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Sung CC, Luxton GWG, Hung KS, Wu YF, Wang CC, Hsu CS, Hu CF. Whole exome sequencing identifies genetic markers of enterovirus susceptibility in East Asians. Front Microbiol 2024; 15:1452595. [PMID: 39234544 PMCID: PMC11372244 DOI: 10.3389/fmicb.2024.1452595] [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: 06/24/2024] [Accepted: 07/29/2024] [Indexed: 09/06/2024] Open
Abstract
Introduction Following acute enterovirus (EV) infection, outcomes vary based on factors like the immune response, viral cell entry receptor expression levels, tissue tropism, and genetic factors of both the host and virus. While most individuals exhibit mild, self-limited symptoms, others may suffer severe complications or prolonged infections that can lead to autoimmune disorders. Methods To elucidate host responses to EV infection, we performed whole exome sequencing on blood samples from both infected and uninfected individuals. Our initial focus was on genes encoding EV entry receptors-PSGL-1, SCARB2, and ANAXA2 for EV-A71, and CD155 for poliovirus-and on host genes ACBD3 and PI4KΒ, crucial for EV replication. Results Although no specific genetic variants directly associated with EV infection were identified, we discovered 118 variants across 116 genes enriched in East Asian populations through multi-layered variant filtering. These variants were further analyzed for their potential impacts on organs, biological processes, and molecular pathways. Phenome-wide association studies were conducted to refine our understanding of their contributions to EV infection susceptibility. Discussion Our findings aim to develop a predictive panel based on these 118 variants, which could help susceptible individuals during EV outbreaks, guiding targeted clinical interventions and preventative strategies.
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Affiliation(s)
- Chia-Cheng Sung
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - G W Gant Luxton
- Department of Molecular and Cellular Biology, University of California, Davis, Davis, CA, United States
| | - Kuo-Sheng Hung
- Center for Precision Medicine and Genomics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yung-Fu Wu
- Center for Precision Medicine and Genomics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Chien Wang
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Sin Hsu
- Genomics Center for Clinical and Biotechnological Applications, Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Fen Hu
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Yu HW, Kuan CH, Tseng LW, Chen HY, Tsai MY, Chen YS. Investigation of the Correlation between Enterovirus Infection and the Climate Factor Complex Including the Ping-Year Factor and El Niño-Southern Oscillation in Taiwan. Viruses 2024; 16:471. [PMID: 38543836 PMCID: PMC10975746 DOI: 10.3390/v16030471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 05/23/2024] Open
Abstract
Enterovirus infection and enterovirus infection with severe complications (EVSC) are critical issues in several aspects. However, there is no suitable predictive tool for these infections. A climate factor complex (CFC) containing several climate factors could provide more effective predictions. The ping-year factor (PYF) and El Niño-Southern Oscillation (ENSO) are possible CFCs. This study aimed to determine the relationship between these two CFCs and the incidence of enterovirus infection. Children aged 15 years and younger with enterovirus infection and/or EVSC were enrolled between 2007 and 2022. Each year was categorized into a ping-year or non-ping-year according to the PYF. Poisson regression was used to evaluate the associations between the PYF, ENSO, and the incidence of enterovirus infection. Compared to the ping-year group, the incidence rate of enterovirus infection, the incidence rate of EVSC, and the ratio of EVSC in the non-ping-year group were 1.24, 3.38, and 2.73 times higher, respectively (p < 0.001). For every one-unit increase in La Niña, the incidence rate of enterovirus infection decreased to 0.96 times (p < 0.001). Our study indicated that CFCs could be potential predictors for enterovirus infection, and the PYF was more suitable than ENSO. Further research is needed to improve the predictive model.
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Affiliation(s)
- Hsueh-Wen Yu
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
| | - Chia-Hsuan Kuan
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
| | - Liang-Wei Tseng
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
| | - Hsing-Yu Chen
- Department of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan;
| | - Meg-Yen Tsai
- Pingzhen Fengze Chinese Medicine Clinic, No. 65, Sec. 2, Yanping Rd., Pingzhen Dist., Taoyuan City 324005, Taiwan;
| | - Yu-Sheng Chen
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, No. 259, Wen-Hwa 1st Rd., Gueishan Dist., Taoyuan City 333323, Taiwan
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Study of the epidemiology and etiological characteristics of hand, foot, and mouth disease in Suzhou City, East China, 2011-2014. Arch Virol 2016; 161:1933-43. [PMID: 27146138 DOI: 10.1007/s00705-016-2878-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is a common childhood illness that is caused by enteroviruses, and the prevalence of HFMD in China and around the world has resulted in a huge disease burden. Since 2010, the HFMD incidence has been the highest among infectious diseases in Suzhou, China. To investigate the epidemical, features, etiological characteristics, and clinical characteristics of HFMD in Suzhou City, East China, from 2011 to 2014. We retrospectively analyzed HFMD epidemiological data in Suzhou from 2011 to 2014. A total of 80,723 outpatients in the city of Suzhou were diagnosed with HFMD, including 1,846 severe cases. There were 2,387 (3.0 %) laboratory-confirmed cases, 807 of which exhibited severe symptoms. All analyses were stratified by age, disease severity, laboratory confirmation status, and enterovirus subtype. From 2011 to 2014, HFMD mainly affected children aged 1-3, and boys were more affected than girls. The highest peak incidences of HFMD occurred in May or June from 2011 to 2014, and lower peak incidences were observed from November to December and in districts with higher humidity. Enterovirus 71 and coxsackievirus A16 were the predominant viral genotypes in Suzhou in 2011 to 2012 and 2014, and the severe cases mainly correlated with EV71 subtypes. In 2013, other EVs were dominant. The proportion of patients with severe disease decreased significantly, and the VP1 capsid proteins of EV71 and CA16 from severe and mild cases were nearly identical. This study shows that it is time to start monitoring EVs in China and that we should accelerate vaccine research and develop public-health interventions for the control and prevention of HFMD, all of which will play an important role in the prevention of HFMD.
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Ljungman P, Snydman D, Boeckh M. Rhinovirus, Coronavirus, Enterovirus, and Bocavirus After Hematopoietic Cell Transplantation or Solid Organ Transplantation. TRANSPLANT INFECTIONS 2016. [PMCID: PMC7123292 DOI: 10.1007/978-3-319-28797-3_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Respiratory viral infections represent a significant cause of morbidity and mortality in immunocompromised hosts. Newer molecular detection assays have allowed for the characterization of several respiratory viruses not previously recognized as having significant clinical impact in the immunocompromised population. Human rhinoviruses are the most common respiratory viruses detected in the upper respiratory tract of hematopoietic cell transplant and lung transplant recipients, and evidence on the impact on clinical outcomes is mounting. Other respiratory viruses including enteroviruses (EVs), coronaviruses (CoVs), and bocavirus may also contribute to pulmonary disease; however, data is limited in the immunocompromised population. Further studies are needed to define the epidemiology, risk factors, and clinical outcomes of these infections; this data will help inform decisions regarding development of antiviral therapy and infection prevention strategies.
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Affiliation(s)
- Per Ljungman
- Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - David Snydman
- Tufts University School of Medicine Tufts Medical Center, Boston, Massachusetts USA
| | - Michael Boeckh
- University of Washington Fred Hutchinson Cancer Research Center, Seattle, Washington USA
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Clinical disease due to enterovirus D68 in adult hematologic malignancy patients and hematopoietic cell transplant recipients. Blood 2015; 125:1724-9. [PMID: 25593338 DOI: 10.1182/blood-2014-12-616516] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The United States Centers for Disease Control and Prevention reported over 1000 cases of severe respiratory disease in pediatric patients associated with enterovirus D68 (EV-D68) in the fall of 2014. We sought to identify and define the clinical burden of disease due to EV-D68 in adult patients with hematologic malignancy or undergoing hematopoietic cell transplant (HCT). Real-time reverse-transcriptase polymerase chain reaction (PCR) for EV-D68 was performed on all respiratory samples positive for human rhinovirus (HRV) or negative for all respiratory viruses by a laboratory-developed respiratory viral PCR panel from August 11, 2014, to November 7, 2014. Presumptive cases were defined as those with an EV-D68 PCR cycle threshold (CT) at least 4 cycles lower than the HRV CT for HRV-positive samples or any EV-D68 CT value for HRV-negative samples. Sequencing of a 150-bp fragment of the 5' noncoding region confirmed EV-D68 in 16 of 506 respiratory samples. Eight patients had a history of hematologic malignancy, and 6 of these had undergone HCT. Presentation ranged from mild upper respiratory symptoms to respiratory failure. EV-D68 can infect adult patients with hematologic malignancy and HCT recipients and may be associated with severe respiratory disease. Current commercial diagnostic assays cannot differentiate EV-D68 from other enteroviruses or HRV, and improved rapid diagnostic tools are needed.
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Coxsackievirus A6 associated hand, foot and mouth disease in adults: Clinical presentation and review of the literature. J Clin Virol 2014; 60:381-6. [DOI: 10.1016/j.jcv.2014.04.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 03/31/2014] [Accepted: 04/23/2014] [Indexed: 12/22/2022]
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Chan TC, Hwang JS, Chen RH, King CC, Chiang PH. Spatio-temporal analysis on enterovirus cases through integrated surveillance in Taiwan. BMC Public Health 2014; 14:11. [PMID: 24400725 PMCID: PMC3890494 DOI: 10.1186/1471-2458-14-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 01/05/2014] [Indexed: 02/06/2023] Open
Abstract
Background Severe epidemics of enterovirus have occurred frequently in Malaysia, Singapore, Taiwan, Cambodia, and China, involving cases of pulmonary edema, hemorrhage and encephalitis, and an effective vaccine has not been available. The specific aim of this study was to understand the epidemiological characteristics of mild and severe enterovirus cases through integrated surveillance data. Methods All enterovirus cases in Taiwan over almost ten years from three main databases, including national notifiable diseases surveillance, sentinel physician surveillance and laboratory surveillance programs from July 1, 1999 to December 31, 2008 were analyzed. The Pearson’s correlation coefficient was applied for measuring the consistency of the trends in the cases between different surveillance systems. Cross correlation analysis in a time series model was applied for examining the capability to predict severe enterovirus infections. Poisson temporal, spatial and space-time scan statistics were used for identifying the most likely clusters of severe enterovirus outbreaks. The directional distribution method with two standard deviations of ellipse was applied to measure the size and the movement of the epidemic. Results The secular trend showed that the number of severe EV cases peaked in 2008, and the number of mild EV cases was significantly correlated with that of severe ones occurring in the same week [r = 0.553, p < 0.01]. These severe EV cases showed significantly higher association with the weekly positive isolation rates of EV-71 than the mild cases [severe: 0.498, p < 0.01 vs. mild: 0.278, p < 0.01]. In a time series model, the increase of mild EV cases was the significant predictor for the occurrence of severe EV cases. The directional distribution showed that both the mild and severe EV cases spread extensively during the peak. Before the detected spatio-temporal clusters in June 2008, the mild cases had begun to rise since May 2008, and the outbreak spread from south to north. Conclusions Local public health professionals can monitor the temporal and spatial trends plus spatio-temporal clusters and isolation rate of EV-71 in mild and severe EV cases in a community when virus transmission is high, to provide early warning signals and to prevent subsequent severe epidemics.
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Affiliation(s)
| | | | | | | | - Po-Huang Chiang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan 350, Taiwan.
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Zeng M, Pu D, Mo X, Zhu C, Gong S, Xu Y, Lin G, Wu B, He S, Jiao X, Wang X, Wang X, Zhu Q, Altmeyer R. Children of rural-to-urban migrant workers in China are at a higher risk of contracting severe hand, foot and mouth disease and EV71 infection: a hospital-based study. Emerg Microbes Infect 2013; 2:e72. [PMID: 26038441 PMCID: PMC3826070 DOI: 10.1038/emi.2013.72] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 07/19/2013] [Accepted: 08/13/2013] [Indexed: 02/05/2023]
Abstract
The incidence and severity of hand, foot and mouth disease have increased in mainland China since 2008. Therapies and vaccines are currently at different stages of development. This study aimed to determine the social factors associated with the outbreaks and severity of the disease in Chinese children. A multicentre, prospective, case-controlled study was conducted in Shanghai, Chongqing, Guangzhou and Shantou to identify the sociodemographic and behavioural risk factors for hand, foot and mouth disease. Children hospitalized for hand, foot and mouth disease were randomly enrolled from April to November 2011. Stool samples were collected to test for the presence of enterovirus 71 (EV71). A total of 443 children between 1.6 and 68 months of age were enrolled; 304 were uncomplicated cases and 139 were severe cases with central nervous system involvement. The overall detection rate of EV71 was 54.2%, and the positivity rate of EV71 was significantly higher in the severe group than in the uncomplicated group (82.0% versus 40.9%, odds ratio (OR): 8.35, P=0.000). The children of migrant workers (OR: 3.014, P=0.000) and children attending kindergarten (OR: 2.133, P=0.002) were significantly associated with a severe outcome of the disease (OR: 1.765, P=0.026). Our findings indicate that kindergarten attendance and migrant worker parents are the major risk factors associated with severe hand, foot and mouth disease in children <5 years of age. Future public health intervention vaccination campaigns should consider the particular difficulties of achieving high compliance with multiple-dose vaccination regimens in the children of migrant workers.
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Affiliation(s)
- Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University , Shanghai 201102, China
| | - Dongbo Pu
- Department of Infectious Diseases, Children's Hospital of Fudan University , Shanghai 201102, China
| | - Xiaowei Mo
- Institut Pasteur Shanghai, Chinese Academy of Sciences , Shanghai 200025, China
| | - Chaomin Zhu
- Department of Infectious Diseases & Gastroenterology, Children's Hospital of Chongqing Medical University , Chongqing 400014, China
| | - Sitang Gong
- Department of Infectious Diseases, Guangzhou Women and Children's Medical Center , Guangzhou 510120, China
| | - Yi Xu
- Department of Infectious Diseases, Guangzhou Women and Children's Medical Center , Guangzhou 510120, China
| | - Guangyu Lin
- Pediatric Department of Shantou University Medical College , Shantou 515041, China
| | - Beiyan Wu
- Pediatric Department of Shantou University Medical College , Shantou 515041, China
| | - Suli He
- Pediatric Department of Shantou University Medical College , Shantou 515041, China
| | - Xiaoyang Jiao
- Pediatric Department of Shantou University Medical College , Shantou 515041, China
| | - Xiangshi Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University , Shanghai 201102, China
| | - Xiaohong Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University , Shanghai 201102, China
| | - Qianqian Zhu
- Institut Pasteur Shanghai, Chinese Academy of Sciences , Shanghai 200025, China
| | - Ralf Altmeyer
- Institut Pasteur Shanghai, Chinese Academy of Sciences , Shanghai 200025, China
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Lee MKP, Chan PKS, Ho IIY, Lai WMR. Enterovirus infection among patients admitted to hospital in Hong Kong in 2010: Epidemiology, clinical characteristics, and importance of molecular diagnosis. J Med Virol 2013; 85:1811-7. [DOI: 10.1002/jmv.23663] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2013] [Indexed: 11/11/2022]
Affiliation(s)
- May Kin-Ping Lee
- Department of Microbiology; Prince of Wales Hospital; Shatin; N.T.; Hong Kong
| | - Paul Kay-Sheung Chan
- Department of Microbiology, Faculty of Medicine; The Chinese University of Hong Kong; Shatin; N.T.; Hong Kong
| | - Iok-Ieng Yolanda Ho
- Department of Microbiology; Prince of Wales Hospital; Shatin; N.T.; Hong Kong
| | - Wai-Man Raymond Lai
- Department of Microbiology; Prince of Wales Hospital; Shatin; N.T.; Hong Kong
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Water outage increases the risk of gastroenteritis and eyes and skin diseases. BMC Public Health 2011; 11:726. [PMID: 21943080 PMCID: PMC3198703 DOI: 10.1186/1471-2458-11-726] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 09/25/2011] [Indexed: 12/04/2022] Open
Abstract
Background The present study used insurance claims data to investigate infections associated with short-term water outage because of constructions or pipe breaks. Methods The present study used medical claims of one million insured persons for 2004-2006. We estimated incidences of gastroenteritis and eye and skin complaints for 10 days before, during, and after 10 days of water supply restriction for outpatient visits and for emergency and in-patient care combined. Results There was an increase in medical services for these complaints in outpatient visits because of water outages. Poisson regression analyses showed that increased risks of medical services were significant for gastroenteritis (relative risk [RR] 1.31, 95% confidence interval [CI] 1.26-1.37), skin disease (RR 1.36, 95% CI 1.30-1.42), and eye disease patients (RR 1.34, 95% CI 1.26-1.44). Similar risks were observed during 10-day lag periods. Compared with those in cool days, risks of medical services are higher when average daily temperature is above 30°C for gastroenteritis (RR 12.1, 95% CI 6.17-23.7), skin diseases (RR 4.48, 95% CI 2.29-8.78), and eye diseases (RR 40.3, 95% CI 7.23-224). Conclusion We suggest promoting personal hygiene education during water supply shortages, particularly during the warm months.
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