The Persistent Circulation of Enterovirus 71 in People's Republic of China: Causing Emerging Nationwide Epidemics Since 2008
Open Access
- 28 September 2011
- journal article
- medicine
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 6 (9), e25662
- https://doi.org/10.1371/journal.pone.0025662
Abstract
Emerging epidemics of hand-foot-and-mouth disease (HFMD) associated with enterovirus 71 (EV71) has become a serious concern in mainland China. It caused 126 and 353 fatalities in 2008 and 2009, respectively. The epidemiologic and pathogenic data of the outbreak collected from national laboratory network and notifiable disease surveillance system. To understand the virological evolution of this emerging outbreak, 326 VP1 gene sequences of EV71 detected in China from 1987 to 2009 were collected for genetic analyses. Evidence from both traditional and molecular epidemiology confirmed that the recent HFMD outbreak was an emerging one caused by EV71 of subgenotype C4. This emerging HFMD outbreak is associated with EV71 of subgenotype C4, circulating persistently in mainland China since 1998, but not attributed to the importation of new genotype. Originating from 1992, subgenotype C4 has been the predominant genotype since 1998 in mainland China, with an evolutionary rate of 4.6∼4.8×10−3 nucleotide substitutions/site/year. The phylogenetic analysis revealed that the majority of the virus during this epidemic was the most recent descendant of subgenotype C4 (clade C4a). It suggests that the evolution might be one of the potential reasons for this native virus to cause the emerging outbreak in China. However, strong negative selective pressure on VP1 protein of EV71 suggested that immune escape might not be the evolving strategy of EV71, predicting a light future for vaccine development. Nonetheless, long-term antigenic and genetic surveillance is still necessary for further understanding.This publication has 44 references indexed in Scilit:
- Identification of a Human SCARB2 Region That Is Important for Enterovirus 71 Binding and InfectionJournal of Virology, 2011
- Retrospective seroepidemiology indicated that human enterovirus 71 and coxsackievirus A16 circulated wildly in central and southern China before large-scale outbreaks from 2008Virology Journal, 2010
- An emerging recombinant human enterovirus 71 responsible for the 2008 outbreak of Hand Foot and Mouth Disease in Fuyang city of ChinaVirology Journal, 2010
- Evolutionary Genetics of Human Enterovirus 71: Origin, Population Dynamics, Natural Selection, and Seasonal Periodicity of the VP1 GeneJournal of Virology, 2010
- Reemergence of Enterovirus 71 in 2008 in Taiwan: Dynamics of Genetic and Antigenic Evolution from 1998 to 2008Journal of Clinical Microbiology, 2009
- Enterovirus 71 Outbreak in the People's Republic of China in 2008Journal of Clinical Microbiology, 2009
- An outbreak of hand, foot, and mouth disease associated with subgenotype C4 of human enterovirus 71 in Shandong, ChinaJournal of Clinical Virology, 2009
- Calibration of Multiple Poliovirus Molecular Clocks Covering an Extended Evolutionary RangeJournal of Virology, 2008
- BEAST: Bayesian evolutionary analysis by sampling treesBMC Evolutionary Biology, 2007
- Unifying the Epidemiological and Evolutionary Dynamics of PathogensScience, 2004