title: Enterovirus spectrum from the active surveillance of hand foot and mouth disease patients under the clinical trial of inactivated Enterovirus A71 vaccine in Jiangsu, China, 2012-2013.
abstract: Epidemiological data from active surveillance on human enterovirus, which could cause hand, foot, and mouth disease, were limited. An active surveillance system was used to investigate the enterovirus spectrum and the incidence of different enteroviruses in infants aged 6-35 months in Jiangsu Province from 2012 to 2013. Fifty-nine infants were randomly selected from 522 non-EV-A71/CV-A16 HFMD patients. We collected 173 throat swabs and 174 rectal swabs from these infants. RT-PCR was used to amplify 5'-UTR and VP1 regions of enteroviruses and the serotypes were determined by the sequence comparison using BLAST. Twenty-one non-EV-A71/CA16 enterovirus serotypes were detected in those infants. E16, E18 were firstly reported in HFMD patients. The four top common non-EV-A71/CV-A enteroviruses among infants were CV-B3, CV-A10, CV-A6, and E9 with the HFMD incidence rates at 1.4%, 0.84%, 0.56%, and 0.47%, respectively. Over 20.8% patients were co-infected with multiple enteroviruses. Neither the course of sickness nor clinical symptoms of the co-infected patients was more severe than those infected with single enterovirus. Two patients were infected different enterovirus successively within 2 months. Several new enterovirus serotypes and multiple models of infection associated with HFMD were discovered through the active surveillance system. These data provide a better understanding of the viral etiology of HFMD.
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yao
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Lian-Lian
authors.initials: LL
authors.lastname: Bian
authors.affiliation: Beijing Vigoo Biological, Beijing, China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Lu
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
authors.forename: Jing-Xin
authors.initials: JX
authors.lastname: Li
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Qun-Ying
authors.initials: QY
authors.lastname: Mao
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Wang
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Gao
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Wu
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ye
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Xu
authors.affiliation: Beijing Vigoo Biological, Beijing, China.
authors.forename: Xiu-Ling
authors.initials: XL
authors.lastname: Li
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
authors.forename: Feng-Cai
authors.initials: FC
authors.lastname: Zhu
authors.affiliation: National Institute for Food and Drug Control, Beijing, China.
authors.forename: Zheng-Lun
authors.initials: ZL
authors.lastname: Liang
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology / Q000821:virology; D004770:Enterovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D062665:Epidemiological Monitoring; D005243:Feces / Q000821:virology; D005260:Female; D005838:Genotype; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D006801:Humans; D015994:Incidence; D007223:Infant; D017720:Molecular Epidemiology; D010614:Pharynx / Q000821:virology; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D065288:Serogroup; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology; D014765:Viral Vaccines / Q000008:administration & dosage / Q000276:immunology
chemical_list: D012367:RNA, Viral; D015164:Vaccines, Inactivated; D014765:Viral Vaccines
keywords: coxsackievirus A16; enterovirus 71; enterovirus spectrum; hand, foot, and mouth disease; human enteroviruses