title: Epidemiology of enterovirus 71 infections in Taiwan.
abstract: Enterovirus 71 (EV71) was first described in USA in 1969 but retrospective studies in The Netherlands further detected EV71 in the clinical specimens collected in 1963. EV71 has one single serotype measured by using hyperimmune animal antisera but can be phylogenetically classified into three genogroups (A, B, and C) including 11 genotypes (A, B1-B5, C1-C5). In Taiwan, EV71 caused a large-scale nationwide epidemic in 1998. Retrospective studies further detected EV71 in clinical specimens collected from hand-foot-mouth disease patients in 1980 and 1986. Therefore, EV71 may have circulated in Taiwan prior to 1980. Since 1998, EV71 has cyclically caused nationwide epidemics with different predominant genotypes in 1998 (genotype C2), 2000-2001 (B4), 2005 (C4), 2008 (B5), and 2012 (B5). Phylogenetic analysis revealed that C4 viruses isolated in 2005 were probably from China, B5 viruses isolated in 2008 were probably from South Eastern Asia, and B5 viruses isolated in 2012 were probably from Xiamen, China. Several studies have collected postinfection sera from children to measure cross-reactive neutralizing antibody titers against different EV71 genotypes and found that antigenic differences between genogroup B and C viruses did not have a clear pattern but that genotype A virus was antigenically different from genogroup B and C viruses. In conclusion, EV71 cyclically caused nationwide epidemics through international importations. EV71 surveillance in Taiwan should combine genetic and serological methods.
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan.
authors.forename: Min-Yuan
authors.initials: MY
authors.lastname: Chia
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan.
authors.forename: Pai-Shan
authors.initials: PS
authors.lastname: Chiang
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan.
authors.forename: Wan-Yu
authors.initials: WY
authors.lastname: Chung
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan.
authors.forename: Shu-Ting
authors.initials: ST
authors.lastname: Luo
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan. Electronic address: minshi@nhri.org.tw.
authors.forename: Min-Shi
authors.initials: MS
authors.lastname: Lee
mesh_terms: D057134:Antibodies, Neutralizing / Q000097:blood; D002675:Child, Preschool; D029821:Enterovirus A, Human / Q000235:genetics* / Q000276:immunology; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000821:virology*; D058872:Epidemics; D005838:Genotype; D006801:Humans; D007223:Infant; D010802:Phylogeny; D016036:Seroepidemiologic Studies; D013624:Taiwan / Q000453:epidemiology
chemical_list: D057134:Antibodies, Neutralizing
keywords: enterovirus 71; epidemiology; vaccine