Chang Ping-Chin, Chen Shou-Chien, Chen Kow-Tong
Division of Infectious Disease, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan 736, Taiwan.
Department of Family Medicine, Da-Chien General Hospital, Miaoli 237, Taiwan.
Int J Environ Res Public Health. 2016 Sep 9;13(9):890. doi: 10.3390/ijerph13090890.
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.
肠道病毒71型（EV71）感染对亚太地区的公共卫生有着重大影响。我们综述了EV71感染的流行病学、发病机制、分子流行病学以及EV71疫苗的研发情况。通过在Medline和PubMed数据库中使用检索词“肠道病毒71型”和“流行病学”或“发病机制”或“分子流行病学”或“疫苗”来查找先前的研究。未以英文发表的文章、没有摘要的手稿以及评论文章均被排除在综述之外。报道的由EV71感染引起的病例流行病学在不同国家有所不同；观察到发病率存在季节性变化。大多数因并发症住院的EV71感染病例发生在五岁以下儿童中。脑干是EV71感染最可能的主要靶器官。亚太地区EV71疫情的出现与不同遗传谱系（B3、B4、C1、C2和C4基因型）的传播有关，这些谱系似乎正在经历快速的进化变化。EV71病毒的基因结构与确保其生存、传播和逃避免疫的因素之间的关系仍然未知。EV71感染已成为一个重要的全球公共卫生问题。疫苗研发工作，包括灭活全病毒减毒活疫苗、亚病毒颗粒疫苗和DNA疫苗的研发，一直在推进。
