Kang Hae Ji, Yoon Youngsil, Lee Young-Pyo, Kim Hye-Jin, Lee Deog-Yong, Lee June-Woo, Hyeon Ji-Yeon, Yoo Jung Sik, Lee Sangwon, Kang Chun, Choi Wooyoung, Han Myung-Guk
Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.
Division of Infectious Diseases Control, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.
J Pediatric Infect Dis Soc. 2021 Apr 30;10(4):398-407. doi: 10.1093/jpids/piaa111.
Enteroviruses (EVs) occur frequently worldwide and are known to be associated with a broad spectrum of clinical manifestations from mild syndromes to neurological disease. To understand the epidemiology of EV in Korea, we characterized EV-infected cases during 2012-2019 based on national surveillance.
We collected specimens from patients with suspected EV infections and analyzed the data using real-time reverse-transcription polymerase chain reaction and VP1 gene sequencing.
Among the 18 261 specimens collected, EVs were detected in 6258 (34.3%) cases. Although the most common EV types changed annually, EV-A71, echovirus 30, coxsackievirus B5, coxsackievirus A6, and coxsackievirus A10 were commonly identified. Among the human EVs, the case numbers associated with the 2 major epidemic species (EV-A and EV-B) peaked in the summer. While EV-A species affected 1-year-old children and were associated with herpangina and hand, foot, and mouth disease, EV-B species were mostly associated with neurologic manifestations. The highest incidence of EV-B species was observed in infants aged <12 months. Feces and respiratory specimens were the most predictive of EV infection. Specimens collected within 5 days of symptom onset allowed for timely virus detection.
EV-A and EV-B species co-circulating in Korea presented different epidemiologic trends in clinical presentation, affected subjects, and seasonality trends. This study could provide information for the characterization of EVs circulating in Korea to aid the development of EV antivirals and vaccines, as well as public health measures to control enteroviral diseases.
肠道病毒（EVs）在全球范围内频繁出现，已知与从轻度综合征到神经系统疾病的广泛临床表现相关。为了解韩国肠道病毒的流行病学情况，我们基于全国监测对2012 - 2019年期间的肠道病毒感染病例进行了特征分析。
我们从疑似肠道病毒感染的患者中收集标本，并使用实时逆转录聚合酶链反应和VP1基因测序分析数据。
在收集的18261份标本中，6258例（34.3%）检测到肠道病毒。尽管最常见的肠道病毒类型每年都有所变化，但常见的有肠道病毒A71型、埃可病毒30型、柯萨奇病毒B5型、柯萨奇病毒A6型和柯萨奇病毒A10型。在人类肠道病毒中，与2种主要流行种类（肠道病毒A和肠道病毒B）相关的病例数在夏季达到峰值。肠道病毒A种类感染1岁儿童，与疱疹性咽峡炎和手足口病相关，而肠道病毒B种类大多与神经系统表现相关。在年龄小于12个月的婴儿中观察到肠道病毒B种类的发病率最高。粪便和呼吸道标本对肠道病毒感染的预测性最强。在症状出现后5天内采集的标本能够实现病毒的及时检测。
在韩国共同流行的肠道病毒A和肠道病毒B种类在临床表现、受影响人群和季节性趋势方面呈现出不同的流行病学趋势。本研究可为韩国流行的肠道病毒特征分析提供信息，以帮助开发肠道病毒抗病毒药物和疫苗，以及制定控制肠道病毒疾病的公共卫生措施。
