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Journal of Clinical Microbiology, November 2009, p. 3653-3662, Vol. 47, No. 11
0095-1137/09/$08.00+0     doi:10.1128/JCM.00630-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Reemergence of Enterovirus 71 in 2008 in Taiwan: Dynamics of Genetic and Antigenic Evolution from 1998 to 2008{triangledown} ,{dagger}

Sheng-Wen Huang,1 Yun-Wei Hsu,5 Derek J. Smith,8,9,10 David Kiang,6 Huey-Pin Tsai,4 Kuei-Hsiang Lin,7 Shih-Min Wang,3 Ching-Chung Liu,3 Ih-Jen Su,5 and Jen-Ren Wang1,2,4,5*

The Institute of Basic Medical Sciences,1 Department of Medical Laboratory Science and Biotechnology,2 Department of Pediatrics, National Cheng Kung University, Tainan, Taiwan,3 Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan,4 Division of Infectious Diseases, National Health Research Institutes, Tainan, Taiwan,5 Viral and Rickettsial Disease Laboratories, California Department of Health Services, Richmond, California,6 Department of Clinical Laboratory, Kaoshiung Medical University, Kaoshiung, Taiwan,7 Department of Zoology, University of Cambridge, Cambridge, United Kingdom,8 Department of Virology, Erasmus Medical Centre, Rotterdam, The Netherlands,9 Fogarty International Center, National Institutes of Health, Bethesda, Maryland 20892,10

Received 28 March 2009/ Returned for modification 3 June 2009/ Accepted 12 September 2009

In recent years, enterovirus 71 (EV71) has been a cause of numerous outbreaks of hand-foot-and-mouth disease, with severe neurological complications in the Asia-Pacific region. The reemergence in Taiwan of EV71 genotype B5 in 2008 resulted in the largest outbreak of EV71 in Taiwan in the past 11 years. Phylogenetic analyses indicated that dominant genotype changes from B to C or C to B occurred at least three times between 1986 and 2008. Furthermore, antigenic cartography of EV71 by using neutralization tests revealed that the reemerging EV71 genotype B5 strains formed a separate cluster which was antigenically distinct from the B4 and C genotypes. Moreover, analyses of full-length genomic sequences of EV71 circulating in Taiwan during this period showed the occurrence of intra- and interserotypic recombination. Therefore, continuous surveillance of EV71 including the monitoring of genetic evolution and antigenic changes is recommended and may contribute to the development of a vaccine for EV71.

* Corresponding author. Mailing address: Department of Medical Laboratory Science and Biotechnology, National Cheng Kung University, One University Road, Tainan, 701, Taiwan. Phone and fax: 886 6 2760695. E-mail: jrwang{at}mail.ncku.edu.tw

{triangledown} Published ahead of print on 23 September 2009.

{dagger} Supplemental material for this article may be found at http://jcm.asm.org/.

Journal of Clinical Microbiology, November 2009, p. 3653-3662, Vol. 47, No. 11
0095-1137/09/$08.00+0     doi:10.1128/JCM.00630-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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