1
|
Yang X, Wu Y, Zhao H, Liu P, Liang L, Yin A. Emergence and circulation of enterovirus B species in infants in southern China: A multicenter retrospective analysis. Virulence 2024; 15:2329569. [PMID: 38555521 PMCID: PMC10984118 DOI: 10.1080/21505594.2024.2329569] [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: 11/28/2023] [Accepted: 03/07/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Enteroviruses (EV) are common and can cause severe diseases, particularly in young children. However, the information of EV infection in infants in China is limited due to the vast population size and extensive geographical area of the country. Here, we conducted a retrospective multicenter analysis of available EV data to assess the current epidemiological situation in the infant population in southern China. METHODS The study enrolled infants with suspected EV infection from 34 hospitals across 12 cities in southern China between 2019 to 2022, and the confirmation of EV was done using RT-PCR and VP1 gene sequencing. RESULTS Out of 1221 infants enrolled, 330 (27.03%) were confirmed as EV-infected. Of these, 260 (78.79%) were newborns aged 0-28 days. The EV belonged to three species: EV-B (80.61%), EV-A (11.82%), and human rhinovirus (7.58%). Newborns were more susceptible to EV-B than older infants (p < 0.001). Within EV-B, we identified 15 types, with coxsackievirus (CV) B3 (20.91%), echovirus (E) 11 (19.70%), and E18 (16.97%) being the most common. The predominant EV types changed across different years. EV infection in infants followed a seasonal pattern, with a higher incidence from May to August. Furthermore, perinatal mother-to-child EV transmission in 12 mother-newborn pairs were observed. CONCLUSION Our study is the first to demonstrate the emergence and widespread circulation of EV-B species, mainly CVB3, E11, and E18, in southern China, primarily affecting young infants. This research provides valuable insights for future epidemic assessment, prediction, as well as the elimination of mother-to-child transmission.
Collapse
Affiliation(s)
- Xiaohan Yang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou 511400, China
| | - Yudan Wu
- Department of Clinical Laboratory, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China
| | - Hongyu Zhao
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou 511400, China
| | - Pan Liu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou 511400, China
| | - Lihua Liang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou 511400, China
| | - Aihua Yin
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou 511400, China
| |
Collapse
|
2
|
Sittikul P, Batty EM, Yodsawat P, Nuanpirom J, Kosoltanapiwat N, Sangket U, Chatchen S, Day NPJ, Thaipadungpanit J. Diversity of Human Enterovirus Co-Circulations in Five Kindergartens in Bangkok between July 2019 and January 2020. Viruses 2023; 15:1397. [PMID: 37376696 DOI: 10.3390/v15061397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Human enterovirus causes various clinical manifestations in the form of rashes, febrile illness, flu-like illness, uveitis, hand-foot-mouth disease (HFMD), herpangina, meningitis, and encephalitis. Enterovirus A71 and coxsackievirus are significant causes of epidemic HFMD worldwide, especially in children aged from birth to five years old. The enterovirus genotype variants causing HFMD epidemics have been reported increasingly worldwide in the last decade. We aim to use simple and robust molecular tools to investigate human enteroviruses circulating among kindergarten students at genotype and subgenotype levels. With the partial 5'-UTR sequencing analysis as a low-resolution preliminary grouping tool, ten enterovirus A71 (EV-A71) and coxsackievirus clusters were identified among 18 symptomatic cases and 14 asymptomatic cases in five kindergartens in Bangkok, Thailand, between July 2019 and January 2020. Two occurrences of a single clone causing an infection cluster were identified (EV-A71 C1-like subgenotype and coxsackievirus A6). Random amplification-based sequencing using MinION (Oxford Nanopore Technology) helped identify viral transmission between two closely related clones. Diverse genotypes co-circulating among children in kindergartens are reservoirs for new genotype variants emerging, which might be more virulent or better at immune escape. Surveillance of highly contagious enterovirus in communities is essential for disease notifications and controls.
Collapse
Affiliation(s)
- Pichamon Sittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Elizabeth M Batty
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LG, UK
| | - Prasert Yodsawat
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
| | - Jiratchaya Nuanpirom
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
| | - Nathamon Kosoltanapiwat
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Unitsa Sangket
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
- Center for Genomics and Bioinformatics Research, Faculty of Science Prince of Songkla University, Songkhla 90110, Thailand
| | - Supawat Chatchen
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LG, UK
| | - Janjira Thaipadungpanit
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Zhou J, Zhou Y, Luo K, Liao Q, Zheng W, Gong H, Shi H, Zhao S, Wang K, Qiu Q, Dai B, Ren L, Wang L, Gao L, Xu M, Liu N, Lu W, Zheng N, Chen X, Chen Z, Yang J, Cauchemez S, Yu H. The transfer of maternal antibodies and dynamics of maternal and natural infection-induced antibodies against coxsackievirus A16 in Chinese children 0-13 years of age: a longitudinal cohort study. BMC Med 2022; 20:436. [PMID: 36352415 PMCID: PMC9645321 DOI: 10.1186/s12916-022-02604-w] [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: 05/26/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A major hand-foot-and-mouth disease (HFMD) pathogen, coxsackievirus A16 (CVA16), has predominated in several of the last 10 years and caused the largest number of HFMD outbreaks between 2011 and 2018 in China. We evaluated the efficacy of maternal anti-CVA16 antibody transfer via the placenta and explored the dynamics of maternal and natural infection-induced neutralizing antibodies in children. METHODS Two population-based longitudinal cohorts in southern China were studied during 2013-2018. Participants were enrolled in autumn 2013, including 2475 children aged 1-9 years old and 1066 mother-neonate pairs, and followed for 3 years. Blood/cord samples were collected for CVA16-neutralizing antibody detection. The maternal antibody transfer efficacy, age-specific seroprevalence, geometric mean titre (GMT) and immune response kinetics were estimated. RESULTS The average maternal antibody transfer ratio was 0.88 (95% CI 0.80-0.96). Transferred maternal antibody levels declined rapidly (half-life: 2.0 months, 95% CI 1.9-2.2 months). The GMT decayed below the positive threshold (8) by 1.5 months of age. Due to natural infections, it increased above 8 after 1.4 years and reached 32 by 5 years of age, thereafter dropping slightly. Although the average duration of maternal antibody-mediated protection was < 3 months, the duration extended to 6 months on average for mothers with titres ≥ 64. CONCLUSIONS Anti-CVA16 maternal antibodies are efficiently transferred to neonates, but their levels decline quickly. Children aged 0-5 years are the main susceptible population and should be protected by CVA16 vaccination, with the optimal vaccination time between 1.5 months and 1 year of age.
Collapse
Affiliation(s)
- Jiaxin Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yonghong Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Kaiwei Luo
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Qiaohong Liao
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Wen Zheng
- 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
| | - Huilin Shi
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Shanlu Zhao
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Kai Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Qi Qiu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Bingbing Dai
- Anhua County Center for Disease Control and Prevention, Yiyang, China
| | - Lingshuang Ren
- 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
| | - Lidong Gao
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Meng Xu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Nuolan Liu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Wanying Lu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Nan Zheng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xinhua Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Zhiyuan Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université de Paris, UMR2000, CNRS, 75015, Paris, France
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
| |
Collapse
|
5
|
Lerdsamran H, Mungaomklang A, Iamsirithaworn S, Prasertsopon J, Wiriyarat W, Saritsiri S, Anusorntanawat R, Siriyakorn N, Intalapaporn P, Sirikhetkon S, Sangsiriwut K, Dangsakul W, Sawadpongpan S, Thinpan N, Kitidee K, Okada P, Techasuwanna R, Mongkalangoon N, Prasert K, Puthavathana P. Seroprevalence of anti-SARS-CoV-2 antibodies in Thai adults during the first three epidemic waves. PLoS One 2022; 17:e0263316. [PMID: 35476709 PMCID: PMC9045619 DOI: 10.1371/journal.pone.0263316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 12/23/2022] Open
Abstract
This study determined the presence of anti-SARS-CoV-2 antibodies in 4964 individuals, comprising 300 coronavirus disease-19 (COVID-19) prepandemic serum samples, 142 COVID-19 patients, 2113 individuals at risk due to their occupations, 1856 individuals at risk due to sharing workplaces or communities with COVID-19 patients, and 553 Thai citizens returning after spending extended periods of time in countries with a high disease prevalence. We recruited participants between May 2020 and May 2021, which spanned the first two epidemic waves and part of the third wave of the COVID-19 outbreaks in Thailand. Their sera were tested in a microneutralization and a chemiluminescence immunoassay for IgG against the N protein. Furthermore, we performed an immunofluorescence assay to resolve discordant results between the two assays. None of the prepandemic sera contained anti-SARS-CoV-2 antibodies, while antibodies developed in 88% (15 of 17) of the COVID-19 patients at 8–14 days and in 94–100% of the patients between 15 and 60 days after disease onset. Neutralizing antibodies persisted for at least 8 months, longer than IgG antibodies. Of the 2113 individuals at risk due to their occupation, none of the health providers, airport officers, or public transport drivers were seropositive, while antibodies were present in 0.44% of entertainment workers. Among the 1856 individuals at risk due to sharing workplaces or communities with COVID-19 patients, seropositivity was present in 1.9, 1.5, and 7.5% of the Bangkok residents during the three epidemic waves, respectively, and in 1.3% of the Chiang Mai people during the first epidemic wave. The antibody prevalence varied between 6.5 and 47.0% in 553 Thai people returning from high-risk countries. This serosurveillance study found a low infection rate of SARS-CoV-2 in Thailand before the emergence of the Delta variant in late May 2021. The findings support the Ministry of Public Health’s data, which are based on numbers of patients and contact tracing.
Collapse
Affiliation(s)
- Hatairat Lerdsamran
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | - Anek Mungaomklang
- Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand
| | | | - Jarunee Prasertsopon
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | | | - Suthee Saritsiri
- The 67th Public Health Center Thaweewatthana, Department of Health, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Ratikorn Anusorntanawat
- Chaophraya Yommarat Hospital, Office of the Permanent Secretary, Ministry of Public Health, Suphanburi, Thailand
| | - Nirada Siriyakorn
- Rajavithi Hospital, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand
| | - Poj Intalapaporn
- Rajavithi Hospital, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand
| | - Somrak Sirikhetkon
- Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand
| | - Kantima Sangsiriwut
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Worawat Dangsakul
- Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand
| | - Suteema Sawadpongpan
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | - Nattakan Thinpan
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | - Kuntida Kitidee
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
| | - Pilailuk Okada
- Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand
| | - Ranida Techasuwanna
- Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Kriengkrai Prasert
- Nakhon Phanom Provincial Hospital, Department of Medical Services, Ministry of Public Health, Nakhon Phanom, Thailand
| | - Pilaipan Puthavathana
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
- * E-mail:
| |
Collapse
|
6
|
Lerdsamran H, Mungaomklang A, Iamsirithaworn S, Prasertsopon J, Prasert K, Intalapaporn P, Siriyakorn N, Wiriyarat W, Thinpan N, Sawadpongpan S, Sirikhetkon S, Mongkalangoon N, Petto S, Puthavathana P. Evaluation of different platforms for the detection of anti-SARS coronavirus-2 antibodies, Thailand. BMC Infect Dis 2021; 21:1213. [PMID: 34872510 PMCID: PMC8646009 DOI: 10.1186/s12879-021-06921-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 11/29/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) help determine previous infection in individuals, regardless of whether they are asymptomatic or symptomatic. The detection of antibodies serves several purposes, including supporting other assays for disease diagnosis, conducting seroepidemiological studies, and evaluating vaccines. Many platforms of immunological methods for anti-SARS-CoV-2 antibody detection and their performance require validation. METHODS This study evaluated the test performance of three autoanalyzer-based assays (Architect IgG, Vitros IgG, and Vitros total Ig) and one manual ELISA (Wantai total Ig) against a microneutralization (microNT) assay on the detection of SARS-CoV-2 antibodies. Furthermore, an indirect immunofluorescence assay verified the discordant results between the microNT and commercial assays. The test sensitivity, specificity, positive predictive value, and negative predictive value were determined based on four groups of 1005 serum samples: 102 COVID-19 prepandemic sera, 45 anti-SARS-CoV-2 positive sera, 366 sera of people at risk, and 492 sera of citizens returning from countries with a high prevalence of infection. RESULTS The analyses as a whole showed that the performance of these commercial assays was comparable. Each group was also analysed separately to gain further insight into test performance. The Architect did not detect two positive sera of people at risk (prevalence of infection 0.55%). The other methods correctly identified these two positive sera but yielded varying false-positive results. The group of returning travellers with an infection rate of 28.3% (139 of 492) better differentiated the test performance of individual assays. CONCLUSIONS High-throughput Architect and Vitros autoanalyzers appear appropriate for working on large sample sizes in countries that can afford the cost. The Wantai ELISA, while requiring more individual time and technical skill, may provide reliable results at a lower cost. The selection of assays will depend on the laboratory facilities and feasibility.
Collapse
Affiliation(s)
- Hatairat Lerdsamran
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Anek Mungaomklang
- Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok, 10220, Thailand
| | - Sopon Iamsirithaworn
- Department of Disease Control, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Jarunee Prasertsopon
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Kriengkrai Prasert
- Department of Medical Services, Nakhon Phanom Provincial Hospital, Ministry of Public Health, Nakhon Phanom, 48000, Thailand
| | - Poj Intalapaporn
- Division of Infectious Disease, Department of Medicine, Rajavithi Hospital, Ministry of Public Health, Bangkok, 10400, Thailand
| | - Nirada Siriyakorn
- Division of Infectious Disease, Department of Medicine, Rajavithi Hospital, Ministry of Public Health, Bangkok, 10400, Thailand
| | - Witthawat Wiriyarat
- Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Nattakan Thinpan
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Suteema Sawadpongpan
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Somrak Sirikhetkon
- Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok, 10220, Thailand
| | - Noparat Mongkalangoon
- Department of Disease Control, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Suwanna Petto
- Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok, 10220, Thailand
| | - Pilaipan Puthavathana
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand.
| |
Collapse
|
7
|
Javadi M, Nejati A, Yousefi M, Mahmoodi M, Shoja Z, Shahmahmoodi S. First seroepidemiological investigation of human enterovirus 71 in Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2021; 13:502-508. [PMID: 34557279 PMCID: PMC8421584 DOI: 10.18502/ijm.v13i4.6975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Human Enterovirus 71 (EV-A71) is the causative agent for many dermal to neurological diseases especially polio-like paralysis outbreaks around the world. This study, the first of this kind in Iran, aimed to find neutralizing antibodies against EV-A71 in serum of healthy individuals in different age groups based on neutralization test (NT). Materials and Methods: In this cross-sectional study, 547 serum samples were collected from healthy individuals who were referring for routine checkup tests (aged from under 6 months to over 31 years old) to Imam-Khomeini Hospital in Tehran during January-December 2015. Serum samples were examined by NT in cell culture to detect neutralizing antibodies against EV-A71. In the next step, some of the positive samples were subjected to complete titration to determine the exact titer of anti-EV-A71 antibodies. Results: Of 547 samples, 310 (56.7%) were positive for EV-A71 neutralizing antibody. The presence of the antibody increased with age (p<0.001), and there was a significant statistical relationship between sex and the presence of antibody (p=0.009). Conclusion: Our results demonstrated an apparent but limited circulation of EV-A71 in our society. After the worldwide eradication of poliovirus, EV-A71 which can cause polio-likes syndrome, might be the new challenge for our health care system as regard more in depth research is however needed.
Collapse
Affiliation(s)
- Mahsa Javadi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Virology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Nejati
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Yousefi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Mahmoodi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shohreh Shahmahmoodi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Li P, Chen Y, Tang A, Gao F, Yan JB. Seroprevalence of coxsackievirus A16 antibody among people of various age groups: a systematic review and meta-analysis. Arch Public Health 2021; 79:166. [PMID: 34535186 PMCID: PMC8447778 DOI: 10.1186/s13690-021-00688-z] [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: 04/27/2021] [Accepted: 09/07/2021] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Coxsackie virus group A type 16 (CoxA16) is the main pathogen and usually an alternative to or joins in prevalence with enterovirus 71 (EV71) causing hand, foot and mouth disease (HFMD). The objective of this study was to estimate the seroprevalence of CoxA16 antibody among people of various age groups by a systematic review and meta-analysis. METHODS The literature of seroprevalence of CoxA16 antibody among people has been systematically searched through databases from the date of their establishment to Jan. 2021. Estimates of seroprevalence of CoxA16 antibody by gender and age groups have been summarized by using fixed- and random- effect models. All analyses have been conducted in STATA version 12.0 software. RESULTS A total of 14 publications with 9 in English and 5 in Chinese containing 9562 samples were finally included in the meta-analysis. The seroprevalence of CoxA16 antibody reported in different studies range from 24.85 to 76.92 %. Meta-analysis has revealed that the seroprevalence of CoxA16 antibody was 56.3 % (95 %CI: 47.7 %~64.9 %) in the overall population and 55.1 % (95 %CI: 44.1 %~66.1 %) in the Chinese population. Subgroup analysis by gender has revealed that the seroprevalence of CoxA16 antibody was 56.1 % (95 %CI: 45.2 %~67.1 %) in males and 60.0 % (95 %CI: 50.0 %~69.9 %) in females. Subgroup analysis by age groups has revealed that the seroprevalence of CoxA16 antibody was 49.1 % (95 %CI: 36.2 %~62.0 %) in the 0 ~ 5 age group and 63.9 % (95 %CI: 53.1 %~74.7 %) in the over 5 age group. Begg's funnel plots have suggested that there were no publication bias in all groups. Sensitive analysis has suggested that the result of the meta-analysis was stable. CONCLUSIONS The seroprevalence of CoxA16 antibody was closely related to age. Children under 5 years old were the main susceptible groups for CoxA16 and also the key groups for the prevention and control of HFMD.
Collapse
Affiliation(s)
- Peng Li
- Zhoushan Municipal Center for Disease Control and Prevention, No.568 Wengshan Road, Zhoushan City, Zhejiang Province, 316021, People's Republic of China
| | - Yan Chen
- Zhoushan Municipal Center for Disease Control and Prevention, No.568 Wengshan Road, Zhoushan City, Zhejiang Province, 316021, People's Republic of China
| | - An Tang
- Zhoushan Municipal Center for Disease Control and Prevention, No.568 Wengshan Road, Zhoushan City, Zhejiang Province, 316021, People's Republic of China
| | - Fan Gao
- Department of Ophthalmology, Zhoushan Hospital, Zhoushan City, Zhejiang Province, 316021, People's Republic of China.
| | - Jian-Bo Yan
- Zhoushan Municipal Center for Disease Control and Prevention, No.568 Wengshan Road, Zhoushan City, Zhejiang Province, 316021, People's Republic of China.
| |
Collapse
|
9
|
Techasaensiri C, Wongsa A, Puthanakit T, Chokephaibulkit K, Chotpitayasunondh T, Charoonruangrit U, Sombatnimitsakul S, Puthavathana P, Lerdsamran H, Auewarakul P, Tassaneetrithep B. Response of Severe EV71-Infected Patients to Hyperimmune Plasma Treatment: A Pilot Study. Pathogens 2021; 10:pathogens10050625. [PMID: 34069574 PMCID: PMC8161181 DOI: 10.3390/pathogens10050625] [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: 04/18/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 11/16/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is highly prevalent in East and Southeast Asia. It particularly affects children under five years of age. The most common causative agents are coxsackieviruses A6 and A16, and enterovirus A71 (EV71). The clinical presentation is usually mild and self-limited, but, in some cases, severe and fatal complications develop. To date, no specific therapy or worldwide vaccine is available. In general, viral infection invokes both antibody and cell-mediated immune responses. Passive immunity transfer can ameliorate the severe symptoms of diseases such as COVID-19, influenza, MERS, and SARS. Hyperimmune plasma (HIP) from healthy donors with high anti-EV71 neutralizing titer were used to transfuse confirmed EV71-infected children with neurological involvement (n = 6). It resulted in recovery within three days, with no neurological sequelae apparent upon examination 14 days later. Following HIP treatment, plasma chemokines were decreased, whereas anti-inflammatory and pro-inflammatory cytokines gradually increased. Interestingly, IL-6 and G-CSF levels in cerebrospinal fluid declined sharply within three days. These findings indicate that HIP has therapeutic potential for HFMD with neurological complications. However, given the small number of patients who have been treated, a larger cohort study should be undertaken. Successful outcomes would stimulate the development of anti-EV71 monoclonal antibody therapy.
Collapse
Affiliation(s)
- Chonnamet Techasaensiri
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
| | - Artit Wongsa
- Center of Research Excellence in Immunoregulation, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Kulkanya Chokephaibulkit
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Tawee Chotpitayasunondh
- Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand;
| | | | | | - Pilaipan Puthavathana
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakon Pathom 73170, Thailand; (P.P.); (H.L.)
| | - Hatairat Lerdsamran
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakon Pathom 73170, Thailand; (P.P.); (H.L.)
| | - Prasert Auewarakul
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Boonrat Tassaneetrithep
- Center of Research Excellence in Immunoregulation, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
- Correspondence: ; Tel.: +66-2-419-2796
| |
Collapse
|
10
|
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.
Collapse
|
11
|
Kang HJ, Yoon Y, Lee YP, Kim HJ, Lee DY, Lee JW, Hyeon JY, Yoo JS, Lee S, Kang C, Choi W, Han MG. A Different Epidemiology of Enterovirus A and Enterovirus B Co-circulating in Korea, 2012-2019. J Pediatric Infect Dis Soc 2021; 10:398-407. [PMID: 33150450 DOI: 10.1093/jpids/piaa111] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/01/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Enteroviruses (EVs) occur frequently worldwide and are known to be associated with a broad spectrum of clinical manifestations from mild syndromes to neurological disease. To understand the epidemiology of EV in Korea, we characterized EV-infected cases during 2012-2019 based on national surveillance. METHODS We collected specimens from patients with suspected EV infections and analyzed the data using real-time reverse-transcription polymerase chain reaction and VP1 gene sequencing. RESULTS Among the 18 261 specimens collected, EVs were detected in 6258 (34.3%) cases. Although the most common EV types changed annually, EV-A71, echovirus 30, coxsackievirus B5, coxsackievirus A6, and coxsackievirus A10 were commonly identified. Among the human EVs, the case numbers associated with the 2 major epidemic species (EV-A and EV-B) peaked in the summer. While EV-A species affected 1-year-old children and were associated with herpangina and hand, foot, and mouth disease, EV-B species were mostly associated with neurologic manifestations. The highest incidence of EV-B species was observed in infants aged <12 months. Feces and respiratory specimens were the most predictive of EV infection. Specimens collected within 5 days of symptom onset allowed for timely virus detection. CONCLUSIONS EV-A and EV-B species co-circulating in Korea presented different epidemiologic trends in clinical presentation, affected subjects, and seasonality trends. This study could provide information for the characterization of EVs circulating in Korea to aid the development of EV antivirals and vaccines, as well as public health measures to control enteroviral diseases.
Collapse
Affiliation(s)
- Hae Ji Kang
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Youngsil Yoon
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Young-Pyo Lee
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Hye-Jin Kim
- Division of Infectious Diseases Control, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Deog-Yong Lee
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - June-Woo Lee
- Division of Vaccine Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Ji-Yeon Hyeon
- Division of Vaccine Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Jung Sik Yoo
- Division of Vaccine Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Sangwon Lee
- Division of Infectious Diseases Control, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Chun Kang
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Wooyoung Choi
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Myung-Guk Han
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| |
Collapse
|
12
|
Puenpa J, Chansaenroj J, Auphimai C, Srimuan D, Thatsanathorn T, Poovorawan Y, Wanlapakorn N. Neutralizing antibody against Enterovirus-A71 in Thai children: A longitudinal study from birth to age 4 years. Vaccine 2020; 38:7638-7644. [PMID: 33067033 DOI: 10.1016/j.vaccine.2020.10.002] [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: 08/21/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/19/2022]
Abstract
Thailand is one of the countries in the Asia-pacific region that has been most affected by the Enterovirus-A71 (EV-A71) epidemic. An individual who is susceptible to EV-A71 may also be infected asymptomatically, thus, a serological assay is a useful tool to estimate the cumulative incidence of infection in the community and to provide guidance for vaccination scheduling. There have been several candidate EV-A71 vaccines, of which three have been approved and licensed in China. The population target for EV-A71 vaccine is children younger than three years of age. In Thailand, there are limited data available on the seroprevalence of EV-A71 neutralizing (NT) antibodies and the timing of seroconversion in children. This study aims to investigate the seroprevalence and seroconversion rate of EV-A71 NT antibody in a cohort of Thai children. Sera were collected at the King Chulalongkorn Memorial Hospital in Bangkok, Thailand from 100 children between 2015 and 2020. Maternal sera were collected on the day of delivery. Serum samples from children were collected at birth (month 0) and at 2, 7, 18, 24, 36, and 48 months of age to test for EV-A71 NT antibody titers using an enzyme-linked immunosorbent assay (ELISA)-based microneutralization test. The seroprotection rate (NT antibody ≥1:16) in children at months 0, 2, 7, 18, 24, 36, and 48 was 81.0%, 60.0%, 9.0%, 10.0%, 13.0%, 17.0%, and 37.1%, respectively. The seroprotection rate was lowest at month 7 due to waning of the maternal antibody and the immunity of children increased with increasing age. At 48 months of age, less than 40% of children were seroprotected. Children at the age of 6 months should be considered a primary target for vaccination.
Collapse
Affiliation(s)
- Jiratchaya Puenpa
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jira Chansaenroj
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chompoonut Auphimai
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Donchida Srimuan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thaksaporn Thatsanathorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| |
Collapse
|
13
|
Kim S, Bae KS, Kim JH, Kang JH, Choi UY. Seroprevalence of Neutralizing Antibodies Against Candidate Serotypes of Enterovirus Vaccines Among Korean Children. Viral Immunol 2020; 34:62-67. [PMID: 33030408 DOI: 10.1089/vim.2020.0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a pediatric public health concern in Asia. Surveillance data on the circulating serotypes of HFMD suggest that Enterovirus A71 (EV-A71) and coxsackieviruses A6, A10, and A16 (CVA6, CVA10, and CVA16) are the major serotypes causing HFMD. Asian countries, including Korea, are currently developing a multivalent vaccine targeting these serotypes. However, the immunity of children against specific serotypes, indicating past infection, should also be considered while selecting candidate serotypes for vaccine development. Therefore, we aimed to identify the age-stratified serological statuses of Korean children to determine candidate serotypes for HFMD vaccine development. This study included 220 participants, categorized into four age groups, 7 months-2 years, 3-5 years, 6-10 years, and 11-15 years. A neutralization test was performed to quantitate the neutralizing antibodies (NtAbs) in the sera of the participants. Only EV-A71 and CVA6 were found suitable as candidate serotypes for vaccine development, whereas further study is needed for CVA10 and CVA16. The highest seropositivity and NtAb titer ranges were observed for CVA6 in all age groups, suggesting that the participants had been predominantly exposed to CVA6. For EV-A71, seropositivity and NtAb titer ranges steadily increased with age, suggesting that children were currently exposed to EV-A71. For CVA10, the 3-5 years group showed the highest seropositivity rate and higher NtAb titer ranges than the older age groups, indicating that the exposure to CVA10 had mainly occurred in recent years. Future studies will identify whether the exposure to CVA10 was transient or will continue. For CVA16, seropositivity and NtAb titer ranges were generally low, indicating that only a few participants had been exposed to CVA16. We identified discrepancies between the sentinel surveillance data and our findings. This study provides a new perspective for HFMD vaccine development and policy making in Asian countries.
Collapse
Affiliation(s)
- Sol Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kil Seong Bae
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Pediatrics, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hyun Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ui Yoon Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Pediatrics, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
14
|
Yang Y, Xu L, Jin H, Song C. Epidemiological Study of Influenza A, Influenza B, Enterovirus 71, and Coxsackievirus A16 Among Children in the Central Region of Zhejiang Province, China. Curr Microbiol 2020; 77:2656-2664. [DOI: 10.1007/s00284-020-02026-y] [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] [Accepted: 05/13/2020] [Indexed: 11/24/2022]
|
15
|
Drug repurposing of pyrimidine analogs as potent antiviral compounds against human enterovirus A71 infection with potential clinical applications. Sci Rep 2020; 10:8159. [PMID: 32424333 PMCID: PMC7235037 DOI: 10.1038/s41598-020-65152-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/28/2020] [Indexed: 01/15/2023] Open
Abstract
Enterovirus A71 (EV-A71) is one of the aetiological agents for the hand, foot and mouth disease (HFMD) in young children and a potential cause of neurological complications in afflicted patients. Since its discovery in 1969, there remains no approved antiviral for EV-A71 and other HFMD-causing enteroviruses. We set out to address the lack of therapeutics against EV-A71 by screening an FDA-approved drug library and found an enrichment of hits including pyrimidine antimetabolite, gemcitabine which showed 90.2% of inhibition on EV-A71 infection. Gemcitabine and other nucleoside analogs, LY2334737 and sofosbuvir inhibition of EV-A71 infection were disclosed using molecular and proteomic quantification, and in vitro and in vivo efficacy evaluation. Gemcitabine displayed a significant reduction of infectious EV-A71 titres by 2.5 logs PFU/mL and was shown to target the early stage of EV-A71 viral RNA and viral protein synthesis process especially via inhibition of the RNA dependent RNA polymerase. In addition, the drug combination study of gemcitabine's synergistic effects with interferon-β at 1:1 and 1:2 ratio enhanced inhibition against EV-A71 replication. Since gemcitabine is known to metabolize rapidly in vivo, other nucleoside analogs, LY2334737 and sofosbuvir conferred protection in mice against lethal EV-A71 challenge by potentially reducing the death rate, viral titers as well on virus-induced pathology in the limb muscle tissue of mice. Additionally, we found that gemcitabine is competent to inhibit other positive-sense RNA viruses of the Flaviviridae and Togaviridae family. Overall, these drugs provide new insights into targeting viral factors as a broad-spectrum antiviral strategy with potential therapeutic value for future development and are worthy of potential clinical application.
Collapse
|
16
|
Kuo FL, Khanh TH, Chung WY, Hung NT, Luo ST, Chang WC, Nhan LNT, Thinh LQ, Lee MS. Seroprevalence of EV-A71 neutralizing antibodies following the 2011 epidemic in HCMC, Vietnam. PLoS Negl Trop Dis 2020; 14:e0008124. [PMID: 32126083 PMCID: PMC7077839 DOI: 10.1371/journal.pntd.0008124] [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: 07/17/2019] [Revised: 03/17/2020] [Accepted: 02/08/2020] [Indexed: 01/04/2023] Open
Abstract
Enterovirus-A71 (EV-A71) cyclically causes hand-foot-mouth disease (HFMD) epidemics in Asian children. An EV-A71 epidemic occurred in Southern Vietnam in 2011, but its scale is not clear. We collected residual sera from non-HFMD Vietnamese inpatients in 2012–2013 to determine seroprevalence of EV-A71 neutralizing antibodies, and measured cross-reactive neutralizing antibody titers against three EV-A71 genogroups. About 23.5% of 1-year-old children in Southern Vietnam has been infected by EV-A71, and the median age of infection was estimated to be 3 years. No significant antigenic variation could be detected among the three EV-A71 genogroups. The high seroprevalence of EV-A71 neutralizing antibody in children living in southern Vietnam indicates the necessity of introducing EV-A71 vaccines in southern Vietnam, particularly for children under 6 months of age. Moreover, it is critical to understand EV-A71 disease burden for formulating national vaccination policy. Enterovirus-A71 (EV-A71), a member of the enterovirus genus, is a virulent pathogen causing neurological complications. EV-A71 mainly spreads through oral-fecal or oral-oral transmission, as well as respiratory droplets. EV-A71 outbreaks have cyclically occurred throughout some Asian countries since 1997, with millions of people affected. The presence of serum neutralizing antibodies to EV-A71 can represent the prevalence of previous EV-A71 infections and seroprevalence studies are widely used to understand prevalence of infectious diseases. The results of our study demonstrate that about 50% of young children under 3 years of age were infected during the 2011 epidemic in southern Vietnam. The high seroprevalence of EV-A71 neutralizing antibody in children living in southern Vietnam indicates the necessity of introducing EV-A71 vaccines, particularly for children under 6 months of age. Moreover, it is critical to understand EV-A71 disease burden for formulating national vaccination policy in the future.
Collapse
Affiliation(s)
- Fang-Lin Kuo
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan
| | | | - Wan-Yu Chung
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan
| | | | - Shu-Ting Luo
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan
| | - Wen-Chiung Chang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan
| | | | - Le Quoc Thinh
- Children’s Hospital No. 1, Ho Chi Minh City, Vietnam
| | - Min-Shi Lee
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan
- * E-mail: ,
| |
Collapse
|
17
|
Replication and cytokine profiles of different subgenotypes of enterovirus 71 isolated from Thai patients in peripheral blood mononuclear cells. Microb Pathog 2019; 132:215-221. [PMID: 31075431 DOI: 10.1016/j.micpath.2019.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 11/22/2022]
Abstract
Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are common causative agents of mild and self-limiting symptoms of childhood hand, foot, and mouth disease (HFMD). However, some EV71-infected HFMD patients can develop severe neurological and/or fatal cardiopulmonary complications. In Thailand, HFMD associated with the EV71 subgenotypes C4a and B5 were reported to be associated with diverse outcomes. However, variations in enterovirus subgenotypes and virulence factors have not been fully elucidated; this study elucidated these variations in peripheral blood mononuclear cells (PBMCs) exposed to different subgenotypes of isolated enteroviruses for 24 and 48 h. Following infection, viral titers were determined by plaque assay. Infected cells and intracellular cytokines were quantified using flow cytometry, and multiplex assay was used to examine cytokine release. All isolated subgenotypes showed replication capability in PBMCs; specifically, the replication titer of EV71 C4a tended to be higher than titers of EV71 B5 and CA16. Additionally, the infectivity of EV71 B5 was higher in monocytes than in lymphocytes. Compared with EV71 B5, EV71 C4a and CA16 had greater ability to induce intra- and extracellular cytokine responses. These findings provide new insights into variations in cellular immune responses to different EV71 subgenotypes isolated from Thai patients, which should be considered for the development of vaccines and therapeutic agents.
Collapse
|