Enterovirus 71 infection in children with hand, foot, and mouth disease in Shanghai, China: epidemiology, clinical feature and diagnosis

Virology Journal

Ralf Altmeyer²  Mei Zeng¹  Shuyi Zhang³  Guimei He³  Shilin Yuan²  Qianqian Gao²  Jiehao Cai¹  Xiangshi Wang¹  Aimei Xia¹  Gang Zou²  Ying Wang² 

[1] Department of Infectious Diseases, Children’s Hospital of Fudan University, Shanghai 201102, China;Unit of Anti-infective Research, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China;Institute of Molecular Ecology and Evolution, SKLEC & IECR, East China Normal University, Shanghai 200062, China

关键词: EV71 diagnosis;    Neutralizing antibody;    VP1 sequence;    Hand, foot and mouth disease;    Enterovirus 71;   

Others  :  1224931
DOI  :  10.1186/s12985-015-0308-2

 received in 2015-03-02, accepted in 2015-05-08,  发布年份 2015

【 摘 要 】

Background

In 2012 a large outbreak of hand, foot, and mouth disease (HFMD) widely spread over China, causing more than 2 million cases and 567 deaths. Our purpose was to characterize the major pathogens responsible for the 2012 HFMD outbreak and analyze the genetic characterization of the enterovirus 71 (EV71) strains in Shanghai; also, to analyze the dynamic patterns of neutralizing antibody (NAb) against EV71 and evaluate the diagnostic value of several methods for clinical detection of EV71.

Methods

Clinical samples including stool, serum and CSF were collected from 396 enrolled HFMD inpatients during the peak seasons in 2012. We analyzed the molecular epidemiology, clinical feature, and diagnostic tests of EV71 infection.

Results

EV71 was responsible for 60.35 % of HFMD inpatients and 88.46 % of severe cases. The circulating EV71 strains belonged to subgenogroup C4a. The nucleotide sequences of VP1 between severe cases and uncomplicated cases shared 99.2 ~ 100 % of homology. Among 218 cases with EV71 infection, 211 (96.79 %) serum samples showed NAb positive against EV71 and NAb titer reached higher level 3 days after disease onset. Of 92 cases with EV71-associated meningitis or encephalitis, 5 (5.43 %) of 92 had EV71 RNA detected in CSF samples. The blood anti-EV71 IgM assay showed a sensitivity of 93.30 % and a specificity of 50 %.

Conclusions

EV71 C4a remained the predominant subgenotype circulating in Shanghai. The severity of the EV71 infection is not associated with the virulence determinants in VP1. RT-PCR together with IgM detection can enhance the early diagnosis of severe EV71-associated HFMD.

【 授权许可】

   
2015 Wang et al.

【 图 表 】

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