The Current Status of the Disease Caused by Enterovirus 71 Infections: Epidemiology, Pathogenesis, Molecular Epidemiology, and Vaccine Development.
Enterovirus 71 (EV71) infections have a major public health impact in the Asia-Pacific region. We reviewed the epidemiology, pathogenesis, and molecular epidemiology of EV71 infection as well as EV71 vaccine development. Previous studies were found using the search terms "enterovirus 71" and "epidemiology" or "pathogenesis" or "molecular epidemiology" or "vaccine" in Medline and PubMed. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded from the review. The reported epidemiology of cases caused by EV71 infection varied from country to country; seasonal variations in incidence were observed. Most cases of EV71 infection that resulted in hospitalization for complications occurred in children less than five years old. The brainstem was the most likely major target of EV71 infection. The emergence of the EV71 epidemic in the Asia-Pacific region has been associated with the circulation of different genetic lineages (genotypes B3, B4, C1, C2, and C4) that appear to be undergoing rapid evolutionary changes. The relationship between the gene structure of the EV71 virus and the factors that ensure its survival, circulation, and evasion of immunity is still unknown. EV71 infection has emerged as an important global public health problem. Vaccine development, including the development of inactivated whole-virus live attenuated, subviral particles, and DNA vaccines, has been progressing.
Division of Infectious Disease, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan 736, Taiwan. 2LH101@TMH.org.tw.
Ping-Chin
PC
Chang
Department of Family Medicine, Da-Chien General Hospital, Miaoli 237, Taiwan. scchen818@gmail.com.|General Education Center, Ta Tung University, Taipei 104, Taiwan. scchen818@gmail.com.
Shou-Chien
SC
Chen
Department of Occupational Medicine, Tainan Municipal Hospital, Tainan 701, Taiwan. ktchen@mail.ncku.edu.tw.|Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan. ktchen@mail.ncku.edu.tw.
Kow-Tong
KT
Chen
D001208:Asia / Q000453:epidemiology; D035843:Biomedical Research; D004196:Disease Outbreaks / Q000517:prevention & control*; D029821:Enterovirus A, Human / Q000235:genetics / Q000472:pathogenicity*; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D006801:Humans; D015994:Incidence; D017720:Molecular Epidemiology; D011634:Public Health; D014765:Viral Vaccines
D014765:Viral Vaccines
enterovirus 71; hand-foot-mouth disease; herpangina; pathogenesis; virology