National Institutes for Food and Drug Control, Beijing 100050, China.
Emerg Microbes Infect. 2016 Jul 20;5(7):e75. doi: 10.1038/emi.2016.73.
Enteroviruses (EVs) are the most common viral agents in humans. Although most infections are mild or asymptomatic, there is a wide spectrum of clinical manifestations that may be caused by EV infections with varying degrees of severity. Among these viruses, EV-A71 and coxsackievirus (CV) CV-A16 from group A EVs attract the most attention because they are responsible for hand, foot and mouth disease (HFMD). Other EV-A viruses such as CV-A6 and CV-A10 were also reported to cause HFMD outbreaks in several countries or regions. Group B EVs such as CV-B3, CV-B5 and echovirus 30 were reported to be the main pathogens responsible for myocarditis and encephalitis epidemics and were also detected in HFMD patients. Vaccines are the best tools to control infectious diseases. In December 2015, China's Food and Drug Administration approved two inactivated EV-A71 vaccines for preventing severe HFMD.The CV-A16 vaccine and the EV-A71-CV-A16 bivalent vaccine showed substantial efficacy against HFMD in pre-clinical animal models. Previously, research on EV-B group vaccines was mainly focused on CV-B3 vaccine development. Because the HFMD pathogen spectrum has changed, and the threat from EV-B virus-associated severe diseases has gradually increased, it is necessary to develop multivalent HFMD vaccines. This study summarizes the clinical symptoms of diseases caused by EVs, such as HFMD, myocarditis and encephalitis, and the related EV vaccine development progress. In conclusion, developing multivalent EV vaccines should be strongly recommended to prevent HFMD, myocarditis, encephalitis and other severe diseases.
肠道病毒（EVs）是人类最常见的病毒病原体。虽然大多数感染是轻微或无症状的，但存在广泛的临床表现，可能由 EV 感染引起，严重程度不一。在这些病毒中，肠道病毒 A71（EV-A71）和柯萨奇病毒（CV）A16 引起了最多的关注，因为它们是手足口病（HFMD）的罪魁祸首。其他肠道病毒 A 病毒，如 CV-A6 和 CV-A10，也被报道在几个国家或地区引发了 HFMD 暴发。B 组肠道病毒，如 CV-B3、CV-B5 和柯萨奇病毒 30，被报道是导致心肌炎和脑炎流行的主要病原体，也在 HFMD 患者中检测到。疫苗是控制传染病的最佳工具。2015 年 12 月，中国食品药品监督管理局批准了两种肠道病毒 A71 灭活疫苗用于预防重症 HFMD。CV-A16 疫苗和 EV-A71-CV-A16 二价疫苗在临床前动物模型中显示出对 HFMD 的显著疗效。此前，肠道病毒 B 组疫苗的研究主要集中在 CV-B3 疫苗的开发上。由于 HFMD 病原体谱发生了变化，EV-B 病毒相关严重疾病的威胁逐渐增加，有必要开发多价 HFMD 疫苗。本研究总结了由 EV 引起的疾病（如手足口病、心肌炎和脑炎）的临床症状，以及相关的 EV 疫苗开发进展。总之，强烈建议开发多价 EV 疫苗，以预防 HFMD、心肌炎、脑炎等严重疾病。
