GEO datasets. The following datasets were used for the analysis: GSE85829, GSE94551, GSE52780, and GSE45589. Differentially expressed genes (DEGs) were acquired, and the analysis of functional and pathway enrichment and the relative regulatory network were conducted. After screening common differentially expressed miRNAs (DE-miRNAs), five key miRNAs were acquired: miR-100-3p, miR-125a-3p, miR-1273g-3p, miR-5585-3p, and miR-671-5p. There were three common enriched GO terms between miRNA-derived prediction and mRNA-derived analysis: biosynthetic process, cytosol, and nucleoplasm. There was one common KEGG pathway, i.e., cell cycle shared between miRNA-based and mRNA-based enrichment. Using TarBase V8 in DIANA tools, we acquired 1,520 potential targets (mRNA) from the five key DE-miRNAs, among which the159 DE-mRNAs also included 11 DEGs. These common DEGs showed a PPI network mainly connected by SMC1A, SMARCC1, SF3B3, LIG1, and BRMS1L. Together, changes in five key miRNAs and 11 key mRNAs may play crucial roles in HFMD progression. A combination of these roles may benefit the early diagnosis and treatment of HFMD.
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Affiliation(s)
- Sheng Lin
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Liu Yang
- Unimed Scientific Inc. Wuxi, Wuxi, China
| | - Shibiao Wang
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Bin Weng
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Min Lin
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
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30
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Min N, Ong YHB, Han AX, Ho SX, Yen EWP, Ban KHK, Maurer-Stroh S, Chong CY, Chu JJH. An epidemiological surveillance of hand foot and mouth disease in paediatric patients and in community: A Singapore retrospective cohort study, 2013-2018. PLoS Negl Trop Dis 2021; 15:e0008885. [PMID: 33566802 PMCID: PMC7901731 DOI: 10.1371/journal.pntd.0008885] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 02/23/2021] [Accepted: 10/13/2020] [Indexed: 11/30/2022] Open
Abstract
Background While hand, foot and mouth disease (HFMD) is primarily self-resolving—soaring incidence rate of symptomatic HFMD effectuates economic burden in the Asia-Pacific region. Singapore has seen a conspicuous rise in the number of HFMD cases from 2010s. Here, we aims to identify the serology and genotypes responsible for such outbreaks in hospitals and childcare facilities. Methods We studied symptomatic paediatric HFMD cases from 2013 to 2018 in Singapore. Surveillance for subclinical enterovirus infections was also performed in childcares at the same time period. Results Genotyping 101 symptomatic HFMD samples revealed CV-A6 as the major etiological agent for recent outbreaks. We detected infections with CV-A6 (41.0%), EV-A71 (7%), CV-A16 (3.0%), coxsackievirus A2, CV-A2 (1.0%) and coxsackievirus A10, CV-A10 (1.0%). Phylogenetic analysis of local CV-A6 strains revealed a high level of heterogeneity compared against others worldwide, dissimilar to other HFMD causative enteroviruses for which the dominant strains and genotypes are highly region specific. We detected sub-clinical enterovirus infections in childcare centres; 17.1% (n = 245) tested positive for enterovirus in saliva, without HFMD indicative symptoms at the point of sample collection. Conclusions CV-A6 remained as the dominant HFMD causative strain in Singapore. Silent subclinical enteroviral infections were detected and warrant further investigations. In most cases, Hand Foot and Mouth Disease or HFMD typically manifest in mild fever along with sore throat and rashes on the body. From 2010 onwards, Singapore has seen a steady increase in the case number of HFMD reaching tens of thousands in recent years. HFMD is caused by intestinal viruses and in this study, we established with molecular surveillance methods that one of the causative serotypes, CV-A6 is the major etiological agent for HFMD in Singapore for the current decade. We discovered that circulating enterovirus, CV-A6 in Singapore share similarities in genetic make-up to those currently circulating strains found worldwide and found to be especially close to the ones in neighbouring countries. HFMD spreads from person to person, especially in high-risk areas such as childcare centers where children congregate. Therefore, we conducted saliva collections routinely from childcare centers across Singapore and found that subclinical enterovirus infections have also been prevailing in clusters, occurring silently and unnoticed.
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Affiliation(s)
- Nyo Min
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yasmin Hui Binn Ong
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Alvin X. Han
- Protein Sequence Analysis Group, Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Si Xian Ho
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Emmerie Wong Phaik Yen
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Kenneth Hon Kim Ban
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sebastian Maurer-Stroh
- Protein Sequence Analysis Group, Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Biological Sciences (DBS), National University of Singapore (NUS), Singapore, Singapore, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Justin Jang Hann Chu
- Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Collaborative and Translation Unit for HFMD, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- * E-mail:
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31
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Zhang Z, Liu Y, Liu F, Ren M, Nie T, Cui J, Chang Z, Li Z. Basic Reproduction Number of Enterovirus 71 Coxsackievirus A16 and A6: Evidence from Outbreaks of Hand, Foot and Mouth Disease in China between 2011 and 2018. Clin Infect Dis 2020; 73:e2552-e2559. [PMID: 33320199 DOI: 10.1093/cid/ciaa1853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Enterovirus 71 (EV-A71), Coxsackievirus A16 (CV-A16) and Coxsackievirus A6 (CV-A6) are common serotypes causing hand, foot, and mouth disease (HFMD). Analyses on the basic reproduction number (R0) of common pathogens causing HFMD are limited and there are no related studies using field data from outbreaks in mainland China. METHODS We estimated the pathogen-specific basic reproduction number based on laboratory-confirmed HFMD outbreaks (clusters of ≥10 HFMD cases) reported to the national surveillance system between 2011 and 2018. The reproduction numbers were calculated using a mathematical model and the cumulative cases during the initial growth periods. RESULTS This study included 539 outbreaks, of which 198 were caused by EV-A71, 316 by CV-A16, and 25 by CV-A6. All 10417 cases involved were children. Assuming the outbreaks occurred in closed systems and the incubation period is 5 days, the median R0s of EV-A71, CV-A16, and CV-A6 were 5.06 [2.81, 10.20], 4.84 [3.00, 9.00] and 5.94 [3.27, 10.00] (Median [IQR]). After adjusting for seroprevalences, the R0s for EV-A71, CV-A16 (optimistic and conservative scenarios), and CV-A6 were 12.60 [IQR: 7.35, 25.40], 9.29 [IQR: 6.01, 19.20], 15.50 [IQR: 9.77, 30.40], and 25.80 [IQR: 14.20, 43.50], respectively. We did not observe changes in the R0s of EV-A71 after vaccine licensure (p-value = 0.67). CONCLUSIONS HFMD is highly transmissible when caused by the three most common serotypes. In mainland China, it primarily affects young children. Although a vaccine became available in 2016, we have not yet observed any related changes in the disease dynamics.
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Affiliation(s)
- Zhong Zhang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China.,Chinese Field Epidemiology Training Program (CFETP), Beijing, China
| | - Yang Liu
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Beijing, China
| | - Fengfeng Liu
- Division of Infectious disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Minrui Ren
- Division of Infectious disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Taoran Nie
- Division of Infectious disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinzhao Cui
- Division of Infectious disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaorui Chang
- Division of Infectious disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhongjie Li
- Division of Infectious disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
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32
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Cheng Q, Collender PA, Heaney AK, Li X, Dasan R, Li C, Lewnard JA, Zelner JL, Liang S, Chang HH, Waller LA, Lopman BA, Yang C, Remais JV. The DIOS framework for optimizing infectious disease surveillance: Numerical methods for simulation and multi-objective optimization of surveillance network architectures. PLoS Comput Biol 2020; 16:e1008477. [PMID: 33275606 PMCID: PMC7744064 DOI: 10.1371/journal.pcbi.1008477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 12/16/2020] [Accepted: 10/28/2020] [Indexed: 11/28/2022] Open
Abstract
Infectious disease surveillance systems provide vital data for guiding disease prevention and control policies, yet the formalization of methods to optimize surveillance networks has largely been overlooked. Decisions surrounding surveillance design parameters-such as the number and placement of surveillance sites, target populations, and case definitions-are often determined by expert opinion or deference to operational considerations, without formal analysis of the influence of design parameters on surveillance objectives. Here we propose a simulation framework to guide evidence-based surveillance network design to better achieve specific surveillance goals with limited resources. We define evidence-based surveillance design as an optimization problem, acknowledging the many operational constraints under which surveillance systems operate, the many dimensions of surveillance system design, the multiple and competing goals of surveillance, and the complex and dynamic nature of disease systems. We describe an analytical framework-the Disease Surveillance Informatics Optimization and Simulation (DIOS) framework-for the identification of optimal surveillance designs through mathematical representations of disease and surveillance processes, definition of objective functions, and numerical optimization. We then apply the framework to the problem of selecting candidate sites to expand an existing surveillance network under alternative objectives of: (1) improving spatial prediction of disease prevalence at unmonitored sites; or (2) estimating the observed effect of a risk factor on disease. Results of this demonstration illustrate how optimal designs are sensitive to both surveillance goals and the underlying spatial pattern of the target disease. The findings affirm the value of designing surveillance systems through quantitative and adaptive analysis of network characteristics and performance. The framework can be applied to the design of surveillance systems tailored to setting-specific disease transmission dynamics and surveillance needs, and can yield improved understanding of tradeoffs between network architectures.
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Affiliation(s)
- Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Philip A. Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Alexandra K. Heaney
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Xintong Li
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Rohini Dasan
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Charles Li
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Joseph A. Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Jonathan L. Zelner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
- Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Benjamin A. Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Changhong Yang
- Institute of Health Informatics, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Justin V. Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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33
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Epidemical and etiological study on hand, foot and mouth disease following EV-A71 vaccination in Xiangyang, China. Sci Rep 2020; 10:20909. [PMID: 33262488 PMCID: PMC7708472 DOI: 10.1038/s41598-020-77768-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/12/2020] [Indexed: 12/29/2022] Open
Abstract
Coxsackievirus A6 (CV-A6) and Coxsackievirus A10 (CV-A10) have been emerging as the prevailing serotypes and overtaking Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16) in most areas as main pathogens of hand, foot and mouth disease (HFMD) in China since 2013. To investigate whole etiological spectrum following EV-A71 vaccination of approximate 40,000 infants and young children in Xiangyang, enteroviruses were serotyped in 4415 HFMD cases from October 2016 to December 2017 using Real Time and conventional PCR and cell cultures. Of the typeable 3201 specimen, CV-A6 was the predominant serotype followed by CV-A16, CV-A10, CV-A5, CV-A2 and EV-A71 with proportions of 59.54%, 15.31%, 11.56%, 4.56%, 3.78% and 3.03%, respectively. Other 12 minor serotypes were also detected. The results demonstrated that six major serotypes of enteroviruses were co-circulating, including newly emerged CV-A2 and CV-A5. A dramatic decrease of EV-A71 cases was observed, whereas the total cases remained high. Multivalent vaccines against major serotypes are urgently needed for control of HFMD.
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34
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Li Y, Xiong T, Meng Y, Zhao R, Yu G, Liu J, Xiao J, Wang K, Wu T, Wei S, Huang J. Risk factors for severe hand, foot, and mouth disease infected with Coxsackievirus A6: A hospital-based case-control study. J Med Virol 2020; 92:3144-3150. [PMID: 32706451 DOI: 10.1002/jmv.26343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/23/2020] [Accepted: 07/12/2020] [Indexed: 12/13/2022]
Abstract
Coxsackievirus 6 (CV-A6) has been emerging as another predominant serotype for severe hand, foot, and mouth disease (HFMD) in China, after the introduction of enterovirus 71 inactivated vaccine (EV71 vaccine) for 3 years. Data on the risk factors for severe HFMD infected with CV-A6 are limited. We interviewed the caregivers to collected data on HFMD patients who sought medical care in the People's Hospital of Baoan district, Shenzhen, from 2015 to 2017. Totally, 131 severe patients were frequency-matched by age and gender with 174 mild patients infected with CV-A6. Univariable and multivariable logistic regression analyses were conducted to analyze the risk factors for severe CV-A6 HFMD. The average age was 20.62 ± 14.18 months and 20.52 ± 12.76 months for severe and mild patients, respectively. Multivariate analyses indicated complications at birth (odds ratio [OR], 4.18; 95% confidence interval [CI]: 1.64-10.63), peak body temperature over 39°C (OR, 4.04; 95% CI: 2.29-7.10) and first-born child (OR, 2.17; 95% CI: 1.27-3.70) increased the risk of severe HFMD infected with CV-A6. Breastfeeding (OR, 0.52; 95% CI: 0.32-0.87), and washing hands after playing frequently (OR, 0.58; 95% CI: 0.34-0.97) were negatively associated with severe illness. Compared with HFMD with infection of EV-A71, complications at birth and first-born child were newly found to be associated with severe illness in HFMD patients infected with CV-A6.
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Affiliation(s)
- Yanan Li
- State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tiantian Xiong
- Department for Infectious Disease Control and Prevention, Baoan District Center for Disease Control and Prevention, Shenzhen, China
| | - Yu Meng
- State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongxian Zhao
- State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangqing Yu
- Department for Infectious Disease Control and Prevention, Baoan District Center for Disease Control and Prevention, Shenzhen, China
| | - Jian Liu
- Deprtment of Pediatrics, People's Hospital of Baoan district, Shenzhen, China
| | - Jinrong Xiao
- State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Wang
- State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Taishun Wu
- Department for Infectious Disease Control and Prevention, Baoan District Center for Disease Control and Prevention, Shenzhen, China
| | - Sheng Wei
- State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiao Huang
- State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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35
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Brown DM, Zhang Y, Scheuermann RH. Epidemiology and Sequence-Based Evolutionary Analysis of Circulating Non-Polio Enteroviruses. Microorganisms 2020; 8:microorganisms8121856. [PMID: 33255654 PMCID: PMC7759938 DOI: 10.3390/microorganisms8121856] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023] Open
Abstract
Enteroviruses (EVs) are positive-sense RNA viruses, with over 50,000 nucleotide sequences publicly available. While most human infections are typically associated with mild respiratory symptoms, several different EV types have also been associated with severe human disease, especially acute flaccid paralysis (AFP), particularly with endemic members of the EV-B species and two pandemic types—EV-A71 and EV-D68—that appear to be responsible for recent widespread outbreaks. Here we review the recent literature on the prevalence, characteristics, and circulation dynamics of different enterovirus types and combine this with an analysis of the sequence coverage of different EV types in public databases (e.g., the Virus Pathogen Resource). This evaluation reveals temporal and geographic differences in EV circulation and sequence distribution, highlighting recent EV outbreaks and revealing gaps in sequence coverage. Phylogenetic analysis of the EV genus shows the relatedness of different EV types. Recombination analysis of the EV-A species provides evidence for recombination as a mechanism of genomic diversification. The absence of broadly protective vaccines and effective antivirals makes human enteroviruses important pathogens of public health concern.
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Affiliation(s)
- David M Brown
- Department of Synthetic Biology, J. Craig Venter Institute, Rockville, MD 20850, USA
| | - Yun Zhang
- Department of Informatics, J. Craig Venter Institute, La Jolla, CA 92037, USA
| | - Richard H Scheuermann
- Department of Informatics, J. Craig Venter Institute, La Jolla, CA 92037, USA
- Department of Pathology, University of California San Diego, La Jolla, CA 92093, USA
- La Jolla Institute for Immunology, La Jolla, CA 92065, USA
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36
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Deng J, Gao X, Xiao C, Xu S, Ma Y, Yang J, Wu M, Pan F. Association between diurnal temperature range and outpatient visits for hand, foot, and mouth disease in Hefei, China: a distributed lag nonlinear analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:35618-35625. [PMID: 32613503 DOI: 10.1007/s11356-020-09878-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
We aimed to quantify the relationship between the outpatient visits of hand, foot, and mouth disease (HFMD) and diurnal temperature range (DTR). The data of daily HFMD outpatient visits and meteorological parameters were obtained. A distributed lag nonlinear model combined with generalized linear model was used to estimate simultaneously nonlinear and delayed effects between DTR and daily HFMD outpatient visits after controlling confounding factors. A total of 15,275 HFMD visits were enrolled. DTR was significantly associated with HFMD outpatient visits in children. High DTR (P75: 11.4 °C) and extreme DTR (P95: 15.3 °C) were compared with 8.5 °C, and HFMD visits increased by a maximum of 3.93% (95% CI: 1.82 to 6.07%) and 4.47% (95% CI: 0.45 to 8.65%) in single-day lag effect, respectively. Furthermore, the extreme DTR effect decreased with the lag time and lasted for 10 days. Cumulative lag effects with markedly increasing percent of visits are over 64.88%. Furthermore, the effects were most pronounced among female children and children aged 0-2 years. Our study suggested that DTR changes were associated with HFMD outpatient visits, and populations of female and aged 0-2 years were more sensitive.
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Affiliation(s)
- Jixiang Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Xing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Changchun Xiao
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, 230032, Anhui Province, China
| | - Shanshan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jiajia Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Meng Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
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37
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From Monovalent to Multivalent Vaccines, the Exploration for Potential Preventive Strategies Against Hand, Foot, and Mouth Disease (HFMD). Virol Sin 2020; 36:167-175. [PMID: 32997323 PMCID: PMC7525078 DOI: 10.1007/s12250-020-00294-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/25/2020] [Indexed: 11/16/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) recently emerged as a global public threat. The licensure of inactivated enterovirus A71 (EV-A71) vaccine was the first step in using a vaccine to control HFMD. New challenges arise from changes in the pathogen spectrum while vaccines directed against other common serotypes are in the preclinical stage. The mission of a broad-spectrum prevention strategy clearly favors multivalent vaccines. The development of multivalent vaccines was attempted via the simple combination of potent monovalent vaccines or the construction of chimeric vaccines comprised of epitopes derived from different virus serotypes. The present review summarizes recent advances in HFMD vaccine development and discusses the next steps toward a safe and effective HFMD vaccine that is capable of establishing a cross-protective antibody response.
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38
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Guo Y, Liu Y, Song J, Liu P, Wu S, Tan Y, Fan F, Chen Z. Association of CD14 rs2569190 G/A genetic polymorphism with the severity of enterovirus 71 infection in Chinese children. Virology 2020; 548:25-30. [PMID: 32838942 DOI: 10.1016/j.virol.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 05/17/2020] [Accepted: 06/01/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Ya Guo
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, Shandong, 266000, PR China; Department of Pharmacology and Toxicology, The University of Mississippi Medical Center, No. 2500 North State Street, Jackson, MS, 39216, USA.
| | - Yedan Liu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, Shandong, 266000, PR China; Department of Pharmacology and Toxicology, The University of Mississippi Medical Center, No. 2500 North State Street, Jackson, MS, 39216, USA.
| | - Jie Song
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, Shandong, 266000, PR China.
| | - Peipei Liu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, Shandong, 266000, PR China.
| | - Sifei Wu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, Shandong, 266000, PR China.
| | - Yuxia Tan
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, Shandong, 266000, PR China; Department of Pediatrics, Zibo City Maternal and Child Health Hospital, No. 11 Xingyuandong Road, Zibo, Shandong, 255029, PR China.
| | - Fan Fan
- Department of Pharmacology and Toxicology, The University of Mississippi Medical Center, No. 2500 North State Street, Jackson, MS, 39216, USA.
| | - Zongbo Chen
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, Shandong, 266000, PR China.
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39
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Xu S, Li H, Qiao P, Xu G, Zhao D, Lin X, Qin Y, Yu H, Zhang X, Zhang W, Huang L. Neonatal hand, foot, and mouth disease due to coxsackievirus A6 in Shanghai. BMC Pediatr 2020; 20:364. [PMID: 32741368 PMCID: PMC7397588 DOI: 10.1186/s12887-020-02262-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 07/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Evidence of hand, foot, and mouth disease (HFMD) in neonates is limited. The aim of this study was to evaluate the clinical symptoms, pathogens, possible transmission routes, and prognosis of neonatal HFMD in Shanghai. METHODS This was a case-control study based on the HFMD registry surveillance system. All neonates and infected family members were enrolled between 2016 and 2017 in Shanghai. Neonates with HFMD were followed for at least half a year. Detailed questionnaires, medical history, and physical examination were recorded. Routine blood examination, liver and renal function, immunophenotypes of peripheral blood lymphocytes (CD3, CD4, and CD8 T-cells; NK cells), immunoglobulin (Ig) M, IgG, and IgA, and cytokine interleukin (IL-1β, IL-2R, IL-6, IL-8, IL-10, and TNF-α) levels were measured. All rectal swab specimens were collected and genotyped for enterovirus, and phylogenetic analysis based on the VP1 sequences of coxsackievirus A6 (CV-A6) was performed to investigate molecular and evolutionary characteristics. T-test or nonparametric test was used to evaluate the differences. Logistic analysis was applied to calculate the risk of clinical manifestations in the group of HFMD neonates and their paired siblings. RESULTS There were 16 neonates among the 12,608 diagnosed patients with HFMD, accounting for 0.13%. All neonatal infections were transmitted by other members of the family, mainly the elder siblings, and were caused by CV-A6. CV-A6 was the emerging and predominant causative agent of HFMD in Shanghai. None of the neonates with HFMD experienced fever, onychomadesis, or severe complications. However, two elder sibling patients showed lethargy, and one developed hypoperfusion. In the elder siblings with HFMD, the proportion of white blood cells was generally higher than in neonates with HFMD. The immunologic function of the neonates with HFMD was basically normal. The levels of inflammatory markers were higher in both neonates and elder siblings with HFMD compared to age-matched controls. The clinical symptoms receded about 1 week after onset. None of the neonates had sequelae. CONCLUSIONS In our study, CV-A6 infection in neonates was benign, but had the character of family clustering. Due to the two-child policy in China, elder siblings may be the main route of HFMD transmission.
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Affiliation(s)
- Shanshan Xu
- Department of Pediatric Infectious Diseases, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Huajun Li
- Department of Pediatric Infectious Diseases, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Peng Qiao
- Department of Infectious Disease Control, Yangpu District Centers for Disease Control and Prevention, Shanghai, 200093, China
| | - Guofeng Xu
- Department of Pediatric Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Dongying Zhao
- Department of Neonatology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xiaoyan Lin
- Department of Pediatric Internal Medicine, Hangzhou Children's Hospital, Hangzhou, 310000, Zhejiang Province, China
| | - Yu Qin
- Department of Pediatric Internal Medicine, Xingtai People's Hospital, Xingtai, 054001, Hebei Province, China
| | - Huiju Yu
- Department of Pediatric Infectious Diseases, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xi Zhang
- Clinical Research Unit, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Wanju Zhang
- Pathogen Diagnosis and Biosafety Department, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China.
| | - Lisu Huang
- Department of Pediatric Infectious Diseases, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
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40
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Lin Z, Li Y, Xu T, Guo M, Wang C, Zhao M, Chen H, Kuang J, Li W, Zhang Y, Lin T, Chen Y, Chen H, Zhu B. Inhibition of Enterovirus 71 by Selenium Nanoparticles Loaded with siRNA through Bax Signaling Pathways. ACS OMEGA 2020; 5:12495-12500. [PMID: 32548434 PMCID: PMC7271353 DOI: 10.1021/acsomega.0c01382] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/04/2020] [Indexed: 05/09/2023]
Abstract
Enterovirus 71 (EV71) is the principal pathogen leading to severe cases of hand, foot, and mouth disease (HFMD). Specific drugs for EV71 are not discovered currently. Small interfering RNA (siRNA) provides a promising antiviral treatment pathway, but it is difficult to cross cell membranes and is easy to degrade. Nanoparticles are promising for their carrying capacity currently. In this study, the siRNA targeting EV71 VP1 gene was loaded with selenium nanoparticles (SeNPs) and surface decorated with polyethylenimine (PEI) (Se@PEI@siRNA). Se@PEI@siRNA showed a remarkable interference efficiency in the nerve cell line SK-N-SH and prevented the cells to be infected. The mechanism study revealed that Se@PEI@siRNA could lighten the extent of SK-N-SH cells for staying in the sub-G1 phase. Activation of Bax apoptosis signaling was restrained either. Taken together, this study demonstrated that Se@PEI@siRNA is a promising drug against EV71 virus.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Bing Zhu
- . Tel: +86 20-81330740. Fax: +86 20 81885978
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41
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Wang J, Zhou J, Xie G, Zheng S, Lou B, Chen Y, Wu Y. The Epidemiological and Clinical Characteristics of Hand, Foot, and Mouth Disease in Hangzhou, China, 2016 to 2018. Clin Pediatr (Phila) 2020; 59:656-662. [PMID: 32146823 DOI: 10.1177/0009922820910822] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is most frequently caused by several serotypes of human enterovirus (EV) including Enterovirus 71 (EV-A71), coxsackievirus A16 (CV-A16), or other types of EV. The aim of this study was to determine the epidemiological characteristics of HFMD and to describe the epidemiologic characteristics of HFMD among severe and mild cases. We collected 4760 HFMD cases in Hangzhou from 2016 to 2018. Specimens from these cases were collected and tested for EV-A71, CV-A16, CV-A6, CV-A10, CV-A2, and CV-A5 by reverse transcriptase polymerase chain reaction. From 2016 to 2018, the prevalence of HFMD was seasonal each year. Among the 4760 probable HFMD cases, 3559 cases were confirmed (74.8%), including 426 cases of EV-A71 infections (8.9%), 249 cases of CV-A16 infections (5.2%), and 2884 cases of other EV infections (60.6%). The percentage of other EV infections was more than 80%, which increased year by year. Random selection of samples for detection of other EV infections in 2017 and 2018, among the 1297 cases, showed there were 835 (64.4%) cases of CV-A6 infections, 177 (13.6%) cases of CV-A10 infections, 100 (7.7%) cases of CV-A2 infections, 40 (3.1%) cases of CV-A5 infections, 3 (0.02 %) cases of mixed infections, and 11.0% untyped EV infections. Preschool children were still the primary population susceptible to HFMD. In severe cases, EV-A71 infection was the main cause. Characterizing the epidemiology and the relationship between severe and common cases of HFMD would provide relevant evidences for the prevention and treatment of HFMD.
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Affiliation(s)
- Jie Wang
- Hangzhou Children's Hospital, Hangzhou, Zhejiang, People's Republic of China
| | - Jun Zhou
- Hangzhou Children's Hospital, Hangzhou, Zhejiang, People's Republic of China
| | - Guoliang Xie
- First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, People's Republic of China
| | - Shufa Zheng
- First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, People's Republic of China
| | - Bin Lou
- First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, People's Republic of China
| | - Yu Chen
- First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, People's Republic of China
| | - Yidong Wu
- Hangzhou Children's Hospital, Hangzhou, Zhejiang, People's Republic of China
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42
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Xie J, Yang XH, Hu SQ, Zhan WL, Zhang CB, Liu H, Zhao HY, Chai HY, Chen KY, Du QY, Liu P, Yin AH, Luo MY. Co-circulation of coxsackieviruses A-6, A-10, and A-16 causes hand, foot, and mouth disease in Guangzhou city, China. BMC Infect Dis 2020; 20:271. [PMID: 32264839 PMCID: PMC7137261 DOI: 10.1186/s12879-020-04992-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/25/2020] [Indexed: 12/15/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is a common infectious disease occurring in children under 5 years of age worldwide, and Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CVA-16) are identified as the predominant pathogens. In recent years, Coxsackievirus A6 (CVA-6) and Coxsackievirus A10 (CVA-10) have played more and more important role in a series of HFMD outbreaks. This study aimed to understand the epidemic characteristics associated with HFMD outbreak in Guangzhou, 2018. Methods The clinical and laboratory data of 1220 enterovirus-associated HFMD patients in 2018 were analysed in this study. Molecular diagnostic methods were performed to identify its serotypes. Phylogenetic analyses were depicted based on the complete VP1 gene. Results There were 21 enterovirus serotypes detected in Guangzhou in 2018. Three serotypes of enterovirus, CVA-6 (364/1220, 29.8%), CVA-10 (305/1220, 25.0%), and CVA-16 (397/1220, 32.5%), were identified as the causative pathogens and accounted for 87.3% among all 1220 HFMD patients. In different seasons, CVA-6 was the predominant pathogen of HFMD during autumn, and CVA-10 as well as CVA-16 were more prevalent in summer. Patients infected by CVA-6, CVA-10 or CVA-16 showed similar clinical features and laboratory characteristics, and the ratios of severe HFMD were 5.8, 5.9, and 1.5% in the three serotypes. Phylogenetic analyses of VP1 sequences showed that the CVA-6, CVA-10, and CVA-16 sequences belonged to the sub-genogroup E2, genogroup E, and genogroup B1, respectively. Conclusions CVA-6, CVA-10, and CVA-16 were the predominant and co-circulated serotypes in Guangzhou China, 2018, which should be the new target for prevention and control of HFMD. Our findings provide useful information for diagnosis, treatment, and prevention of HFMD.
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Affiliation(s)
- Jia Xie
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China
| | - Xiao-Han Yang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Si-Qi Hu
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China
| | - Wen-Li Zhan
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Chang-Bin Zhang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Hong Liu
- Department of Pediatrics, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Hong-Yu Zhao
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Hui-Ying Chai
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Ke-Yi Chen
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Qian-Yi Du
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Pan Liu
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Ai-Hua Yin
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Ming-Yong Luo
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China. .,Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China.
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Wang Y, Meng F, Li J, Li G, Hu J, Cao J, Yu Q, Liang Q, Zhu F. Willingness of parents to vaccinate their 6-60-month-old children with EV71 vaccines: a cross-sectional study in rural areas of northern Jiangsu Province. Hum Vaccin Immunother 2020; 16:1579-1585. [PMID: 32209003 DOI: 10.1080/21645515.2020.1737465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Enterovirus 71 (EV71) is the dominant pathogen in severe and fatal hand-foot-mouth disease (HFMD) cases. Since 2015, three inactivated EV71 vaccines have been approved in China. The vaccination coverage of the EV71 vaccine has been relatively low, especially in rural areas. A cross-sectional survey from July 19 to August 22, 2018, was conducted in three rural counties of northern Jiangsu Province among parents of children aged 6-60 months. We adopted a pretested validated questionnaire to assess knowledge, awareness, and attitude of HFMD and EV71 vaccines among respondents and used univariate and multivariate binary logistic analyses to explore potential factors associated with the acceptance of EV71 vaccines. Of the 1,112 parents who participated, 87.8% were willing to vaccinate their children with EV71 vaccines. Parents over 40 y old were less likely to have their children vaccinated [adjusted odds ratio (aOR) = 2.12, 95% confidence interval (CI): 1.13-3.97]. Parents who lived in Ganyu (aOR = 0.50, 95% CI: 0.31-0.79) or Xinyi county (aOR = 0.33, 95% CI: 0.20-0.53), had a university or higher degree (aOR = 0.26, 95% CI: 0.11-0.64), had good knowledge of EV71 vaccines (aOR = 0.81, 95% CI: 0.67-0.98), perceived their children's disease susceptibility, and worried about the severity of HFMD had a higher willingness to vaccinate their children. Most parents were willing to vaccinate their children against EV71-related HFMD. Parental age, location, education level, knowledge of EV71 vaccines, concern about susceptibility, and severity of HFMD were all factors that influenced willingness to vaccinate.
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Affiliation(s)
- Yuanyuan Wang
- School of Public Health, Nanjing Medical University , Nanjing, PR China
| | - Fanyu Meng
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Jingxin Li
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Guifan Li
- Department of Registration, Beijing Minhai Biotechnology Co. Ltd ., Beijing, PR China
| | - Jialei Hu
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Jiaqian Cao
- School of Public Health, Nanjing Medical University , Nanjing, PR China
| | - Qiufan Yu
- School of Public Health, Southeast University , Nanjing, PR China
| | - Qi Liang
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Fengcai Zhu
- School of Public Health, Nanjing Medical University , Nanjing, PR China.,Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China.,Center for Global Health, Nanjing Medical University , Nanjing, PR China
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Comparative Molecular Biology Approaches for the Production of Poliovirus Virus-Like Particles Using Pichia pastoris. mSphere 2020; 5:5/2/e00838-19. [PMID: 32161150 PMCID: PMC7067596 DOI: 10.1128/msphere.00838-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Although the current poliovirus immunization program has been extremely successful in reducing the number of cases of paralytic polio worldwide, now more cases are caused by vaccine-derived polioviruses than by wild poliovirus. Switching to inactivated poliovirus vaccines will reduce this over time; however, their production requires the growth of large amounts of virus. This biosafety concern can be addressed by producing just the virus capsid. The capsid serves to protect the genetic material, which causes disease when introduced into a cell. Therefore, empty capsids (virus-like particles [VLPs]), which lack the viral RNA genome, are safe both to make and to use. We exploit yeast as a versatile model expression system to produce VLPs, and here we specifically highlight the potential of this system to supply next-generation poliovirus vaccines to secure a polio-free world for the future. For enteroviruses such as poliovirus (PV), empty capsids, which are antigenically indistinguishable from mature virions, are produced naturally during viral infection. The production of such capsids recombinantly, in heterologous systems such as yeast, have great potential as virus-like particle (VLP) vaccine candidates. Here, using PV as an exemplar, we show the production of VLPs in Pichia pastoris by coexpression of the structural precursor protein P1 and the viral protease 3CD. The level of expression of the potentially cytotoxic protease relative to that of the P1 precursor was modulated by three different approaches: expression of the P1 precursor and protease from different transcription units, separation of the P1 and protease proteins using the Thosea asigna virus (TaV) 2A translation interruption sequence, or separation of the P1 and protease-coding sequences by an internal ribosome entry site sequence from Rhopalosiphum padi virus (RhPV). We also investigate the antigenicity of VLPs containing previously characterized mutations when produced in Pichia. Finally, using transmission electron microscopy and two-dimensional classification, we show that Pichia-derived VLPs exhibited the classical icosahedral capsid structure displayed by enteroviruses. IMPORTANCE Although the current poliovirus immunization program has been extremely successful in reducing the number of cases of paralytic polio worldwide, now more cases are caused by vaccine-derived polioviruses than by wild poliovirus. Switching to inactivated poliovirus vaccines will reduce this over time; however, their production requires the growth of large amounts of virus. This biosafety concern can be addressed by producing just the virus capsid. The capsid serves to protect the genetic material, which causes disease when introduced into a cell. Therefore, empty capsids (virus-like particles [VLPs]), which lack the viral RNA genome, are safe both to make and to use. We exploit yeast as a versatile model expression system to produce VLPs, and here we specifically highlight the potential of this system to supply next-generation poliovirus vaccines to secure a polio-free world for the future.
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Li Z, Huan C, Wang H, Liu Y, Liu X, Su X, Yu J, Zhao Z, Yu XF, Zheng B, Zhang W. TRIM21-mediated proteasomal degradation of SAMHD1 regulates its antiviral activity. EMBO Rep 2020; 21:e47528. [PMID: 31797533 PMCID: PMC6944907 DOI: 10.15252/embr.201847528] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 10/09/2019] [Accepted: 11/13/2019] [Indexed: 01/01/2023] Open
Abstract
SAMHD1 possesses multiple functions, but whether cellular factors regulate SAMHD1 expression or its function remains not well characterized. Here, by investigating why cultured RD and HEK293T cells show different sensitivity to enterovirus 71 (EV71) infection, we demonstrate that SAMHD1 is a restriction factor for EV71. Importantly, we identify TRIM21, an E3 ubiquitin ligase, as a key regulator of SAMHD1, which specifically interacts and degrades SAMHD1 through the proteasomal pathway. However, TRIM21 has no effect on EV71 replication itself. Moreover, we prove that interferon production stimulated by EV71 infection induces increased TRIM21 and SAMHD1 expression, whereas increasing TRIM21 overrides SAMHD1 inhibition of EV71 in cells and in a neonatal mouse model. TRIM21-mediated degradation of SAMHD1 also affects SAMHD1-dependent restriction of HIV-1 and the regulation of interferon production. We further identify the functional domains in TRIM21 required for SAMHD1 binding and the ubiquitination site K622 in SAMHD1 and show that phosphorylation of SAMHD1 at T592 also blocks EV71 restriction. Our findings illuminate how EV71 overcomes SAMHD1 inhibition via the upregulation of TRIM21.
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Affiliation(s)
- Zhaolong Li
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Chen Huan
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Hong Wang
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Yue Liu
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Xin Liu
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Xing Su
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Jinghua Yu
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Zhilei Zhao
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Xiao-Fang Yu
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Ministry of Education), Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Baisong Zheng
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
| | - Wenyan Zhang
- The First Hospital of Jilin University, Institute of Virology and AIDS Research, Changchun, China
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Chen FH, Liu X, Fang HL, Nan N, Li Z, Ning NZ, Luo DY, Li T, Wang H. VP1 of Enterovirus 71 Protects Mice Against Enterovirus 71 and Coxsackievirus B3 in Lethal Challenge Experiment. Front Immunol 2019; 10:2564. [PMID: 31787970 PMCID: PMC6856078 DOI: 10.3389/fimmu.2019.02564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/16/2019] [Indexed: 12/16/2022] Open
Abstract
Enterovirus and Coxsackievirus are the major viruses that cause hand, foot, and mouth disease (HFMD) outbreaks worldwide. Several studies have shown the potential of viral envelope protein 1 (VP1) on providing protective effects from viral strains of different genotypes. However, whether VP1 has the cross-protection in Enteroviruses or Coxsackievirus has not been studied in-depth. In this study, the vp1 gene of Enterovirus 71 (EV71) and Coxsackievirus B3 (CB3) was inserted into the vector pET22b (+) to form the respective expression plasmids pEVP1 or pCVP1, and then transformed into Escherichia coli strain BL21 (DE3). The recombinant EVP1 or CVP1 protein was overexpressed successfully and effectively purified to homogeneity. Then, we identified that EVP1 and CVP1 protein could generate effectively specific humoral immunity and cellular immunity in mice, what's more, we determined the cross-protection of VP1 between EV71 and CB3 in a murine model. The results showed that immunization with EVP1 could effectively induce specific IgG and secretory IgA against CVP1 and the sera from EVP1-immunized mice could neutralize CB3 with mean titers 1:440. In contrast, no measurable neutralizing antibodies to EV71 were detected in CVP1-immunized mice. Then, newborn BALB/C mice, whose mother was immunized with EVP1 or CVP1, were administered with different lethal doses of EV71 or CB3. The EVP1 immunized group showed a 90% protective efficacy for a CB3 dosage of 120 LD50, but the CVP1 immunized group showed no significantly different protective efficacy against 15 LD50 of EV71 compared with the BSA immunized group. Hence, EVP1 is a promising subunit vaccine candidate against Enterovirus 71 and Coxsackievirus B3 caused HFMD.
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Affiliation(s)
- Fang-Hong Chen
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.,Department of Microbiology, Anhui Medical University, Anhui, China
| | - Xiong Liu
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.,PLA Center for Disease Control and Prevention, Beijing, China
| | - Hua-Li Fang
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.,Department of Microbiology, Anhui Medical University, Anhui, China
| | - Nan Nan
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Zhan Li
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Nian-Zhi Ning
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - De-Yan Luo
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Tao Li
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Hui Wang
- State Key Laboratory of Pathogens and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.,Department of Microbiology, Anhui Medical University, Anhui, China
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Interleukin-7 promotes CD8+ T cell activity in patients with enterovirus 71 associated encephalitis. Int Immunopharmacol 2019; 75:105773. [DOI: 10.1016/j.intimp.2019.105773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/10/2019] [Accepted: 07/18/2019] [Indexed: 01/25/2023]
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Liao YW, Ho BC, Chen MH, Yu SL. Host relieves lnc-IRAK3-3-sequestered miR-891b to attenuate apoptosis in Enterovirus 71 infection. Cell Microbiol 2019; 21:e13043. [PMID: 31099182 DOI: 10.1111/cmi.13043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/22/2019] [Accepted: 05/10/2019] [Indexed: 12/11/2022]
Abstract
Enterovirus 71 (EV71) is an emerging life-threatening pathogen particularly in the Asia-Pacific region. Apoptosis is a major pathogenic feature in EV71 infection. However, which molecular mechanism participating in EV71-induced apoptosis is not completely understood. Long noncoding RNAs (lncRNAs), a newly discovered class of regulatory RNA molecules, govern a wide range of biological functions through multiple regulatory mechanisms. Whether lncRNAs involved in EV71-induced apoptosis was investigated in this study. We conducted an apoptosis-oriented approach by integrating lncRNA and mRNA profilings. lnc-IRAK3-3 is down-regulated in EV71 infection and plays an important role in EV71 infection-induced apoptosis. Compensation of lnc-IRAK3-3 in EV71 infection promoted cell apoptosis wherein GADD45β expression was increased and further triggered caspase3 and PARP cleavage. Using bioinformatics analysis and functional assays, lnc-IRAK3-3 could functionally sequester miR-891b and GADD45β 3'UTR whereas miR-891b showed the inhibitory activity on GADD45β expression. Taken together, lnc-IRAK3-3 has the ability capturing miR-891b to enforce GADD45β expression and eventually promotes apoptosis. On the contrary, host cells suppress lnc-IRAK3-3 to relieve lnc-IRAK3-3-sequestered miR-891b, restrain GADD45β, and attenuate apoptosis in EV71 infection that prevent host cells from severe damages. We discover a new molecular mechanism by which host cells counteract EV71-induced apoptosis through the lnc-IRAK3-3/miR-891b/GADD45β axis partially.
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Affiliation(s)
- Yu-Wen Liao
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Bing-Ching Ho
- Centers of Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Hsuan Chen
- Centers of Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan
| | - Sung-Liang Yu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Centers of Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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Qin L, Dang D, Wang X, Zhang R, Feng H, Ren J, Chen S, Zhou G, Huang P, Wang B, Xi Y, Wu W, Jin Y, Duan G. Identification of immune and metabolic predictors of severe hand-foot-mouth disease. PLoS One 2019; 14:e0216993. [PMID: 31120941 PMCID: PMC6532886 DOI: 10.1371/journal.pone.0216993] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 05/02/2019] [Indexed: 01/15/2023] Open
Abstract
Hand, foot and mouth disease (HFMD) is an infectious disease that affects mostly children. The children with HFMD also have other immune and metabolic disorders. However, the association of these disorders with the severity of HFMD has not yet been determined. In this study, we used a case-control study design to examine the correlation of immune and metabolic disorders with HFMD development in children. 406 mild and severe patients were recruited and divided into different subgroups based on the number of days from the initial onset time to hospitalization (1, 2, 3, 4, and ≥5 days). Logistic regression model was used to define the predictors of severe HFMD. We found that the patients from rural area (OR = 1.76, 95% CI [1.19~2.63], P = 0.005) or with body temperature of >39°C (OR = 2.14, 95% CI [1.12~4.12], P = 0.022) exhibited higher risk for severe symptoms. In addition, the risk increased with the rise of body temperature by using a Chis-quare trend test (P = 0.01). We also found that a decreased number of eosinophils was an predictor of severe HFMD at 1, 2, 3,and 4 days post infection (dpi). Decreased levels of Na+, Cl-, and creatine kinase were also predictors at 1 and ≥5 dpi. On the other hand, elevated level of globulin was a predictor for severe HFMD at 4 dpi and ≥5 dpi, and the increased number of neutrophils or increased level of alkaline phosphatase posed risk for severe HFMD at 3 and ≥5 dpi. Our results suggested that rural living, hyperpyrexia, changes in the immune system that include the numbers of eosinophils and neutrophils and the levels of IgG and globulin, and metabolic alterations, such as the levels of alkaline phosphatase, Na+, Cl-, and creatine kinase in peripheral blood are predictors of severe HFMD.
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Affiliation(s)
- Luwei Qin
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Dejian Dang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinhong Wang
- Department of Infectious Disease, The Children's Hospital of Zhengzhou City, Zhengzhou, China
| | - Rongguang Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Huifen Feng
- Department of Gastroenterology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingchao Ren
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guangyuan Zhou
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Ping Huang
- Department of Gastroenterology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bin Wang
- Department of Gastroenterology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuanlin Xi
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
- * E-mail: (GD); (YJ)
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
- * E-mail: (GD); (YJ)
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50
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Andrés C, Guasch E, Piñana M, Fernandes P, Gimferrer L, Esso DV, Codina MG, Esperalba J, Vila J, Rodrigo C, Martín MC, Fuentes F, Rubio S, Pumarola T, Antón A. Recombinant CV-A6 strains related to hand-foot-mouth disease and herpangina at primary care centers (Barcelona, Spain). Future Microbiol 2019; 14:499-507. [PMID: 31033351 DOI: 10.2217/fmb-2018-0336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Aim: To describe the genetic diversity of enteroviruses (EV) causing hand, foot and mouth disease (HFMD) and herpangina, especially of coxsackievirus (CV)-A6, from patients attended at pediatric primary care centers during the 2017-2018 season. Methods: Phylogenetic analysis of partial VP1 region was performed for genetic characterization. The complete VP1 and 3Dpol proteins were sequenced for lineage determination and detection of recombination events. Results: An 80% of samples were EV laboratory-confirmed. CV-A6 was the most detected (70%) and associated with atypical HFMD (78%). The comparison of VP1 and 3Dpol phylogenies showed evidence of recombination in three strains, in which two shifted to CV-A16 3Dpol. Conclusion: The study provides recent information regarding the nonrecombinant and recombinant EVs related to HFMD at primary care centers.
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Affiliation(s)
- Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eulàlia Guasch
- Primary Care Service Muntanya, Institut Català de la Salut, Department of Health, Barcelona, Spain
| | - Maria Piñana
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paula Fernandes
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Gimferrer
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Diego Van Esso
- Primary Care Service Muntanya, Institut Català de la Salut, Department of Health, Barcelona, Spain
| | - Maria Gema Codina
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juliana Esperalba
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jorgina Vila
- Paediatric Hospitalisation Unit, Department of Paediatrics, Hospital Universitari Maternoinfantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Rodrigo
- Paediatric Hospitalisation Unit, Department of Paediatrics, Hospital Universitari Maternoinfantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Carmen Martín
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francisco Fuentes
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Rubio
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tomàs Pumarola
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
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- Primary Care Service Muntanya, Institut Català de la Salut, Department of Health, Barcelona, Spain
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
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