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Yang A, Luo Y, Yang J, Xie T, Wang W, Wan X, Wang K, Pang D, Yang D, Dai H, Wu J, Meng S, Guo J, Wang Z, Shen S. Quantitation of Enterovirus A71 Empty and Full Particles by Sedimentation Velocity Analytical Ultracentrifugation. Viruses 2024; 16:573. [PMID: 38675915 PMCID: PMC11053756 DOI: 10.3390/v16040573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
The enterovirus A71 (EV71) inactivated vaccine is an effective intervention to control the spread of the virus and prevent EV71-associated hand, foot, and mouth disease (HFMD). It is widely administered to infants and children in China. The empty particles (EPs) and full particles (FPs) generated during production have different antigenic and immunogenic properties. However, the antigen detection methods currently used were established without considering the differences in antigenicity between EPs and FPs. There is also a lack of other effective analytical methods for detecting the different particle forms, which hinders the consistency between batches of products. In this study, we analyzed the application of sedimentation velocity analytical ultracentrifugation (SV-AUC) in characterizing the EPs and FPs of EV71. Our results showed that the proportions of the two forms could be quantified simultaneously by SV-AUC. We also determined the repeatability and accuracy of this method and found that both parameters were satisfactory. We assessed SV-AUC for bulk vaccine quality control, and our findings indicated that SV-AUC can be used effectively to analyze the percentage of EPs and FPs and monitor the consistency of the process to ensure the quality of the vaccine.
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Affiliation(s)
- Anna Yang
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Yun Luo
- The Research Core Facilities for Life Science (HUST), College of Life Science and Technology, Huazhong University of Science and Technology, Luoyu Road, Wuhan 430074, China
| | - Jie Yang
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Tingbo Xie
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Wenhui Wang
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Xin Wan
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Kaiwen Wang
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Deqin Pang
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Dongsheng Yang
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Hanyu Dai
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Jie Wu
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Shengli Meng
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Jing Guo
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Zejun Wang
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
| | - Shuo Shen
- Wuhan Institute of Biological Products Co., Ltd., No. 1 Huangjin Industrial Park Road, Wuhan 430207, China (J.Y.); (S.M.)
- National Engineering Technology Research Center of Combined Vaccines, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- National Key Laboratory for Novel Vaccines Research and Development of Emerging Infectious Diseases, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
- Hubei Provincial Vaccines Technology Innozation Center, No. 1 Huangjin Industrial Park Road, Wuhan 430207, China
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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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Song JH, Mun SH, Yang H, Kwon YS, Kim SR, Song MY, Ham Y, Choi HJ, Baek WJ, Cho S, Ko HJ. Antiviral Mechanisms of Saucerneol from Saururus chinensis against Enterovirus A71, Coxsackievirus A16, and Coxsackievirus B3: Role of Mitochondrial ROS and the STING/TKB-1/IRF3 Pathway. Viruses 2023; 16:16. [PMID: 38275951 PMCID: PMC10821076 DOI: 10.3390/v16010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Enterovirus A71 (EV71), coxsackievirus A16 (CVA16), and coxsackievirus B3 (CVB3) are pathogenic members of the Picornaviridae family that cause a range of diseases, including severe central nervous system complications, myocarditis, and pancreatitis. Despite the considerable public health impact of these viruses, no approved antiviral treatments are currently available. In the present study, we confirmed the potential of saucerneol, a compound derived from Saururus chinensis, as an antiviral agent against EV71, CVA16, and CVB3. In the in vivo model, saucerneol effectively suppressed CVB3 replication in the pancreas and alleviated virus-induced pancreatitis. The antiviral activity of saucerneol is associated with increased mitochondrial ROS (mROS) production. In vitro inhibition of mROS generation diminishes the antiviral efficacy of saucerneol. Moreover, saucerneol treatment enhanced the phosphorylation of STING, TBK-1, and IRF3 in EV71- and CVA16-infected cells, indicating that its antiviral effects were mediated through the STING/TBK-1/IRF3 antiviral pathway, which was activated by increased mROS production. Saucerneol is a promising natural antiviral agent against EV71, CVA16, and CVB3 and has potential against virus-induced pancreatitis and myocarditis. Further studies are required to assess its safety and efficacy, which is essential for the development of effective antiviral strategies against these viruses.
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Affiliation(s)
- Jae-Hyoung Song
- Department of Pharmacy, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.-H.S.); (S.-H.M.); (H.Y.); (M.-y.S.)
- Kangwon Institute of Inclusive Technology, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Seo-Hyeon Mun
- Department of Pharmacy, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.-H.S.); (S.-H.M.); (H.Y.); (M.-y.S.)
| | - Heejung Yang
- Department of Pharmacy, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.-H.S.); (S.-H.M.); (H.Y.); (M.-y.S.)
| | - Yong Soo Kwon
- Department of Pharmacy, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.-H.S.); (S.-H.M.); (H.Y.); (M.-y.S.)
| | - Seong-Ryeol Kim
- Division of Acute Viral Diseases, Centers for Emerging Virus Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju 28159, Republic of Korea;
| | - Min-young Song
- Department of Pharmacy, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.-H.S.); (S.-H.M.); (H.Y.); (M.-y.S.)
| | - Youngwook Ham
- Nucleic Acid Therapeutics Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Cheongju 28116, Republic of Korea;
- Department of Biomolecular Science, KRIBB School of Bioscience, Korea University of Science and Technology (KUST), Daejeon 34113, Republic of Korea
| | - Hwa-Jung Choi
- Department of Beauty Art, Youngsan University, 142 Bansong Beltway, Busan 48015, Republic of Korea; (H.-J.C.); (W.-J.B.)
| | - Won-Jin Baek
- Department of Beauty Art, Youngsan University, 142 Bansong Beltway, Busan 48015, Republic of Korea; (H.-J.C.); (W.-J.B.)
| | - Sungchan Cho
- Nucleic Acid Therapeutics Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Cheongju 28116, Republic of Korea;
- Department of Biomolecular Science, KRIBB School of Bioscience, Korea University of Science and Technology (KUST), Daejeon 34113, Republic of Korea
| | - Hyun-Jeong Ko
- Department of Pharmacy, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.-H.S.); (S.-H.M.); (H.Y.); (M.-y.S.)
- Kangwon Institute of Inclusive Technology, Kangwon National University, Chuncheon 24341, Republic of Korea
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Man H, Huang H, Qin Z, Li Z. Analysis of a SARIMA-XGBoost model for hand, foot, and mouth disease in Xinjiang, China. Epidemiol Infect 2023; 151:e200. [PMID: 38044833 PMCID: PMC10729004 DOI: 10.1017/s0950268823001905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/29/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common childhood infectious disease. The incidence of HFMD has a pronounced seasonal tendency and is closely related to meteorological factors such as temperature, rainfall, and wind speed. In this paper, we propose a combined SARIMA-XGBoost model to improve the prediction accuracy of HFMD in 15 regions of Xinjiang, China. The SARIMA model is used for seasonal trends, and the XGBoost algorithm is applied for the nonlinear effects of meteorological factors. The geographical and temporal weighted regression model is designed to analyze the influence of meteorological factors from temporal and spatial perspectives. The analysis results show that the HFMD exhibits seasonal characteristics, peaking from May to August each year, and the HFMD incidence has significant spatial heterogeneity. The meteorological factors affecting the spread of HFMD vary among regions. Temperature and daylight significantly impact the transmission of the disease in most areas. Based on the verification experiment of forecasting, the proposed SARIMA-XGBoost model is superior to other models in accuracy, especially in regions with a high incidence of HFMD.
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Affiliation(s)
- Haojie Man
- School of Mathematics and Statistics, Beijing Institute of Technology, Beijing, China
| | - Hanting Huang
- School of Mathematical Sciences, Beihang University, Beijing, China
| | - Zhuangyan Qin
- College of Mathematics and System Science, Xinjiang University, Urumqi, China
| | - Zhiming Li
- College of Mathematics and System Science, Xinjiang University, Urumqi, China
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Tan YW, Teo FMS, Ler SG, Alli-Shaik A, Nyo M, Chong CY, Tan NWH, Wang RYL, Gunaratne J, Chu JJH. Potential relevance of salivary legumain for the clinical diagnostic of hand, foot, and mouth disease. J Med Virol 2023; 95:e29243. [PMID: 38009231 DOI: 10.1002/jmv.29243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023]
Abstract
The fight against hand, foot, and mouth disease (HFMD) remains an arduous challenge without existing point-of-care (POC) diagnostic platforms for accurate diagnosis and prompt case quarantine. Hence, the purpose of this salivary biomarker discovery study is to set the fundamentals for the realization of POC diagnostics for HFMD. Whole salivary proteome profiling was performed on the saliva obtained from children with HFMD and healthy children, using a reductive dimethylation chemical labeling method coupled with high-resolution mass spectrometry-based quantitative proteomics technology. We identified 19 upregulated (fold change = 1.5-5.8) and 51 downregulated proteins (fold change = 0.1-0.6) in the saliva samples of HFMD patients in comparison to that of healthy volunteers. Four upregulated protein candidates were selected for dot blot-based validation assay, based on novelty as biomarkers and exclusions in oral diseases and cancers. Salivary legumain was validated in the Singapore (n = 43 healthy, 28 HFMD cases) and Taiwan (n = 60 healthy, 47 HFMD cases) cohorts with an area under the receiver operating characteristic curve of 0.7583 and 0.8028, respectively. This study demonstrates the feasibility of a broad-spectrum HFMD POC diagnostic test based on legumain, a virus-specific host systemic signature, in saliva.
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Affiliation(s)
- Yong Wah Tan
- Collaborative and Translation Unit for Hand, Foot and Mouth Disease (HFMD), Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Fiona Mei Shan Teo
- Collaborative and Translation Unit for Hand, Foot and Mouth Disease (HFMD), Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Siok Ghee Ler
- Translational Biomedical Proteomics, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Asfa Alli-Shaik
- Translational Biomedical Proteomics, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Min Nyo
- Infectious Disease Translational Research Programme, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Robert Y L Wang
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Kidney Research Center and Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial and Children's Hospital, Linkou, Taiwan
| | - Jayantha Gunaratne
- Translational Biomedical Proteomics, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Justin Jang Hann Chu
- Collaborative and Translation Unit for Hand, Foot and Mouth Disease (HFMD), Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Infectious Disease Translational Research Programme, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Cheong DHJ, Yogarajah T, Wong YH, Arbrandt G, Westman J, Chu JJH. CUR-N399, a PI4KB inhibitor, for the treatment of Enterovirus A71 infection. Antiviral Res 2023; 218:105713. [PMID: 37657668 DOI: 10.1016/j.antiviral.2023.105713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/19/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
Over the years, the hand, foot and mouth disease (HFMD) has sparked epidemics across many countries which mainly affected young children. While symptoms are usually mild, severe complications may arise, and some even lead to death. Such concerns, coupled with the lack of approved vaccines and antivirals to date, create an urgency in the identification of safe therapeutics against HFMD. The disease is mainly transmitted by enteroviruses like enterovirus A71 (EV-A71). Essential for enterovirus replication is the host protein, PI4KB. In this study, we investigate the antiviral efficacy of a novel PI4KB inhibitor, CUR-N399. We found that CUR-N399 displayed broad-spectrum antiviral activity against picornaviruses in cell culture models. Using a suckling mouse model of lethal EV-A71 infection, CUR-N399 was found to be well-tolerated, promote survival and reduce viral titre in mice organs. Together, these support the discovery of CUR-N399 as an antiviral against EV-A71 and potentially other closely related viruses.
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Affiliation(s)
- Dorothy Hui Juan Cheong
- Infectious Disease Translational Research Programme and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Thinesshwary Yogarajah
- Infectious Disease Translational Research Programme and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yi Hao Wong
- Biosafety Level 3 Core Facility, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Justin Jang Hann Chu
- Infectious Disease Translational Research Programme and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Biosafety Level 3 Core Facility, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Collaborative and Translation Unit for Hand, Foot and Mouth Disease (HFMD), Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore, Singapore.
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Lai J, Li Z, Pan L, Huang Y, Zhou Z, Ma C, Guo J, Xu L. Research progress on pathogenic and therapeutic mechanisms of Enterovirus A71. Arch Virol 2023; 168:260. [PMID: 37773227 DOI: 10.1007/s00705-023-05882-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/12/2023] [Indexed: 10/01/2023]
Abstract
In recent years, enterovirus A71 (EV-A71) infection has become a major global public health problem, especially for infants and young children. The results of epidemiological research show that EV-A71 infection can cause acute hand, foot, and mouth disease (HFMD) and complications of the nervous system in severe cases, including aseptic pediatric meningoencephalitis, acute flaccid paralysis, and even death. Many studies have demonstrated that EV-A71 infection may trigger a variety of intercellular and intracellular signaling pathways, which are interconnected to form a network that leads to the innate immune response, immune escape, inflammation, and apoptosis in the host. This article aims to provide an overview of the possible mechanisms underlying infection, signaling pathway activation, the immune response, immune evasion, apoptosis, and the inflammatory response caused by EV-A71 infection and an overview of potential therapeutic strategies against EV-A71 infection to better understand the pathogenesis of EV-A71 and to aid in the development of antiviral drugs and vaccines.
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Affiliation(s)
- Jianmei Lai
- Academy of Pediatrics, Guangzhou Medical University, Guangzhou, China
| | - Zhishan Li
- Academy of Pediatrics, Guangzhou Medical University, Guangzhou, China
| | - Lixin Pan
- The First People's Hospital of Foshan, Foshan, China
| | - Yunxia Huang
- The Sixth Clinical College, Guangzhou Medical University, Guangzhou, China
| | - Zifei Zhou
- Academy of Pediatrics, Guangzhou Medical University, Guangzhou, China
| | - Chunhong Ma
- Academy of Pediatrics, Guangzhou Medical University, Guangzhou, China
| | - Jiachun Guo
- Academy of Pediatrics, Guangzhou Medical University, Guangzhou, China
| | - Lingqing Xu
- Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China.
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Jin WP, Wang C, Wu J, Guo J, Meng SL, Wang ZJ, Yu DG, Shen S. Reporter Coxsackievirus A5 Expressing iLOV Fluorescent Protein or Luciferase Used for Rapid Neutralizing Assay in Cells and Living Imaging in Mice. Viruses 2023; 15:1868. [PMID: 37766275 PMCID: PMC10535187 DOI: 10.3390/v15091868] [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: 08/08/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Coxsackievirus A5 (CV-A5) is a re-emerging enterovirus that causes hand, foot, and mouth disease in children under five years of age. CV-A5-M14-611 is a mouse-adapted strain that can infect orally and lead to the death of 14-day-old mice. Here, recombinants based on CV-A5-M14-611 were constructed carrying three reporter genes in different lengths. Smaller fluorescent marker proteins, light, oxygen, voltage sensing (iLOV), and nano luciferase (Nluc) were proven to be able to express efficiently in vitro. However, the recombinant with the largest insertion of the red fluorescence protein gene (DsRed) was not rescued. The construction strategy of reporter viruses was to insert the foreign genes between the C-terminus of VP1 and the N-terminus of 2A genes and to add a 2A protease cleavage domain at both ends of the insertions. The iLOV-tagged or Nluc-tagged recombinants, CV-A5-iLOV or CV-A5-Nluc, exhibited a high capacity for viral replication, genetic stability in cells and pathogenicity in mice. They were used to establish a rapid, inexpensive and convenient neutralizing antibody assay and greatly facilitated virus neutralizing antibody titration. Living imaging was performed on mice with CV-A5-Nluc, which exhibited specific bioluminescence in virus-disseminated organs, while fluorescence induced by CV-A5-iLOV was weakly detected. The reporter-gene-tagged CV-A5 can be used to study the infection and mechanisms of CV-A5 pathogenicity in a mouse model. They can also be used to establish rapid and sensitive assays for detecting neutralizing antibodies.
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Affiliation(s)
| | | | | | | | | | | | | | - Shuo Shen
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China; (W.-P.J.); (C.W.); (J.W.); (J.G.); (S.-L.M.); (Z.-J.W.); (D.-G.Y.)
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9
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Shimizu JF, Feferbaum-Leite S, Santos IA, Martins DOS, Kingston NJ, Shegdar M, Zothner C, Sampaio SV, Harris M, Stonehouse NJ, Jardim ACG. Effect of proteins isolated from Brazilian snakes on enterovirus A71 replication cycle: An approach against hand, foot and mouth disease. Int J Biol Macromol 2023; 241:124519. [PMID: 37085072 PMCID: PMC7615699 DOI: 10.1016/j.ijbiomac.2023.124519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/14/2023] [Accepted: 04/15/2023] [Indexed: 04/23/2023]
Abstract
Enterovirus A71 (EVA71) belongs to the Picornaviridae family and is the main etiological agent of hand, foot, and mouth disease (HFMD). There is no approved antiviral against EVA71, and therefore the search for novel anti-EVA71 therapeutics is essential. In this context, the antiviral activity of proteins isolated from snake venoms has been reported against a range of viruses. Here, the proteins CM10 and CM14 isolated from Bothrops moojeni, and Crotamin and PLA2CB isolated from Crotalus durissus terrificus were investigated for their antiviral activity against EVA71 infection. CM14 and Crotamin possessed a selective index (SI) of 170.8 and 120.4, respectively, while CM10 and PLA2CB had an SI of 67.4 and 12.5, respectively. CM14 inhibited all steps of viral replication (protective effect: 76 %; virucidal: 99 %; and post-entry: 99 %). Similarly, Crotamin inhibited up to 99 % of three steps. In contrast, CM10 and PLA2CB impaired one or two steps of EVA71 replication, respectively. Further dose-response assays using increasing titres of EVA71 were performed and CM14 and Crotamin retained functionality with high concentrations of EVA71 (up to 1000 TCID50). These data demonstrate that proteins isolated from snake venom are potent inhibitors of EVA71 and could be used as scaffolds for future development of novel antivirals.
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Affiliation(s)
- Jacqueline Farinha Shimizu
- Laboratory of Antiviral Research, Institute of Biomedical Science - ICBIM, Federal University of Uberlândia - UFU, Uberlândia, MG, Brazil; Institute of Biosciences, Language and Exact Science - IBILCE, São Paulo State University - UNESP, São José do Rio Preto, SP, Brazil; Brazilian Biosciences National Laboratory (LNBio), Brazilian Centre for Research in Energy and Materials (CNPEM), Campinas, SP 13083-100, Brazil
| | - Shiraz Feferbaum-Leite
- Laboratory of Antiviral Research, Institute of Biomedical Science - ICBIM, Federal University of Uberlândia - UFU, Uberlândia, MG, Brazil
| | - Igor Andrade Santos
- Laboratory of Antiviral Research, Institute of Biomedical Science - ICBIM, Federal University of Uberlândia - UFU, Uberlândia, MG, Brazil
| | - Daniel Oliveira Silva Martins
- Laboratory of Antiviral Research, Institute of Biomedical Science - ICBIM, Federal University of Uberlândia - UFU, Uberlândia, MG, Brazil; Institute of Biosciences, Language and Exact Science - IBILCE, São Paulo State University - UNESP, São José do Rio Preto, SP, Brazil
| | - Natalie J Kingston
- School of Molecular and Cellular Biology, Faculty of Biological Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Mona Shegdar
- School of Molecular and Cellular Biology, Faculty of Biological Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Carsten Zothner
- School of Molecular and Cellular Biology, Faculty of Biological Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Suely Vilela Sampaio
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo - USP, SP, Brazil
| | - Mark Harris
- School of Molecular and Cellular Biology, Faculty of Biological Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Nicola J Stonehouse
- School of Molecular and Cellular Biology, Faculty of Biological Sciences and Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Ana Carolina Gomes Jardim
- Laboratory of Antiviral Research, Institute of Biomedical Science - ICBIM, Federal University of Uberlândia - UFU, Uberlândia, MG, Brazil; Institute of Biosciences, Language and Exact Science - IBILCE, São Paulo State University - UNESP, São José do Rio Preto, SP, Brazil.
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10
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Shi S, Xie L, Ma S, Xu B, An H, Ye S, Wang Y. Computational and experimental studies of salvianolic acid A targets 3C protease to inhibit enterovirus 71 infection. Front Pharmacol 2023; 14:1118584. [PMID: 36937869 PMCID: PMC10017496 DOI: 10.3389/fphar.2023.1118584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common childhood infectious disease caused by enterovirus (EV) infection. EV71 is one of the major pathogens causing hand, foot, and mouth disease and is more likely to cause exacerbation and death than other enteroviruses. Although a monovalent vaccine for EV71 has been developed, there are no clinically available anti-EV71 specific drugs. Here, we performed virtual screening and biological experiments based on the traditional Chinese medicine monomer library. We identified a traditional Chinese medicine monomer, Salvianolic acid A (SA), a polyphenolic compound isolated from Salvia miltiorrhiza. Salvianolic acid A inhibits EV71 virus infection in a concentration-dependent manner, and its antiviral activity is higher than that of other reported natural polyphenols and has a high biosafety. Furthermore, molecular dynamics simulations showed that salvianolic acid A can anchor to E71, a member of the enzyme catalytic triad, and cause H40 to move away from the catalytic center. Meanwhile, molecular mechanics generalized born surface area (MMGBSA) and steered molecular dynamics (SMD) results showed that the P1 group of SA was most easily unbound to the S1 pocket of 3Cpro, which provided theoretical support to further improve the affinity of salvianolic acid A with 3Cpro. These findings suggest that salvianolic acid A is a novel EV71 3Cpro inhibitor with excellent antiviral activity and is a promising candidate for clinical studies.
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Affiliation(s)
- Sai Shi
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin University, Tianjin, China
| | - Lei Xie
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin University, Tianjin, China
| | - Sen Ma
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin University, Tianjin, China
| | - Binghong Xu
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin University, Tianjin, China
| | - Hailong An
- Key Laboratory of Molecular Biophysics of Hebei Province, Institute of Biophysics, Hebei University of Technology, Tianjin, China
| | - Sheng Ye
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin University, Tianjin, China
- *Correspondence: Sheng Ye, ; Yaxin Wang,
| | - Yaxin Wang
- Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, School of Life Sciences, Tianjin University, Tianjin, China
- *Correspondence: Sheng Ye, ; Yaxin Wang,
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11
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Aggarwal M, Bansal N, Naresh A, Tikute S, Dubey S, Rajmohan KS, Kumar R, Gopalkrishna V. Clinical profile and molecular typing of viral etiological agents associated with Hand, Foot and Mouth Disease (HFMD): A study from Udhampur, Northern India. Indian J Med Microbiol 2023; 41:97-100. [PMID: 36470773 DOI: 10.1016/j.ijmmb.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/28/2022] [Accepted: 11/09/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE Hand, Foot and Mouth disease (HFMD) is a contagious pediatric viral disease caused due to enteroviruses (EV) of the family Picornaviridae. Cases of HFMD were reported from a tertiary care health centre, Udhampur, (Jammu and Kashmir), Northern India. The present study highlights the clinical and molecular virological aspects of HFMD cases. MATERIAL AND METHODS Cases reported during August 2016-September 2017, and clinically diagnosed as HFMD of all age groups were included. Clinical, Biochemical and molecular virology aspects were compared. Clinical samples (n = 50) such as vesicle swab, buccal and throat swabs were collected for enterovirus detection. EV-RNA was detected by 5'NCR based RT-PCR and genotyping by VP1 gene amplification and cycle sequencing. RESULTS Of the cases of HFMD enrolled (n = 50), highest (84%) were of children aged <5 years, presented either or both anathemas and exanthemas with prodromal symptoms (fever, irritability). Clinical presentations involved mainly oral ulcers on lips and tongue (48%). Oral erosions were either single or multiple in numbers. Exanthemas were seen on hand and palm, widely spread up to buttocks, legs, arms and trunk. Of these, six patients were found anemic. Complete blood count (CBC) indicated lymphocytosis and C-reactive protein (n = 10) in children aged <5 years. EV-RNA was detected in 78% (39/50) of the clinical samples. VP1 gene based typing indicated the presence of CV-A16, CVA6 and EV-A71 types. CONCLUSIONS The study highlights association of EVs in HFMD cases in the reported region. CV-A16, CV-A6 and EV-A71 types were reported for the first time from Udhampur (J&K), Northern India. No differences were observed in the clinical profile of EV strains detected. Circulation of the strains warrant and alarm outbreaks. More focused studies on HFMD and monitoring of viral strains is mandatory.
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Affiliation(s)
| | - Naresh Bansal
- Command Hospital, Udhampur, Jammu and Kashmir, India.
| | - Amit Naresh
- Command Hospital, Udhampur, Jammu and Kashmir, India
| | | | - Sudhir Dubey
- Command Hospital, Udhampur, Jammu and Kashmir, India
| | - K S Rajmohan
- Command Hospital, Udhampur, Jammu and Kashmir, India
| | - Rakesh Kumar
- Command Hospital, Udhampur, Jammu and Kashmir, India
| | - Varanasi Gopalkrishna
- Enteric Viruses Group, ICMR-National Institute of Virology, 20-A, Dr.Ambedkar Road, Pune, 41100, India
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12
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Xing J, Wang K, Wang G, Li N, Zhang Y. Recent advances in enterovirus A71 pathogenesis: a focus on fatal human enterovirus A71 infection. Arch Virol 2022; 167:2483-2501. [PMID: 36171507 DOI: 10.1007/s00705-022-05606-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/05/2022] [Indexed: 12/14/2022]
Abstract
Enterovirus A71 (EV-A71) is one of the major pathogens responsible for hand, foot, and mouth disease (HFMD). Many HFMD outbreaks have been reported throughout the world in the past decades. Compared with other viruses, EV-A71 infection is more frequently associated with severe neurological complications and even death in children. EV-A71 can also infect adults and cause severe complications and death, although such cases are very uncommon. Although fatal cases of EV-A71 infection have been reported, the underlying mechanisms of EV-A71 infection, especially the mode of viral spread into the central nervous system (CNS) and mechanisms of pulmonary edema, which is considered to be the direct cause of death, have not yet been fully clarified, and more studies are needed. Here, we first summarize the pathological findings in various systems of patients with fatal EV-A71 infections, focussing in detail on gross changes, histopathological examination, tissue distribution of viral antigens and nucleic acids, systemic inflammatory cell infiltration, and tissue distribution of viral receptors and their co-localization with viral antigens. We then present our conclusions about viral dissemination, neuropathogenesis, and the mechanism of pulmonary edema in EV-A71 infection, based on pathological findings.
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Affiliation(s)
- Jingjun Xing
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China
| | - Ke Wang
- The Affiliated Hospital of Medical School, Ningbo University, No. 247 Renmin Road, Jiangbei District, Ningbo, 315020, Zhejiang Province, P. R. China
| | - Geng Wang
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China
| | - Na Li
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China
| | - Yanru Zhang
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China.
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13
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Cui G, Wang H, Yang C, Zhou X, Wang J, Wang T, Ma T. Berberine prevents lethal EV71 neurological infection in newborn mice. Front Pharmacol 2022; 13:1027566. [PMID: 36386168 PMCID: PMC9640474 DOI: 10.3389/fphar.2022.1027566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/14/2022] [Indexed: 12/01/2022] Open
Abstract
Enterovirus 71 (EV71) is the major pathogen causing fatal neurological complications of hand, foot, and mouth disease (HFMD) in young children. Currently no effective antiviral therapy is available. In the present study, we found that natural compound Berberine (BBR) displayed potent inhibitory effects on EV71 replication in various neural cells (IC50 of 2.79–4.03 μM). In a newborn mouse model of lethal EV71 infection, Berberine at 2–5 mg/kg markedly reduced mortality and clinical scores. Consistently, the replication of EV71 and pathological changes were attenuated in various infected organs including brain and lung with BBR treatment. Interestingly, EV71 infection in the brain mainly localized in the peripheral zone of brainstem and largely in astrocytes. Primary culture of astrocytes from newborn mouse brain confirmed the efficient EV71 replication that was mostly inhibited by BBR treatment at 5 μM. Further investigations revealed remarkably elevated cellular reactive oxygen species (ROS) levels that coincided with EV71 replication in primary cultured astrocytes and various cell lines. BBR largely abolished the virus-elevated ROS production and greatly diminished EV71 replication by up-regulating NFE2 like bZIP transcription factor 2 (Nrf2) via the kelch like ECH associated protein 1 (Keap)-Nrf2 axis. The nuclear localization of Nrf2 and expression of downstream antioxidant enzymes heme oxygenase 1 (HO-1) and NAD(P)H quinone dehydrogenase 1 (NQO1) were increased significantly by BBR treatment. Collectively, our findings revealed that BBR prevents lethal EV71 neurological infection via inhibiting virus replication through regulating Keap-Nrf2 axis and ROS generation in astrocytes of brainstem, thus providing a potential antiviral treatment for severe EV71 infection associated with neurological complications.
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14
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Cheng D, Chiu YW, Huang SW, Lien YY, Chang CL, Tsai HP, Wang YF, Wang JR. Genetic and Cross Neutralization Analyses of Coxsackievirus A16 Circulating in Taiwan from 1998 to 2021 Suggest Dominant Genotype B1 can Serve as Vaccine Candidate. Viruses 2022; 14:2306. [PMID: 36298861 PMCID: PMC9608817 DOI: 10.3390/v14102306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 07/30/2023] Open
Abstract
Coxsackievirus A16 (CVA16) is well known for causing hand-foot-and-mouth disease (HFMD) and outbreaks were frequently reported in Taiwan in the past twenty years. The epidemiology and genetic variations of CVA16 in Taiwan from 1998 to 2021 were analyzed in this study. CVA16 infections usually occurred in early summer and early winter, and showed increased incidence in 1998, 2000-2003, 2005, 2007-2008, and 2010 in Taiwan. Little or no CVA16 was detected from 2017 to 2021. CVA16 infection was prevalent in patients between 1 to 3 years old. A total of 69 isolates were sequenced. Phylogenetic analysis based on the VP1 region showed that CVA16 subgenotype B1 was dominantly isolated in Taiwan from 1998 to 2019, and B2 was identified only from isolates collected in 1999 and 2000. There was a high frequency of synonymous mutations in the amino acid sequences of the VP1 region among CVA16 isolates, with the exception of position 145 which showed positive selection. The recombination analysis of the whole genome of CVA16 isolates indicated that the 5'-untranslated region and the non-structural protein region of CVA16 subgenotype B1 were recombined with Coxsackievirus A4 (CVA4) and enterovirus A71 (EVA71) genotype A, respectively. The recombination pattern of subgenotype B2 was similar to B1, however, the 3D region was similar to EVA71 genotype B. Cross-neutralization among CVA16 showed that mouse antisera from various subgenotypes viruses can cross-neutralize different genotype with high neutralizing antibody titers. These results suggest that the dominant CVA16 genotype B1 can serve as a vaccine candidate for CVA16.
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Affiliation(s)
- Dayna Cheng
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yo-Wei Chiu
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70101, Taiwan
| | - Sheng-Wen Huang
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Tainan 70101, Taiwan
| | - Yun-Yin Lien
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70101, Taiwan
| | - Chia-Lun Chang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70101, Taiwan
| | - Huey-Pin Tsai
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ya-Fang Wang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70101, Taiwan
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Tainan 70101, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Jen-Ren Wang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70101, Taiwan
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
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Li W, Wang J, Zhou K, Tian Y, Wei F, Zhang M, Wang X. Association of PM 2.5 and its components with lengths of hospital stay for hand foot and mouth disease in children. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:50598-50607. [PMID: 35237913 DOI: 10.1007/s11356-022-19448-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
Hand foot and mouth disease (HFMD) is a widespread public health concern but the studies on air pollution and the lengths of hospital stay (LOS) of HFMD are scarce nevertheless. Clinic demographic features among 5135 hospitalized HFMD cases in Nanjing, China, had been characterized from 2012 to 2017. Then, we had analyzed the association between PM2.5 short-term exposure as well as its components (OM, BC, SO42-, NH4+, NIT, SOIL, and SS) and the LOS of HFMD. Among these cases that were involved in our study, 98.62% were aged 0-6 years old, and 3772 (73.46%) were hospitalized within 1 week or less. The LOS of HFMD patients was different in various age ranges, illness onset years, and illness onset seasons (P < 0.01). For per IQR increase in PM2.5 concentrations, LOS of HFMD increased by 0.52 (0.33, 0.71), 0.50 (95% CI, 0.31-0.69) and 0.46 (95% CI, 0.28-0.65) day in adjusted models at lag 3 days, lag 7 days, and lag 14 days, respectively. In addition, per IQR increase of BC, SO42-, NH4+, NIT, and SOIL was also significantly associated with the LOS of HFMD. Our findings corroborated that short-term PM2.5 exposure was associated with the increased LOS of HFMD, and its components (BC, SO42-, NH4+, NIT, and SOIL) of PM2.5 might play a key role in prolonged LOS of HFMD.
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Affiliation(s)
- Wei Li
- Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Jieguo Wang
- Department of Emergency, Pediatric Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Kai Zhou
- Department of Infection, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Ye Tian
- Department of Infection, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Feiran Wei
- Division of Rheumatology, Zhongda Hospital Southeast University, Nanjing, 210008, China
| | - Mingzhi Zhang
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Xu Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
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16
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Xiao J, Zhu Q, Yang F, Zeng S, Zhu Z, Gong D, Li Y, Zhang L, Li B, Zeng W, Li X, Rong Z, Hu J, He G, Sun J, Lu J, Liu T, Ma W, Sun L. The impact of enterovirus A71 vaccination program on hand, foot, and mouth disease in Guangdong, China:a longitudinal surveillance study. J Infect 2022; 85:428-435. [PMID: 35768049 DOI: 10.1016/j.jinf.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 10/17/2022]
Abstract
Enterovirus A71 (EV71) vaccination program was introduced in 2016 in China. Based on a longitudinal surveillance dataset from 2012 to 2019 in Guangdong, China, we estimated the impact of the EV71 vaccination program on hand, foot, and mouth disease (HFMD) incidence, by using a counterfactual prediction made from synthetic control approach integrated with a Bayesian time-series model. We observed a relative reduction of 41.4% for EV71-associated HFMD cases during the post-vaccination period of 2017-2019, corresponding to 26,226 cases averted. The reduction of EV71-associated HFMD cases raised with the elevation of EV71 vaccine coverage by year. We found an indirect effect for the children aged 6-14 years who were less likely to be vaccinated. Whereas, the EV71 vaccine may not protect against non-EV71-associated HFMD. This study provides a template for ongoing public health surveillance of EV71 vaccine effectiveness with a counterfactual study design. Our results show strong evidence of the EV71 vaccination program working on reducing EV71-associated HFMD in real-world settings. The finding will benefit policy-making of EV71 vaccination and the prevention of HFMD.
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Affiliation(s)
- Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Qi Zhu
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Fen Yang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Siqing Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Zhihua Zhu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Dexin Gong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China; World Health Organization Western Pacific Region, 1000 Metro Manila, the Philippines
| | - Yihan Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Li Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Bin Li
- Chengde College of Applied Technology, Chengde 067000, Hebei, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Jing Lu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China.
| | - Limei Sun
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China.
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Nayak G, Bhuyan SK, Bhuyan R, Sahu A, Kar D, Kuanar A. Global emergence of Enterovirus 71: a systematic review. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2022; 11:78. [PMID: 35730010 PMCID: PMC9188855 DOI: 10.1186/s43088-022-00258-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/29/2022] [Indexed: 02/06/2023] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is a viral infection caused by a virus from the enterovirus genus of picornavirus family that majorly affects children. Though most cases of HFMD do not cause major problems, the outbreaks of Enterovirus 71 (EV71) can produce a high risk of neurological sequelae, including meningoencephalitis, lung difficulties, and mortality. In Asia, HFMD caused by EV71 has emerged as an acutely infectious disease of highly pathogenic potential, which demands the attention of the international medical community.
Main body of the abstract Some online databases including NCBI, PubMed, Google Scholar, ProQuest, Scopus, and EBSCO were also accessed using keywords relating to the topic for data mining. The paid articles were accessed through the Centre Library facility of Siksha O Anusandhan University. This work describes the structure, outbreak, molecular epidemiology of Enterovirus 71 along with different EV71 vaccines. Many vaccines have been developed such as inactivated whole-virus live attenuated, subviral particles, and DNA vaccines to cure the patients. In Asia–Pacific nations, inactivated EV71 vaccination still confronts considerable obstacles in terms of vaccine standardization, registration, price, and harmonization of pathogen surveillance and measurements. Short conclusion HFMD has emerged as a severe health hazard in Asia–Pacific countries in recent decades. In Mainland China and other countries with high HFMD prevalence, the inactivated EV71 vaccination will be a vital tool in safeguarding children's health. When creating inactivated EV71 vaccines, Mainland China ensured maintaining high standards of vaccine quality. The Phase III clinical studies were used to confirm the safety and effectiveness of vaccinations. Graphical Abstract ![]()
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Affiliation(s)
- Gayatree Nayak
- Centre for Biotechnology, Siksha O Anusandhan (Deemed to Be) University, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha 751003 India
| | - Sanat Kumar Bhuyan
- Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to Be) University, Bhubaneswar, Odisha 751003 India
| | - Ruchi Bhuyan
- Department of Medical Research, Health Science, IMS and SUM Hospital, Siksha O Anusandhan (Deemed to Be) University, Bhubaneswar, Odisha 751003 India
| | - Akankshya Sahu
- Centre for Biotechnology, Siksha O Anusandhan (Deemed to Be) University, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha 751003 India
| | - Dattatreya Kar
- Department of Medical Research, Health Science, IMS and SUM Hospital, Siksha O Anusandhan (Deemed to Be) University, Bhubaneswar, Odisha 751003 India
| | - Ananya Kuanar
- Centre for Biotechnology, Siksha O Anusandhan (Deemed to Be) University, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha 751003 India
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18
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Du Z, Zhang W, Yu S, Lin S, Hao Y. Assessing the impact of ambient temperature on the risk of hand, foot, and mouth disease in Guangdong, China: New insight from the disease severity and burden. PLoS Negl Trop Dis 2022; 16:e0010470. [PMID: 35737664 PMCID: PMC9223337 DOI: 10.1371/journal.pntd.0010470] [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: 09/23/2021] [Accepted: 05/05/2022] [Indexed: 11/19/2022] Open
Abstract
Background The association between the incidence of hand, foot, and mouth disease (HFMD) and ambient temperature has been well documented. Although the severity of symptoms is an important indicator of disease burden and varies significantly across cases, it usually was ignored in previous studies, potentially leading to biased estimates of the health impact of temperature. Methods We estimated the disability-adjusted life year (DALY) by considering the severity of symptoms for each HFMD case reported during 2010–2012 in Guangdong and used distributed lag-nonlinear models to estimate the association between the daily average temperature and daily DALY of HFMD cases at the city-level. We investigated the potential effect modifiers on the pathway between temperature and DALY and pooled city-specific estimates to a provincial association using a meta-regression. The overall impact of temperature was further evaluated by estimates of DALYs that could be attributed to HFMD. Results The overall cumulative effect of daily mean temperature on the DALY of HFMD showed an inverse-U shape, with the maximum effect estimated to be β = 0.0331 (95%CI: 0.0199–0.0463) DALY at 23.8°C. Overall, a total of 6.432 (95%CI: 3.942–8.885) DALYs (attributable fraction = 2.721%, 95%CI: 1.660–3.759%) could be attributed to temperature exposure. All the demographic subgroups had a similar trend as the main analysis, while the magnitude of the peak of the temperature impact tended to be higher among the males, those aged ≥3yrs or from the Pear-River Delta region. Additionally, the impact of temperature on DALY elevated significantly with the increasing population density, per capita GDP, and per capita green space in parks. Conclusions Temperature exposure was associated with increased burden of HFMD nonlinearly, with certain groups such as boys and those from areas with greater population density being more vulnerable. Hand, foot, and mouth disease (HFMD) is a contagious viral infection common in young children. Although the association between ambient temperature and the risk of HFMD has been well documented, existing studies were solely based on the reported number of cases, failing to differentiate cases of different severity. This study improves the estimation of disease burden by additionally accounting for the severity of symptoms. Our major findings included that (1) we identified an inverse-U shaped association between the ambient temperature and the daily DALY (i.e. an established indicator for disease burden) associated with HFMD, with 2.7% DALY could be attributed to the temperature exposure; (2) the peak impact of temperature on DALY was estimated to be β = 0.0331 (95%CI: 0.0199–0.0463) DALY and identified at 23.8°C; (3) the trends were generally consistent across different demographic and geographic subgroups, with the peak effect identified to be greater among the males, those aged ≥3yrs or from the Pear-River Delta region; (4) the impact of temperature on DALY elevated more apparently in areas with a greater population density, per capita GDP, or per capita green space in parks.
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Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, the State University of New York, Albany, New York, USA
| | - Yuantao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- * E-mail:
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Molecular Epidemiology of Enterovirus A71 in Surveillance of Acute Flaccid Paralysis Cases in Senegal, 2013-2020. Vaccines (Basel) 2022; 10:vaccines10060843. [PMID: 35746451 PMCID: PMC9230434 DOI: 10.3390/vaccines10060843] [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: 04/28/2022] [Revised: 05/19/2022] [Accepted: 05/21/2022] [Indexed: 12/10/2022] Open
Abstract
Enterovirus A71 (EV-A71) is a non-polio enterovirus that currently represents a major public health concern worldwide. In Africa, only sporadic cases have been reported. Acute flaccid paralysis and environmental surveillance programs have been widely used as strategies for documenting the circulation of polio and non-polio enteroviruses. To date, little is known about the molecular epidemiology of enterovirus A71 in Africa where resources and diagnostic capacities are limited. To fill this gap in Senegal, a total of 521 non-polio enterovirus isolates collected from both acute flaccid paralysis (AFP) and environmental surveillance (ES) programs between 2013 and 2020 were screened for enterovirus A71 using real-time RT-PCR. Positive isolates were sequenced, and genomic data were analyzed using phylogeny. An overall rate of 1.72% (9/521) of the analyzed isolates tested positive for enterovirus A71. All positive isolates originated from the acute flaccid paralysis cases, and 44.4% (4/9) of them were isolated in 2016. The nine newly characterized sequences obtained in our study included eight complete polyprotein sequences and one partial sequence of the VP1 gene, all belonging to the C genogroup. Seven out of the eight complete polyprotein sequences belonged to the C2 subgenotype, while one of them grouped with previous sequences from the C1 subgenotype. The partial VP1 sequence belonged to the C1 subgenotype. Our data provide not only new insights into the recent molecular epidemiology of enterovirus A71 in Senegal but also point to the crucial need to set up specific surveillance programs targeting non-polio enteroviruses at country or regional levels in Africa for rapid identification emerging or re-emerging enteroviruses and better characterization of public health concerns causing acute flaccid paralysis in children such as enterovirus A71. To estimate the real distribution of EV-A71 in Africa, more sero-epidemiological studies should be promoted, particularly in countries where the virus has already been reported.
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Xie MZ, Chen LY, Yang YN, Cui Y, Zhang SH, Zhao TS, Zhang WX, Du J, Cui FQ, Lu QB. Molecular Epidemiology of Herpangina Children in Tongzhou District, Beijing, China, During 2019-2020. Front Med (Lausanne) 2022; 9:822796. [PMID: 35547223 PMCID: PMC9082675 DOI: 10.3389/fmed.2022.822796] [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: 11/26/2021] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background The changing pattern of pathogen spectrum causing herpangina in the time of coronavirus disease 2019 (COVID-19) pandemic was unknown. The purpose of this study was to investigate the changes on the molecular epidemiology of herpangina children during 2019-2020 in Tongzhou district, Beijing, China. Method From January 2019 to December 2020, children diagnosed with herpangina were recruited by the staff from Tongzhou Center for Disease Control and Prevention (CDC) in Beijing. Viral RNA extraction from pharyngeal swabs was used for enterovirus (EV) detection and the complete VP1 gene was sequenced. The phylogenetic analysis was performed based on all VP1 sequences for EV genotypes. Result A total of 1,331 herpangina children were identified during 2019-2020 with 1,121 in 2019 and 210 in 2020, respectively. The predominant epidemic peak of herpangina children was in summer and autumn of 2019, but not observed in 2020. Compared to the number of herpangina children reported in 2019, it decreased sharply in 2020. Among 129 samples tested in 2019, 61 (47.3%) children were detected with EV, while 22.5% (20/89) were positive in 2020. The positive rate for EV increased since June 2019, peaked at August 2019, and decreased continuously until February 2020. No cases were observed from February to July in 2020, and the positive rate of EV rebounded to previous level since August 2020. Four genotypes, including coxsackievirus A6 (CV-A6, 9.3%), CV-A4 (7.8%), CV-A10 (2.3%) and CV-A16 (10.1%), were identified in 2019, and only three genotypes, including CV-A6 (9.0%), CV-A10 (6.7%) and CV-A16 (1.1%), were identified in 2020. The phylogenetic analysis showed that all CV-A6 strains from Tongzhou located in Group C, and the predominant strains mainly located in C2-C4 subgroups during 2016-2018 and changed into C1 subgroup during 2018-2020. CV-A16 strains mainly located in Group B, which consisting of strains widely distributed around the world. Conclusions The predominant genotypes gradually shifted from CV-A16, CV-A4 and CV-A6 in 2019 to CV-A6 in 2020 under COVID-19 pandemic. Genotype-based surveillance will provide robust evidence and facilitate the development of public health measures.
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Affiliation(s)
- Ming-Zhu Xie
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Lin-Yi Chen
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Yan-Na Yang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Disease Control and Prevention, Beijing, China
| | - Yan Cui
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Tongzhou Center for Disease Control and Prevention, Beijing, China
| | - Si-Hui Zhang
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Tian-Shuo Zhao
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Wan-Xue Zhang
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Juan Du
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Fu-Qiang Cui
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China
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21
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Liu H, Zhang Y, Zhang H, Zheng Y, Gou F, Yang X, Cheng Y, McClymont H, Li H, Liu X, Hu W. Prototypes virus of hand, foot and mouth disease infections and severe cases in Gansu, China: a spatial and temporal analysis. BMC Infect Dis 2022; 22:408. [PMID: 35473588 PMCID: PMC9040212 DOI: 10.1186/s12879-022-07393-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 04/13/2022] [Indexed: 11/11/2022] Open
Abstract
Background Little research has been conducted on the spatio-temporal relationship between the severe cases and the enteroviruses infections of hand, foot and mouth disease (HFMD). This study aimed to investigate epidemic features and spatial clusters of HFMD incidence rates and assess the relationship between Enterovirus 71 (EV71) and Coxsackievirus A16 (CoxA16) and severe cases of HMFD in Gansu province, China. Methods Weekly county-specific data on HFMD between 1st January and 31st December 2018 were collected from the China Infectious Disease Information System (CIDIS), including enterovirus type (EV71 and CoxA16), severe and non-severe cases in Gansu province, China. Temporal risk [frequency index (α), duration index (β) and intensity index (γ)] and spatial cluster analysis were used to assess epidemic features and identify high-risk areas for HFMD. Time-series cross-correlation function and regression model were used to explore the relationship between the ratios of two types of viruses (i.e. EV71/Cox16) (EC) and severe cases index (i.e. severe cases/non-severe cases) (SI) of HFMD. Results Some counties in Dingxi City, Gansu were identified as a hot spot for the temporal risk indices. Time-series cross-correlation analysis showed that SI was significantly associated with EC (r = 0.417, P < 0.05) over a 4-week time lag. The regression analysis showed that SI was positively associated with EC (β = 0.04, 95% confidence interval (CI) 0.02–0.06). Conclusion The spatial patterns of HFMD incidence were associated with enteroviruses in Gansu. The research suggested that the EC could be considered a potential early warning sign for predicting severe cases of HFMD in Gansu province.
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Affiliation(s)
- Haixia Liu
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Yuzhou Zhang
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.,College of Computer Science and Technology, Zhejiang University, Hangzhou, China.,Department of Research, Baolue Technology (Zhejiang) Co., Ltd, Ningbo, China
| | - Hong Zhang
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Yunhe Zheng
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Faxiang Gou
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xiaoting Yang
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Yao Cheng
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Hannah McClymont
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hui Li
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xinfeng Liu
- Division of Infectious Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China.
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
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22
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Zhang D, Yang Y, Li M, Lu Y, Liu Y, Jiang J, Liu R, Liu J, Huang X, Li G, Qu J. Ecological Barrier Deterioration Driven by Human Activities Poses Fatal Threats to Public Health due to Emerging Infectious Diseases. ENGINEERING (BEIJING, CHINA) 2022; 10:155-166. [PMID: 33903827 PMCID: PMC8060651 DOI: 10.1016/j.eng.2020.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 05/24/2023]
Abstract
The coronavirus disease 2019 (COVID-19) and concerns about several other pandemics in the 21st century have attracted extensive global attention. These emerging infectious diseases threaten global public health and raise urgent studies on unraveling the underlying mechanisms of their transmission from animals to humans. Although numerous works have intensively discussed the cross-species and endemic barriers to the occurrence and spread of emerging infectious diseases, both types of barriers play synergistic roles in wildlife habitats. Thus far, there is still a lack of a complete understanding of viral diffusion, migration, and transmission in ecosystems from a macro perspective. In this review, we conceptualize the ecological barrier that represents the combined effects of cross-species and endemic barriers for either the natural or intermediate hosts of viruses. We comprehensively discuss the key influential factors affecting the ecological barrier against viral transmission from virus hosts in their natural habitats into human society, including transmission routes, contact probability, contact frequency, and viral characteristics. Considering the significant impacts of human activities and global industrialization on the strength of the ecological barrier, ecological barrier deterioration driven by human activities is critically analyzed for potential mechanisms. Global climate change can trigger and expand the range of emerging infectious diseases, and human disturbances promote higher contact frequency and greater transmission possibility. In addition, globalization drives more transmission routes and produces new high-risk regions in city areas. This review aims to provide a new concept for and comprehensive evidence of the ecological barrier blocking the transmission and spread of emerging infectious diseases. It also offers new insights into potential strategies to protect the ecological barrier and reduce the wide-ranging risks of emerging infectious diseases to public health.
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Affiliation(s)
- Dayi Zhang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Yunfeng Yang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Miao Li
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Yun Lu
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Yi Liu
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Jingkun Jiang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Ruiping Liu
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Jianguo Liu
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Xia Huang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Guanghe Li
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Jiuhui Qu
- School of Environment, Tsinghua University, Beijing 100084, China
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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23
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Enteroviral Infections in the First Three Months of Life. Pathogens 2022; 11:pathogens11010060. [PMID: 35056008 PMCID: PMC8782040 DOI: 10.3390/pathogens11010060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/20/2021] [Accepted: 12/30/2021] [Indexed: 01/27/2023] Open
Abstract
Enteroviruses (EVs) are an important source of infection in the paediatric age, with most cases concerning the neonatal age and early infancy. Molecular epidemiology is crucial to understand the circulation of main serotypes in a specific area and period due to their extreme epidemiological variability. The diagnosis of EVs infection currently relies on the detection of EVs RNA in biological samples (usually cerebrospinal fluid and plasma, but also throat swabs and feces) through a polymerase chain reaction assay. Although EVs infections usually have a benign course, they sometimes become life threatening, especially when symptoms develop in the first few days of life. Mortality is primarily associated with myocarditis, acute hepatitis, and multi-organ failure. Neurodevelopmental sequelae have been reported following severe infections with central nervous system involvement. Unfortunately, at present, the treatment of EVs infections is mainly supportive. The use of specific antiviral agents in severe neonatal infections has been reported in single cases or studies including few neonates. Therefore, further studies are needed to confirm the efficacy of these drugs in clinical practice.
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Jiang Y, Xu J, Lai H, Lin H. Association between Meteorological Parameters and Hand, Foot and Mouth Disease in Mainland China: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1757-1765. [PMID: 34722370 PMCID: PMC8542837 DOI: 10.18502/ijph.v50i9.7046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022]
Abstract
Background: This study reports a systematic review of association between meteorological parameters and hand, foot and mouth disease (HFMD) in mainland China. Methods: Using predefined study eligibility criteria, three electronic databases (PubMed, Web of Science, and Embase) were searched for relevant articles. Using a combination of search terms, including “Hand foot and mouth disease,” “HFMD,” “Meteorological,” “Climate,” and “China,” After removal of duplicates, our initial search generated 2435 studies published from 1990 to December 31, 2019. From this cohort 51 full-text articles were reviewed for eligibility assessment. The meta-analysis was devised in accordance with the published guidelines of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Effect sizes, heterogeneity estimates and publication bias were computed using R software and Review Manager Software. Results: The meta-analysis of 18 eligible studies showed that the meteorological parameters played an important role in the prevalence of HFMD. Lower air pressure may be the main risk factor for the incidence of HFMD in Chinese mainland, and three meteorological parameters (mean temperature, rainfall and relative humidity) have a significant association with the incidence of HFMD in subtropical regions. Conclusion: Lower air pressure might be the main risk factor for the incidence of HFMD in Chinese mainland. The influence of meteorological parameters on the prevalence of HFMD is mainly through changing virus viability in aerosols, which may be different in different climate regions. In an environment with low air pressure, wearing a mask that filters the aerosol outdoors may help prevent HFMD infection.
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Affiliation(s)
- Yuan Jiang
- Affiliated Jinhua Hospital, School of Medicine, Zhejiang University, Jinhua, China
| | - Jing Xu
- College of Ocean and Earth Sciences, Xiamen University, Xiamen, China
| | - Huijung Lai
- Department of Dermatology Xiang'an Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Hui Lin
- Third Institute of Oceanography, Ministry of Natural Resources, Xiamen 361005, China
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Abdul Wahid NA, Suhaila J, Rahman HA. Effect of climate factors on the incidence of hand, foot, and mouth disease in Malaysia: A generalized additive mixed model. Infect Dis Model 2021; 6:997-1008. [PMID: 34466760 PMCID: PMC8379622 DOI: 10.1016/j.idm.2021.08.003] [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: 05/21/2021] [Revised: 07/15/2021] [Accepted: 08/08/2021] [Indexed: 12/09/2022] Open
Abstract
Climate change is one of the critical determinants affecting life cycles and transmission of most infectious agents, including malaria, cholera, dengue fever, hand, foot, and mouth disease (HFMD), and the recent Corona-virus pandemic. HFMD has been associated with a growing number of outbreaks resulting in fatal complications since the late 1990s. The outbreaks may result from a combination of rapid population growth, climate change, socioeconomic changes, and other lifestyle changes. However, the modeling of climate variability and HFMD remains unclear, particularly in statistical theory development. The statistical relationship between HFMD and climate factors has been widely studied using generalized linear and additive modeling. When dealing with time-series data with clustered variables such as HFMD with clustered states, the independence principle of both modeling approaches may be violated. Thus, a Generalized Additive Mixed Model (GAMM) is used to investigate the relationship between HFMD and climate factors in Malaysia. The model is improved by using a first-order autoregressive term and treating all Malaysian states as a random effect. This method is preferred as it allows states to be modeled as random effects and accounts for time series data autocorrelation. The findings indicate that climate variables such as rainfall and wind speed affect HFMD cases in Malaysia. The risk of HFMD increased in the subsequent two weeks with rainfall below 60 mm and decreased with rainfall exceeding 60 mm. Besides, a two-week lag in wind speeds between 2 and 5 m/s reduced HFMD's chances. The results also show that HFMD cases rose in Malaysia during the inter-monsoon and southwest monsoon seasons but fell during the northeast monsoon. The study's outcomes can be used by public health officials and the general public to raise awareness, and thus, implement effective preventive measures.
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Affiliation(s)
- Nurmarni Athirah Abdul Wahid
- Department of Mathematical Sciences, Faculty of Science, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia
| | - Jamaludin Suhaila
- Department of Mathematical Sciences, Faculty of Science, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia.,UTM Centre for Industrial and Applied Mathematics (UTM-CIAM), Ibnu Sina Institute for Scientific and Industrial Research, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia
| | - Haliza Abd Rahman
- Department of Mathematical Sciences, Faculty of Science, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia
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Ngoc Nguyen S, Van Dang C, Thi Tran T. Surveillance and outbreak response of hand - foot - mouth disease in Haiphong Children’s Hospital, Vietnam. GLOBAL SECURITY: HEALTH, SCIENCE AND POLICY 2021. [DOI: 10.1080/23779497.2021.1939760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Sang Ngoc Nguyen
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Chuc Van Dang
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Tham Thi Tran
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
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27
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Ji W, Qin L, Tao L, Zhu P, Liang R, Zhou G, Chen S, Zhang W, Yang H, Duan G, Jin Y. Neonatal Murine Model of Coxsackievirus A2 Infection for the Evaluation of Antiviral Therapeutics and Vaccination. Front Microbiol 2021; 12:658093. [PMID: 34122374 PMCID: PMC8192712 DOI: 10.3389/fmicb.2021.658093] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/30/2021] [Indexed: 01/08/2023] Open
Abstract
Coxsackievirus (CV) A2 has emerged as an important etiological agent in the pathogen spectrum of hand, foot, and mouth disease (HFMD). The symptoms of CVA2 infections are generally mild, but worsen rapidly in some people, posing a serious threat to children’s health. However, compared with enterovirus 71 detected frequently in fatal cases, limited attention has been paid to CVA2 infections because of its benign clinical course. In the present study, we identified three CVA2 strains from HFMD infections and used the cell-adapted CVA2 strain HN202009 to inoculate 5-day-old BALB/c mice intramuscularly. These mice developed remarkably neurological symptoms such as ataxia, hind-limb paralysis, and death. Histopathological determination showed neuronophagia, pulmonary hemorrhage, myofiberlysis and viral myocarditis. Viral replication was detected in multiple organs and tissues, and CVA2 exhibited strong tropism to muscle tissue. The severity of illness was associated with abnormally high levels of inflammatory cytokines, including interleukin (IL)-6, IL-10, tumor necrosis factor α, and monocyte chemotactic protein 1, although the blockade of these proinflammatory cytokines had no obvious protection. We also tested whether an experimental formaldehyde-inactivated CVA2 vaccine could induce protective immune response in adult mice. The CVA2 antisera from the vaccinated mice were effective against CVA2 infection. Moreover, the inactivated CVA2 vaccine could successfully generate immune protection in neonatal mice. Our results indicated that the neonatal mouse model could be a useful tool to study CVA2 infection and to develop CVA2 vaccines.
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Affiliation(s)
- Wangquan Ji
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Luwei Qin
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Ling Tao
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Peiyu Zhu
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ruonan Liang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guangyuan Zhou
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Weiguo Zhang
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
| | - Haiyan Yang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
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Yang Z, Zhuo Q, Qin W, Wang J, Wang L, Tien P. MicroRNAs miR-18a and miR-452 regulate the replication of enterovirus 71 by targeting the gene encoding VP3. Virus Genes 2021; 57:318-326. [PMID: 34002325 DOI: 10.1007/s11262-021-01842-z] [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: 08/22/2020] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
MicroRNAs (miRNAs) are crucial in the process of host-pathogen interaction. In this study, we established a screening system for miRNAs of target genes to detect the effect of miRNAs on Enterovirus 71 (EV71) replication in rhabdomyosarcoma (RD) cells. A 3'-untranslated region (UTR) dual-luciferase assay was performed to confirm putative miRNA targets in EV71 genome. Firstly, 13 fragments of EV71 genome were inserted into the vector pMIR, and luciferase activities were analyzed to identify the putative miRNAs of target genes. The expression of the reporter protein was significantly downregulated in cells transfected with the vector containing gene VP3. Then we screened for miRNAs that might target to VP3 through online analysis software. In addition, Western blot, real-time PCR, virus titration, and morphological changes were considered to examine the effects of miRNAs on virus replication. The results suggested that miR-18a and miR-452 repress the reproduction of EV71 virus by binding to VP3. Moreover, EV71 infection also affected the expression of endogenous miR-18a and miR-452. In addition, no significant cytotoxic effects were observed. The results from this study suggest that the intracellular miRNAs may play vital roles in the host-virus interaction.
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Affiliation(s)
- Zhuo Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
| | - Qin Zhuo
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Wen Qin
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Jingbo Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Liyuan Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Po Tien
- Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
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Jia J, Kong F, Xin X, Liang J, Xin H, Dong L, Jiang F. Epidemiological Characteristics of Hand, Foot, and Mouth Disease Outbreaks in Qingdao, 2009-2018. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:999-1008. [PMID: 34183958 PMCID: PMC8223573 DOI: 10.18502/ijph.v50i5.6117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: In China, hand, foot, and mouth disease (HFMD) outbreaks have become an important issue recent years. We analyzed the epidemiological characteristics of HFMD outbreaks in Qingdao during 2009–2018, and provided evidences for prevention and control of the disease. Methods: Data were analyzed by descriptive analysis and correlation analysis, and throat swabs were detected for enterovirus RNA using RT-PCR. Results: Overall, 116 HFMD outbreaks were reported in Qingdao during 2009–2018, with the epidemic of the outbreaks exhibiting a decreasing tendency. The characteristics of outbreaks presented two patterns, including two-peak pattern and rural area to urban-rural fringe area to urban areas pattern. Male patients were predominant in these outbreaks. The location of the outbreaks changed from nursery to community. Non-EV71/CA16 enteroviruses were gradually becoming predominant enteroviruses serotypes. The durations of outbreaks were positively correlated with response times and the number of cases. Conclusion: The epidemiological characteristics analysis of HFMD outbreaks could provide a scientific basis for the prevention and control the disease. Reporting and handling promptly are the keys to control epidemic outbreaks of HFMD.
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Affiliation(s)
- Jing Jia
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Fei Kong
- Sinopec Research Institute of Safety Engineering, Qingdao, Shandong, China
| | - Xueling Xin
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Jiwei Liang
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Hualei Xin
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Liyan Dong
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Fachun Jiang
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
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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.
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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
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Zhang L, Gao F, Zeng G, Yang H, Zhu T, Yang S, Meng X, Mao Q, Liu X. Immunogenicity and Safety of Inactivated Enterovirus 71 Vaccine in Children Aged 36-71 Months: A Double-Blind, Randomized, Controlled, Non-inferiority Phase III Trial. J Pediatric Infect Dis Soc 2021; 10:440-447. [PMID: 33269798 DOI: 10.1093/jpids/piaa129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/27/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Sinovac enterovirus 71 (EV71) vaccine has been given to children aged 6-35 months with good safety, immunogenicity, and efficacy. Further exploration is needed for the application of Sinovac EV71 vaccine in older children. METHODS A phase III, double-blind, single-center, randomized, controlled, non-inferiority, and bridging-designed trial enrolled 300 participants aged 6-35 months and 600 participants aged 36-71 months. Non-inferiority and superiority analyses were made to determine the immunogenicity of Sinovac EV71 vaccine in older children (Older-S group), comparing with that of control EV71 vaccine in the same age group (Older-C group), or comparing with that of Sinovac EV71 vaccine in younger children (Younger-S group). RESULTS The seroconversion rate of anti-EV71 in Older-S group (95.5%) was superior to that of Older-C group (86.0%), and non-inferior to that of Younger-S group (98.5%). For baseline seronegative participants, the geometric mean titer of Older-S group (370.0) was non-inferior to that of Older-C group (296.2) and superior to that of Younger-S group (176.5). Incidence of adverse reactions in Older-S group (47.0%) was similar to that of Older-C group (44.8%), or Younger-S group (49.8%). CONCLUSIONS This study showed good safety and immunogenicity of Sinovac EV71 vaccine in children aged 36-71 months. CLINICAL TRIALS REGISTRATION NCT03909074. URL https://clinicaltrials.gov/ct2/show/NCT03909074?term=NCT03909074&draw=2&rank=1.
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Affiliation(s)
- Lifen Zhang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Fan Gao
- National Institutes for Food and Drug Control, Beijing, China
| | - Gang Zeng
- Sinovac Biotech Co., Ltd, Beijing, China
| | - Haitao Yang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Taotao Zhu
- Sinovac Biotech Co., Ltd, Beijing, China
| | - Shuangmin Yang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xing Meng
- Sinovac Biotech Co., Ltd, Beijing, China
| | - Qunying Mao
- National Institutes for Food and Drug Control, Beijing, China
| | - Xiaoqiang Liu
- Yunnan Center for Disease Control and Prevention, Kunming, China
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Wang F, Qiang X, Jiang S, Shao J, Fang B, Zhou L. The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease-a retrospective study. BMC Infect Dis 2021; 21:208. [PMID: 33632141 PMCID: PMC7905911 DOI: 10.1186/s12879-021-05889-z] [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: 07/23/2020] [Accepted: 02/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is an acute infectious disease caused by human enterovirus 71 (EV71), coxsackievirus, or echovirus, which is particularly common in preschool children. Severe HFMD is prone to cause pulmonary edema before progressing to respiratory and circulatory failure; thus hemodynamic monitoring and fluid management are important to the treatment process. METHODS We did a review of young patients who had been successfully treated in our department for severe HFMD, which had been caused by EV71. A total of 20 patients met the inclusion criteria. Eight cases were monitored by the pulse indicator continuous cardiac output (PiCCO) technique, and fluid management was administered according to its parameters. With regard to the treatment with PiCCO monitoring, patients were divided into two groups: the PiCCO group (8 patients) and the control group (12 patients). The groups were then compared comprehensively to evaluate whether PiCCO monitoring could improve patients' clinical outcomes. RESULTS After analysis, the findings informed that although PiCCO failed to shorten the length of ICU stay, reduce the days of vasoactive drug usage, or lower the number of cases which required mechanical ventilation, PiCCO did reduce the incidence of fluid overload (p = 0.085) and shorten the days of mechanical ventilation (p = 0.028). After effective treatment, PiCCO monitoring indicated that the cardiac index (CI) increased gradually(p < 0.0001), in contrast to their pulse (P, p < 0.0001), the extra vascular lung water index (EVLWI, p < 0.0001), the global end diastolic volume index (GEDVI, p = 0.0043), and the systemic vascular resistance index (SVRI, p < 0.0001), all of which decreased gradually. CONCLUSION Our study discovered that PiCCO hemodynamic monitoring in young children with severe HFMD has some potential benefits, such as reducing fluid overload and the duration of mechanical ventilation. However, whether it can ameliorate the severity of the disease, reduce mortality, or prevent multiple organ dysfunction remain to be further investigated.
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Affiliation(s)
- Fengyun Wang
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China
| | - Xinhua Qiang
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China
| | - Suhua Jiang
- Department of Pediatric Intensive Care Units, The First People's Hospital of Foshan, Foshan, China
| | - Jingsong Shao
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China
| | - Bin Fang
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China.
| | - Lixin Zhou
- Department of Critical Care Medicine, The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China.
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Efficacy of Coxsackievirus A5 Vaccine Candidates in an Actively Immunized Mouse Model. J Virol 2021; 95:JVI.01743-20. [PMID: 33408178 DOI: 10.1128/jvi.01743-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/18/2020] [Indexed: 12/17/2022] Open
Abstract
Coxsackievirus A5 (CV-A5) has recently emerged as a main hand, foot, and mouth disease (HFMD) pathogen. Following a large-scale vaccination campaign against enterovirus 71 (EV-71) in China, the number of HFMD-associated cases with EV-71 was reduced, especially severe and fatal cases. However, the total number of HFMD cases remains high, as HFMD is also caused by other enterovirus serotypes. A multivalent HFMD vaccine containing 4 or 6 antigens of enterovirus serotypes is urgently needed. A formaldehyde-inactivated CV-A5 vaccine derived from Vero cells was used to inoculate newborn Kunming mice on days 3 and 10. The mice were challenged on day 14 with a mouse-adapted CV-A5 strain at a dose that was lethal for 14-day-old suckling mice. Within 14 days postchallenge, groups of mice immunized with three formulations, empty particles (EPs), full particles (FPs), and a mixture of the EP and FP vaccine candidates, all survived, while 100% of the mock-immunized mice died. Neutralizing antibodies (NtAbs) were detected in the sera of immunized mice, and the NtAb levels were correlated with the survival rate of the challenged mice. The virus loads in organs were reduced, and pathological changes and viral protein expression were weak or not observed in the immunized mice compared with those in alum-inoculated control mice. Another interesting finding was the identification of CV-A5 dense particles (DPs), facilitating morphogenesis study. These results demonstrated that the Vero cell-adapted CV-A5 strain is a promising vaccine candidate and could be used as a multivalent HFMD vaccine component in the future.IMPORTANCE The vaccine candidate strain CV-A5 was produced with a high infectivity titer and a high viral particle yield. Three particle forms, empty particles (EPs), full particles (FPs), and dense particles (DPs), were obtained and characterized after purification. The immunogenicities of EP, FP, and the EP and FP mixture were evaluated in mice. Mouse-adapted CV-A5 was generated as a challenge strain to infect 14-day-old mice. An active immunization challenge mouse model was established to evaluate the efficacy of the inactivated vaccine candidate. This animal model mimics vaccination, similar to immune responses of the vaccinated. The animal model also tests protective efficacy in response to the vaccine against the disease. This work is important for the preparation of multivalent vaccines against HFMD caused by different emerging strains.
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Zhao X, Li C, Liu X, Chiu MC, Wang D, Wei Y, Chu H, Cai JP, Hau-Yee Chan I, Kak-Yuen Wong K, Fuk-Woo Chan J, Kai-Wang To K, Yuen KY, Zhou J. Human Intestinal Organoids Recapitulate Enteric Infections of Enterovirus and Coronavirus. Stem Cell Reports 2021; 16:493-504. [PMID: 33626333 PMCID: PMC7940440 DOI: 10.1016/j.stemcr.2021.02.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Enteroviruses, such as EV-A71 and CVA16, mainly infect the human gastrointestinal tract. Human coronaviruses, including SARS-CoV and SARS-CoV-2, have been variably associated with gastrointestinal symptoms. We aimed to optimize the human intestinal organoids and hypothesize that these optimized intestinal organoids can recapitulate enteric infections of enterovirus and coronavirus. We demonstrate that the optimized human intestinal organoids enable better simulation of the native human intestinal epithelium, and that they are significantly more susceptible to EV-A71 than CVA16. Higher replication of EV-A71 than CVA16 in the intestinal organoids triggers a more vigorous cellular response. However, SARS-CoV and SARS-CoV-2 exhibit distinct dynamics of virus-host interaction; more robust propagation of SARS-CoV triggers minimal cellular response, whereas, SARS-CoV-2 exhibits lower replication capacity but elicits a moderate cellular response. Taken together, the disparate profile of the virus-host interaction of enteroviruses and coronaviruses in human intestinal organoids may unravel the cellular basis of the distinct pathogenicity of these viral pathogens. An optimized differentiation protocol improves maturation of intestinal organoids SARS-CoV-2 and SARS-CoV infection triggers less robust response than enteroviruses Coronaviruses show lower sensitivity to type III IFNs than enteroviruses Intestinal organoids recapitulate disparate pathogenicity of CoVs and enteroviruses
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Affiliation(s)
- Xiaoyu Zhao
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Cun Li
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Xiaojuan Liu
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Man Chun Chiu
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Dong Wang
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Yuxuan Wei
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Hin Chu
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Jian-Piao Cai
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China
| | - Ivy Hau-Yee Chan
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kenneth Kak-Yuen Wong
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jasper Fuk-Woo Chan
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China; Carol Yu Centre for Infection, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Kelvin Kai-Wang To
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China; Carol Yu Centre for Infection, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Kwok Yung Yuen
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China; Carol Yu Centre for Infection, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Jie Zhou
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China.
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Xie C, Wen H, Yang W, Cai J, Zhang P, Wu R, Li M, Huang S. Trend analysis and forecast of daily reported incidence of hand, foot and mouth disease in Hubei, China by Prophet model. Sci Rep 2021; 11:1445. [PMID: 33446859 PMCID: PMC7809027 DOI: 10.1038/s41598-021-81100-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is common among children below 5 years. HFMD has a high incidence in Hubei Province, China. In this study, the Prophet model was used to forecast the incidence of HFMD in comparison with the autoregressive-integrated moving average (ARIMA) model, and HFMD incidence was decomposed into trends, yearly, weekly seasonality and holiday effect. The Prophet model fitted better than the ARIMA model in daily reported incidence of HFMD. The HFMD incidence forecast by the Prophet model showed that two peaks occurred in 2019, with the higher peak in May and the lower peak in December. Periodically changing patterns of HFMD incidence were observed after decomposing the time-series into its major components. In specific, multi-year variability of HFMD incidence was found, and the slow-down increasing point of HFMD incidence was identified. Relatively high HFMD incidences appeared in May and on Mondays. The effect of Spring Festival on HFMD incidence was much stronger than that of other holidays. This study showed the potential of the Prophet model to detect seasonality in HFMD incidence. Our next goal is to incorporate climate variables into the Prophet model to produce an accurate forecast of HFMD incidence.
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Affiliation(s)
- Cong Xie
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, 430079, Hubei, China
| | - Haoyu Wen
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China
| | - Wenwen Yang
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, 430079, Hubei, China
| | - Jing Cai
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, 430079, Hubei, China
| | - Peng Zhang
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, 430079, Hubei, China
| | - Ran Wu
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, 430079, Hubei, China
| | - Mingyan Li
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, 430079, Hubei, China.
| | - Shuqiong Huang
- Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, 430079, Hubei, China.
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Protecting the most vulnerable from hand, foot, and mouth disease. THE LANCET. INFECTIOUS DISEASES 2020; 21:308-309. [PMID: 33031751 DOI: 10.1016/s1473-3099(20)30452-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 01/31/2023]
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Li H, Deng J, Yu P, Deng L, Ren X. Gaining insight into irrational off-label use of vidarabine through analysis of a spontaneous reporting system in China. J Clin Pharm Ther 2020; 45:1301-1311. [PMID: 32614099 DOI: 10.1111/jcpt.13209] [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: 01/13/2020] [Revised: 05/30/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Although superseded by other antiviral agents in many Western countries, vidarabine is still widely used in some countries, including China; hence, the extent and appropriateness of vidarabine prescriptions in children require better characterization. This study examined the rationale, extent, and health risks associated with irrational off-label vidarabine use in China. METHODS Data used in the study were extracted from a multi-provincial joint adverse drug reactions monitoring platform from 2002 to 2018. Descriptive statistics were used to analyse the characteristics of individual case safety reports (ICSRs) related to vidarabine use. RESULTS AND DISCUSSION Among 2772 individual ICSRs related to vidarabine, 2223 (80.19%) cases occurred in patients aged 0-9. In all patients, the median age and interquartile range were 2 (0-6). Although most adverse events were mild, five deaths were recorded, all in children below 7 years of age. Paediatric use is the most prominent off-label use of vidarabine. Additionally, several other irrational off-label uses were identified, including 218 (7.86%) cases of overdosing and numerous applications beyond the approved indications, dosages, routes of administration, and solvents. WHAT IS NEW AND CONCLUSION Data indicate that vidarabine was mainly prescribed for suspected common viral infections in paediatric patients, demonstrating serious inappropriate off-label uses. The problem was further complicated by the lack of sufficient information regarding safety, efficacy, and dosing regimens in children, as well as by several additional risk factors such as inappropriate solvents, routes of administration, and overdose. In the case of children, the physicians' lack of understanding of antiviral activities and compassionate prescriptions were mainly responsible for drug overuse. The health risks associated with the paediatric use of vidarabine in China require greater attention and further investigation.
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Affiliation(s)
- Haona Li
- Huaihe Hospital of Henan University, Kaifeng, China.,Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, China
| | - Jianxiong Deng
- Adverse Drug Reaction Monitoring Centre of Guangdong Province, Guangzhou, China
| | - Peiming Yu
- School of Pharmacy, Henan University, Kaifeng, China
| | - Lewen Deng
- Adverse Drug Reaction Monitoring Centre of Guangdong Province, Guangzhou, China
| | - Xuequn Ren
- Huaihe Hospital of Henan University, Kaifeng, China.,Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, China
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Heparan sulfate attachment receptor is a major selection factor for attenuated enterovirus 71 mutants during cell culture adaptation. PLoS Pathog 2020; 16:e1008428. [PMID: 32187235 PMCID: PMC7105141 DOI: 10.1371/journal.ppat.1008428] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/30/2020] [Accepted: 02/23/2020] [Indexed: 02/06/2023] Open
Abstract
Enterovirus 71 (EV71) is a causative agent of hand, foot, and mouth disease (HFMD). However, this infection is sometimes associated with severe neurological complications. Identification of neurovirulence determinants is important to understand the pathogenesis of EV71. One of the problems in evaluating EV71 virulence is that its genome sequence changes rapidly during replication in cultured cells. The factors that induce rapid mutations in the EV71 genome in cultured cells are unclear. Here, we illustrate the population dynamics during adaptation to RD-A cells using EV71 strains isolated from HFMD patients. We identified a reproducible amino acid substitution from glutamic acid (E) to glycine (G) or glutamine (Q) in residue 145 of the VP1 protein (VP1-145) after adaptation to RD-A cells, which was associated with attenuation in human scavenger receptor B2 transgenic (hSCARB2 tg) mice. Because previous reports demonstrated that VP1-145G and Q mutants efficiently infect cultured cells by binding to heparan sulfate (HS), we hypothesized that HS expressed on the cell surface is a major factor for this selection. Supporting this hypothesis, selection of the VP1-145 mutant was prevented by depletion of HS and overexpression of hSCARB2 in RD-A cells. In addition, this mutation promotes the acquisition of secondary amino acid substitutions at various positions of the EV71 capsid to increase its fitness in cultured cells. These results indicate that attachment receptors, especially HS, are important factors for selection of VP1-145 mutants and subsequent capsid mutations. Moreover, we offer an efficient method for isolation and propagation of EV71 virulent strains with minimal selection pressure for attenuation. Viruses must overcome various setbacks in a variety of tissues and cells during transmission from the initial replication site to the final target site. To achieve this, RNA viruses employ a strategy to adapt to different environments by creating a diverse viral population using low-fidelity RNA-dependent RNA polymerases. On the other hand, when the viruses are propagated in clonal cell cultures, in vitro adaptation occurs. The viruses may acquire new properties or lose some properties they had in vivo. In vitro adaptation is often associated with attenuation. Therefore, the selection pressures imposed on viruses replicating in vitro and in vivo are quite different. It is unclear how this environmental difference affects viral populations. Clinical isolates of EV71 replicate in cultured cells poorly. However, after a few passages, the viruses adapt to this condition and replicate efficiently. In this study, we demonstrate that attachment receptor usage is a major selection pressure for in vitro adaptation of EV71 by analyzing the population dynamics of cell culture-adapted viruses. This mechanism appears to be a major mode of attenuation.
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Bo Z, Ma Y, Chang Z, Zhang T, Liu F, Zhao X, Long L, Yi X, Xiao X, Li Z. The spatial heterogeneity of the associations between relative humidity and pediatric hand, foot and mouth disease: Evidence from a nation-wide multicity study from mainland China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 707:136103. [PMID: 31874401 DOI: 10.1016/j.scitotenv.2019.136103] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/04/2019] [Accepted: 12/11/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) remains a serious health threat to young children in East and Southeast Asia. The humidity is crucial for the survival of enterovirus, but the evidence of the humidity-HFMD association is inconsistent. In this study we investigated the spatial heterogeneity of humidity-HFMD associations and related effect modifiers. METHODS We retrieved the daily surveillance data of childhood HFMD counts and meteorological variables from 143 cities in mainland China between 2009 and 2014 and then adopted a three-stage time series analysis. We first fitted a common distributed lag nonlinear model (DLNM) for each of the 143 cities separately to obtain the city-specific estimates of humidity-HFMD association. Then, we pooled the city-specific estimates through multivariate meta-regression with city-level characteristics as potential effect modifiers to study the reasons for heterogeneity. Finally, we applied a region-specific analysis to verify our findings and to better visualize our results. RESULTS We found that the overall pooled humidity-HFMD relationship was shown as an approximately U-shaped curve with substantial spatial heterogeneity (I2 = 77.8%). Taking the reference relative humidity as 70%, the minimum relative risk (RR) was obtained at 45% with a value of 0.83 (0.79, 0.87), while the maximum RR was found to be at both 20% and over 85% separately with a value of 1.10 (1.05, 1.15). The spatial heterogeneity can be well explained by the climatic, social characteristics and terrains among cities. The modification effects can be roughly classified into two types, including change in the overall slope and the shape of the curve. CONCLUSIONS Due to substantial spatial heterogeneity, caution should be taken when interpreting the weather-HFMD association in a single-site study and to avoid generalizing its findings to another site. Our study also implied the existence of interactions among meteorological factors given that climatic factors can modify the weather-HFMD association.
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Affiliation(s)
- Zhenyan Bo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yue Ma
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 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
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 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
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lu Long
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaowei Yi
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiong Xiao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 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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Wang S, Zeng J, Zhang X, Gan Z, Fan J, Chen Y, Liang Z, Hu X, Zeng G, Lv H. Short-term dynamic changes in neutralizing antibodies against enterovirus 71 after vaccination. Hum Vaccin Immunother 2020; 16:1595-1601. [PMID: 31977278 DOI: 10.1080/21645515.2020.1711678] [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: 01/22/2023] Open
Abstract
BACKGROUND Short-term dynamic changes in neutralizing antibodies against EV71 and EV71-IgM after inactivated EV71 vaccine injection are unknown. METHODS This study was designed as a randomized, open-label study and was registered at ClinicalTrials.gov (NCT03278132). In total, 120 healthy infants aged 6-35 months were randomized 1:1:1 to provide a second blood sample on day 10, day 20, or day 30 after the first vaccine dose, respectively. RESULTS According to the per-protocol set, a rapid immune response against EV71 was observed 10 days after the first EV71 vaccine dose, with antibody titers ≥1:8 in 89.19% of participants (95% CI: 74.58-96.97%) on day 10, in 80.65% (95% CI: 62.53-92.55%) on day 20, in 66.67% (95% CI: 49.03-81.44%) on day 30, and in 100% (95% CI: 96.52%-.) on day 60. Based on an ELISA, the percentages of participants positive for EV71-IgM on day 0 and day 60 were 1.71% (2 out of 117) and 82.86% (87 out of 105), respectively. CONCLUSIONS The EV71 vaccine could be used for contingency vaccination to further control EV71-associated disease outbreaks. Caution should be taken in using the EV71-IgM test for rapid EV71 infection diagnosis after EV71 vaccine administration. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT03278132.
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Affiliation(s)
- Shenyu Wang
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Ji Zeng
- Clinical Research Department, Sinovac Biotech Co., Ltd , Beijing, China
| | - Xinpei Zhang
- Shangyu District Center for Disease Control and Prevention , Shaoxing, China
| | - Zhengkai Gan
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China.,Department of Immunization Programme, Xiuzhou District Center for Disease Control and Prevention , Jiaxing, China
| | - Jianqiang Fan
- Shangyu District Center for Disease Control and Prevention , Shaoxing, China
| | - Yingping Chen
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Zhenzhen Liang
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Xiaosong Hu
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Gang Zeng
- Clinical Research Department, Sinovac Biotech Co., Ltd , Beijing, China
| | - Huakun Lv
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
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Yang X, Li Y, Zhang C, Zhan W, Xie J, Hu S, Chai H, Liu P, Zhao H, Tang B, Chen K, Yu J, Yin A, Luo M. Clinical features and phylogenetic analysis of severe hand-foot-and-mouth disease caused by Coxsackievirus A6. INFECTION GENETICS AND EVOLUTION 2020; 77:104054. [DOI: 10.1016/j.meegid.2019.104054] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/24/2019] [Accepted: 09/27/2019] [Indexed: 12/17/2022]
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Tseng JJ, Lin CH, Lin MC. Long-Term Outcomes of Pediatric Enterovirus Infection in Taiwan: A Population-Based Cohort Study. Front Pediatr 2020; 8:285. [PMID: 32596191 PMCID: PMC7303813 DOI: 10.3389/fped.2020.00285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/06/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction: The major burden of diseases in childhood has shifted from infectious diseases to chronic health conditions in recent decades. Although the rates of infectious diseases have decreased, the incidence of chronic diseases stemming from infectious agents continues to grow. Enterovirus is a major infectious disease of childhood and has been linked to numerous chronic diseases. We analyzed population-based data from Taiwan's National Health Insurance Research Database (NHIRD) to investigate the correlations between enterovirus infection and major chronic health conditions in children. Method: Children diagnosed with enterovirus (EV) infection during 1999-2003 were identified from the Longitudinal Health Insurance Database 2000 (LHID 2000), a subdataset of Taiwan's National Health Insurance Research Database (NHIRD). A total of 14,168 patients were selected after excluding patients with existing chronic diseases and missing data. Another 14,168 children matched by age and sex were selected as the control group. Five primary outcomes, including attention deficit and hyperactivity disorder (ADHD), epilepsy, asthma, allergic rhinitis, and atopic dermatitis, were recorded. Results: The risks of ADHD, asthma, allergic rhinitis, and epilepsy were significantly increased in the EV group compared with the control group. The risk of atopic dermatitis was significantly increased in the crude model. However, there were no significant differences in the adjusted model. The risks of ADHD, asthma, allergic rhinitis, and epilepsy were also significantly increased in patients with severe EV infection compared with patients with non-severe EV infection. Conclusion: Chronic diseases, such as ADHD, epilepsy, asthma, allergic rhinitis, and atopic dermatitis were shown to be associated with enterovirus infection during childhood. EV infection during early childhood might have long-term public health implications and thus prevention strategies should be implemented.
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Affiliation(s)
- Jui-Ju Tseng
- Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Chih Lin
- Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Food and Nutrition, Providence University, Taichung, Taiwan
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A method for hand-foot-mouth disease prediction using GeoDetector and LSTM model in Guangxi, China. Sci Rep 2019; 9:17928. [PMID: 31784625 PMCID: PMC6884467 DOI: 10.1038/s41598-019-54495-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/14/2019] [Indexed: 12/14/2022] Open
Abstract
Hand-foot-mouth disease (HFMD) is a common infectious disease in children and is particularly severe in Guangxi, China. Meteorological conditions are known to play a pivotal role in the HFMD. Previous studies have reported numerous models to predict the incidence of HFMD. In this study, we proposed a new method for the HFMD prediction using GeoDetector and a Long Short-Term Memory neural network (LSTM). The daily meteorological factors and HFMD records in Guangxi during 2014–2015 were adopted. First, potential risk factors for the occurrence of HFMD were identified based on the GeoDetector. Then, region-specific prediction models were developed in 14 administrative regions of Guangxi, China using an optimized three-layer LSTM model. Prediction results (the R-square ranges from 0.39 to 0.71) showed that the model proposed in this study had a good performance in HFMD predictions. This model could provide support for the prevention and control of HFMD. Moreover, this model could also be extended to the time series prediction of other infectious diseases.
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44
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Xu Z, Hu W, Jiao K, Ren C, Jiang B, Ma W. The effect of temperature on childhood hand, foot and mouth disease in Guangdong Province, China, 2010-2013: a multicity study. BMC Infect Dis 2019; 19:969. [PMID: 31718560 PMCID: PMC6852944 DOI: 10.1186/s12879-019-4594-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/24/2019] [Indexed: 12/30/2022] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is a serious infectious disease, which has become a public health problem. Previous studies have shown that temperature may influence the incidence of HFMD, but most only focus on single city and the results are highly heterogeneous. Therefore, a multicity study was conducted to explore the association between temperature and HFMD in different cities and search for modifiers that influence the heterogeneity. Methods We collected daily cases of childhood HFMD (aged 0–5 years) and meteorological factors of 21 cities in Guangdong Province in the period of 2010–2013. Distributed lag non-linear model (DLNM) with quasi-Poisson was adopted to quantify the effects of temperature on HFMD in 21 cities. Then the effects of each city were pooled by multivariate meta-analysis to obtain the heterogeneity among 21 cities. Potential city-level factors were included in meta-regression to explore effect modifiers. Results A total of 1,048,574 childhood cases were included in this study. There was a great correlation between daily childhood HFMD cases and temperature in each city, which was non-linear and lagged. High heterogeneity was showed in the associations between temperature and HFMD in 21 cities. The pooled temperature-HFMD association was peaking at the 79th percentile of temperature with relative risk (RR) of 2.474(95% CI: 2.065–2.965) as compared to the median temperature. Latitude was the main modifier for reducing the heterogeneity to 69.28% revealed by meta-analysis. Conclusions There was a strong non-linear and lagged correlation between temperature and HFMD. Latitude was strongly associated with the relationship between temperature and HFMD. Meanwhile, it had an effect on modifying the relationship. These findings can conducive to local governments developing corresponding preventive measures.
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Affiliation(s)
- Zece Xu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Wenqi Hu
- Qianfoshan Hospital of Shandong Province, 16766 Jingshi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Kedi Jiao
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ci Ren
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.,Shandong University Climate Change and Health Center, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China. .,Shandong University Climate Change and Health Center, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
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Liu H, Song G, He N, Zhai S, Song H, Kong Y, Liang L, Liu X. Spatial-temporal variation and risk factor analysis of hand, foot, and mouth disease in children under 5 years old in Guangxi, China. BMC Public Health 2019; 19:1491. [PMID: 31703735 PMCID: PMC6842152 DOI: 10.1186/s12889-019-7619-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) incidence is a critical challenge to disease control and prevention in parts of China, particularly Guangxi. However, the association between socioeconomic factors and meteorological factors on HFMD is still unclear. METHODS This study applied global and local Moran's I to examine the spatial pattern of HFMD and series analysis to explore the temporal pattern. The effects of meteorological factors and socioeconomic factors on HFMD incidence in Guangxi, China were analyzed using GeoDetector Model. RESULTS This study collected 45,522 cases from 87 counties in Guangxi during 2015, among which 43,711 cases were children aged 0-4 years. Temporally, there were two HFMD risk peaks in 2015. One peak was in September with 7890 cases. The other appeared in May with 4687 cases of HFMD. A high-risk cluster was located in the valley areas. The tertiary industry, precipitation and second industry had more influence than other risk factors on HFMD incidence with explanatory powers of 0.24, 0.23 and 0.21, respectively. The interactive effect of any two risk factors would enhance the risk of HFMD. CONCLUSIONS This study suggests that precipitation and tertiary industry factors might have stronger effects on the HFMD incidence in Guangxi, China, compared with other factors. High-risk of HFMD was identified in the valley areas characterized by high temperature and humidity. Local government should pay more attention and strengthen public health services level in this area.
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Affiliation(s)
- Huan Liu
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, Henan, China
| | - Genxin Song
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, Henan, China
| | - Nan He
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, Henan, China
| | - Shiyan Zhai
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, Henan, China. .,Institute of Urban Big Data, College of Environment and Planning, Henan University, Kaifeng, 475004, Henan, China.
| | - Hongquan Song
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, Henan, China.,Institute of Urban Big Data, College of Environment and Planning, Henan University, Kaifeng, 475004, Henan, China
| | - Yunfeng Kong
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, Henan, China.,Institute of Urban Big Data, College of Environment and Planning, Henan University, Kaifeng, 475004, Henan, China
| | - Lizhong Liang
- The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
| | - Xiaoxiao Liu
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Puenpa J, Wanlapakorn N, Vongpunsawad S, Poovorawan Y. The History of Enterovirus A71 Outbreaks and Molecular Epidemiology in the Asia-Pacific Region. J Biomed Sci 2019; 26:75. [PMID: 31627753 PMCID: PMC6798416 DOI: 10.1186/s12929-019-0573-2] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/01/2019] [Indexed: 01/01/2023] Open
Abstract
Enterovirus A71 (EV-A71) is one of the common causative pathogens for hand foot and mouth disease (HFMD) affecting young children. HFMD outbreak can result in a substantial pediatric hospitalization and burden the healthcare services, especially in less-developed countries. Since the initial epidemic of predominantly EV-A71 in California in 1969, the high prevalence of HFMD in the Asia-pacific region and elsewhere around the world represents a significant morbidity in this age group. With the advent of rapid and accurate diagnostic tools, there has been a dramatic increase in the number of laboratory-confirmed EV-A71 infection over the past two decades. The population, cultural, and socioeconomic diversity among countries in the Asia-Pacific region all influence the transmission and morbidity associated with HFMD. This review summarizes the current state of epidemiology of EV-A71 in Asia-Pacific countries based on the most recent epidemiological data and available information on the prevalence and disease burden. This knowledge is important in guiding the prevention, control and future research on vaccine development of this highly contagious disease of significant socioeconomic implications in public health.
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Affiliation(s)
- Jiratchaya Puenpa
- 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.,Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sompong Vongpunsawad
- 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.
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Lee JT, Yen TY, Shih WL, Lu CY, Liu DP, Huang YC, Chang LY, Huang LM, Lin TY. Enterovirus 71 seroepidemiology in Taiwan in 2017 and comparison of those rates in 1997, 1999 and 2007. PLoS One 2019; 14:e0224110. [PMID: 31622436 PMCID: PMC6797108 DOI: 10.1371/journal.pone.0224110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/04/2019] [Indexed: 01/31/2023] Open
Abstract
Background During recent 20 years, enterovirus 71 (EV71) has emerged as a major concern among children, particularly in the Asia-Pacific region. To understand current EV71 serostatus, to find risk factors associated with EV71 infection and to establish future EV71 vaccine policy, we performed a seroepidemiology study in Taiwan in 2017. Methods After informed consent was obtained, we enrolled preschool children, 6–15-year-old students, 16–50-year-old people. They received a questionnaire and a blood sample was collected to measure the EV71 neutralization antibody. Results Altogether, 920 subjects were enrolled with a male-to-female ratio of 1.03. The EV71 seropositive rate was 10% (8/82) in infants, 4% (6/153) in 1-year-old children, 8% (7/83) in 2-year-old children, 8% (13/156) in 3–5-year-old children, 31% (38/122) in 6–11-year-old primary school students, 45% (54/121) in 12–15-year-old high school students and 75% (152/203) in 16-50-year-old people. Risk factors associated with EV71 seropositivity in preschool children were female gender, having siblings, more siblings, and contact with herpangina or hand-foot-and-mouth disease. The risk factor with EV71 seropositivity in 16–50-year-old people was having children in their families in addition to older age (p<0.001). Compared with the rates in 1997, 1999 and 2007, the rates in children were significantly lower in 2017. Conclusion EV71 seropositive rates were very low, at 4% to 10%, in preschool children and not high, at 31%, in primary school students. Preschool children are highly susceptible and need EV71 vaccine most.
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Affiliation(s)
- Jian-Te Lee
- Department of Pediatrics, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
| | - Ting-Yu Yen
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Wei-Liang Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University and Infectious Diseases Research and Education Center, Ministry of Health and Welfare and National Taiwan University, Taipei, Taiwan
| | - Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Ding-Ping Liu
- Epidemic Intelligence Center, Centers for Disease Control, Taipei, Taiwan
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yi-Chuan Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Luan-Yin Chang
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
- * E-mail:
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Tzou-Yien Lin
- Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- The National Health Research Institutes, Miaoli, Taiwan
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48
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Yan S, Wei L, Duan Y, Li H, Liao Y, Lv Q, Zhu F, Wang Z, Lu W, Yin P, Cheng J, Jiang H. Short-Term Effects of Meteorological Factors and Air Pollutants on Hand, Foot and Mouth Disease among Children in Shenzhen, China, 2009-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193639. [PMID: 31569796 PMCID: PMC6801881 DOI: 10.3390/ijerph16193639] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A few studies have explored the association between meteorological factors and hand, foot, and mouth disease (HFMD) with inconsistent results. Besides, studies about the effects of air pollutants on HFMD are very limited. METHODS Daily HFMD cases among children aged 0-14 years in Shenzhen were collected from 2009 to 2017. A distributed lag nonlinear model (DLNM) model was fitted to simultaneously assess the nonlinear and lagged effects of meteorological factors and air pollutants on HFMD incidence, and to further examine the differences of the effect across different subgroups stratified by gender, age and childcare patterns. RESULTS The cumulative relative risk (cRR) (median as reference) of HFMD rose with the increase of daily temperature and leveled off at about 30 °C (cRR: 1.40, 95%CI: 1.29, 1.51). There was a facilitating effect on HFMD when relative humidity was 46.0% to 88.8% (cRR at 95th percentile: 1.18, 95%CI: 1.11, 1.27). Short daily sunshine duration (5th vs. 50th) promoted HFMD (cRR: 1.07, 95%CI: 1.02, 1.11). The positive correlation between rainfall and HFMD reversed when it exceeded 78.3 mm (cRR: 1.41, 95% CI: 1.22, 1.63). Ozone suppressed HFMD when it exceeded 104 µg /m3 (cRR at 99th percentile: 0.85, 95%CI: 0.76, 0.94). NO2 promoted HFMD among infants and the cRR peaked at lag 9 day (cRR: 1.47, 95%CI: 1.02, 2.13) (99th vs. 50th). Besides, children aged below one year, males and scattered children were more vulnerable to high temperature, high relative humidity, and short sunshine duration. CONCLUSIONS Temperature, relative humidity, sunshine duration, rainfall, ozone and NO2 were significantly associated with HFMD, and such effects varied with gender age and childcare patterns. These findings highlight the need for more prevention effort to the vulnerable populations and may be helpful for developing an early environment-based warning system for HFMD.
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Affiliation(s)
- Siyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Lan Wei
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Hongyan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Yi Liao
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Qiuying Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Fang Zhu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Zhihui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Wanrong Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Hongwei Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
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49
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Chang LY, Lin HY, Gau SSF, Lu CY, Hsia SH, Huang YC, Huang LM, Lin TY. Enterovirus A71 neurologic complications and long-term sequelae. J Biomed Sci 2019; 26:57. [PMID: 31395054 PMCID: PMC6688366 DOI: 10.1186/s12929-019-0552-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/06/2019] [Indexed: 11/10/2022] Open
Abstract
During recent 20 years, enterovirus A71 (EV-A71) has emerged as a major concern among pediatric infectious diseases, particularly in the Asia-Pacific region. The clinical manifestations of EV-A71 include uncomplicated hand, foot, and mouth disease, herpanina or febrile illness and central nervous system (CNS) involvement such as aseptic meningitis, myoclonic jerk, polio-like syndrome, encephalitis, encephalomyelitis and cardiopulmonary failure due to severe rhombencephalitis. In follow-up studies of patients with EV-A 71 CNS infection, some still have hypoventilation and need tracheostomy with ventilator support, some have dysphagia and need nasogastric tube or gastrostomy feeding, some have limb weakness/astrophy, cerebellar dysfunction, neurodevelopmental delay, lower cognition, or attention deficiency hyperactivity disorder. Long term sequelae may be related to greater severity of CNS involvement or neuron damage, hypoxia and younger age of onset.
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Affiliation(s)
- Luan-Yin Chang
- Departments of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei, Taiwan.
| | - Hsiang-Yuan Lin
- Psychiatry, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Psychiatry, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chin-Yu Lu
- Departments of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei, Taiwan
| | - Shao-Hsuan Hsia
- Departments of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Yhu-Chering Huang
- Departments of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Li-Min Huang
- Departments of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei, Taiwan
| | - Tzou-Yien Lin
- Departments of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan
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50
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Merzel Šabović EK, Točkova O, Uršič T, Žgavec B, Dolenc-Voljč M. Atypical hand, foot, and mouth disease in an adult patient: a case report and literature review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2019. [DOI: 10.15570/actaapa.2019.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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