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. 2016 Aug 18;16(1):425.
doi: 10.1186/s12879-016-1755-0.

Epidemiology and virologic investigation of human enterovirus 71 infection in the Republic of Korea from 2007 to 2012: a nationwide cross-sectional study

Hye-Jin Kim  1 , Ji-Yeon Hyeon  1 , Seoyeon Hwang  1 , Yong-Pyo Lee  1 , Sang Won Lee  1 , Jung Sik Yoo  1 , Byunghak Kang  1 , Jeong-Bae Ahn  1 , Yong-Seok Jeong  2 , June-Woo Lee  3
Affiliations

Epidemiology and virologic investigation of human enterovirus 71 infection in the Republic of Korea from 2007 to 2012: a nationwide cross-sectional study

Hye-Jin Kim et al. BMC Infect Dis. .

Abstract

Background: Enterovirus (EV) 71 is the main pathogen associated with hand, foot and mouth disease (HFMD) or herpangina. Outbreaks of HFMD caused by EV71 infection are associated severe neurological disease and high mortality rates in children. Several sporadic cases of EV71 infection occurred in the Republic of Korea (ROK) in 2000, and EV71 infections were not reported thereafter until 2006. In this prospective study, we report the epidemic and virologic characteristics of the EV71 endemic from 2007 to 2012 in the Republic of Korea.

Methods: We analyzed characteristics of the EV71 infection-associated epidemic from collected specimens and clinical information from 9987 patients with suspected EV infection from the National EV Surveillance System in ROK. To identify the EV71 subgenotype, the homology of viral protein 1 sequences obtained using reverse transcription polymerase chain reaction was compared with the sequences on other countries available from GenBank database.

Results: EV71 was detected in 585 (16.7 %) specimens (cerebrospinal fluid, stool or rectal swabs, throat swabs and blood) during study period and was most frequently observed during epidemic seasons in 2009-2012. Major manifestations due to EV71 infection were HFMD (62.2 %) and HFMD with severe neurological complications (28.4 %). Five deaths (0.9 %) due to EV71 infection occurred, with an increased mortality rate during the period after 2009. Most patients (476; 81.4 %) were less than 5 years of age. Analysis of the monthly distribution showed that there was an obvious seasonal pattern to the epidemics, with infections appearing from June to August. The major subgenotype of EV71 isolates circulating in ROK was the C4a strain, which has also appeared in China, Japan and Vietnam.

Conclusions: This surveillance provided valuable data on the epidemic characteristics of EV71 infections in ROK during a 6-year period. Our findings provide data to assist during future outbreaks of EV71 and associated acute neurologic disease.

Keywords: Foot and mouth disease; Hand; Human enterovirus 71; Neurological complications.

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Figures

Fig. 1
Fig. 1
Seasonal distribution of EV71 infection from 2007 to 2012 in the Republic of Korea. EV71, enterovirus 71
Fig. 2
Fig. 2
Phylogenetic dendrogram based on the partial nucleotide sequence of the VP1 gene using the neighbor-joining method (bootstrapped 1000 times). The scale bar represents 2 % difference in nucleotide sequences. GenBank accession numbers are given behind the country name
See this image and copyright information in PMC

References

    1. Hyypiä T, Hovi T, Knowles NJ, Stanway G. Classification of enteroviruses based on molecular and biological properties. J Gen Virol. 1997;78:1–11. doi: 10.1099/0022-1317-78-1-1. - DOI - PubMed
    1. Brown BA, Oberste MS, Alexander JP, Jr, Kennett ML, Pallansch MA. Molecular epidemiology and evolution of enterovirus 71 strains isolated from 1970 to 1998. J Virol. 1999;73:9969–9975. - PMC - PubMed
    1. Bible JM, Pantelidis P, Chan PK, Tong CY. Genetic evolution of enterovirus 71: epidemiological and pathological implications. Rev Med Virol. 2007;17:371–379. doi: 10.1002/rmv.538. - DOI - PubMed
    1. Witsø E, Palacios G, Rønningen KS, Cinek O, Janowitz D, Rewers M, et al. Asymptomatic circulation of HEV71 in Norway. Virus Res. 2007;123:19–29. doi: 10.1016/j.virusres.2006.07.015. - DOI - PubMed
    1. Perez-Velez CM, Anderson MS, Robinson CC, McFarland EJ, Nix WA, Pallansch MA, et al. Outbreak of neurologic enterovirus type 71 disease: a diagnostic challenge. Clin Infect Dis. 2007;45:950–957. doi: 10.1086/521895. - DOI - PubMed

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