Human Enterovirus 71
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The human enterovirus 71 (also Enterovirus 71 , EV71 , EV-71 or HEV-A71) is a virus subtype of the species Enterovirus A in the genus Enterovirus , family Picornaviridae , that can infect humans. The infection is usually asymptomatic, but it can also trigger hand, foot and mouth disease . Rarely are serious neurological complications, and the brain stem - encephalitis with a neurogenic pulmonary edema may be associated and a high mortality rate has particularly in children under two years and rarely heals without serious residual neurological disorders, and acute, the polio -like flaccid paralysis , which also mostly is associated with permanent paralysis.
discovery
EV71 was first discovered in 1969 as a causative agent of aseptic meningitis and encephalitis in California . The first epidemics with severe neurological diseases were later described in Bulgaria in 1975 and in Hungary in 1978 . The first major epidemic was then reported from Malaysia in 1997 , in which 41 children died. The following year, 1.5 million Taiwanese people fell ill, killing 78. Since then, major epidemics have been reported regularly from Southeast Asia and the Pacific region , from Singapore , Brunei , Japan , Vietnam , Hong Kong , South Korea , Thailand , Cambodia , the Philippines and every year from China , but also from France . It is estimated that in the first decade of the new millennium, six million people worldwide became infected with EV71 and over 2000 died from it.
features
The human enterovirus 71 is a non-enveloped single (+) - strand RNA virus = ss (+) RNA. This virus is spread all over the world and humans are proven to be its only reservoir host. It occurs seasonally in temperate climates, especially in late summer and autumn.
The HV71 is divided into four genetic lines (A, B, C and D) according to the nucleotide sequence of the variable structural protein VP1, with further subdivisions. New lines appear again and again, which often circulate for up to five years before they trigger larger epidemics.
transmission
The pathogen is transmitted directly from person to person through contact with body fluids such as saliva, droplets, secretions from vesicles or faecal-oral , whereby the pathogens penetrate via the oral mucosa or the small intestine and enter the bloodstream via the regional lymph nodes after three days ( Viraemia ). Transmission via surfaces contaminated with saliva or stool is also possible.
vaccination
Due to the increasing spread with possible fatal complications, the lack of antiviral therapy and inadequate prevention, there is a great need for a vaccine. The first three studies on three different monovalent vaccines from China appeared in 2014 and showed an immunity of over 98.8% in children after the second vaccination with minor complications, but based on the genetic lines of the EV71 that are dominant in China.
literature
- Gholamreza Darai et al. (Ed.): Lexicon of infectious diseases in humans. 2nd, completely revised and updated edition, Springer, Berlin / Heidelberg / New York and others in 2003, ISBN 3-540-61995-X .
Web links
- Robert Koch Institute: Enterovirus 71 infections: On the current incidence of hand, foot and mouth disease in various countries in Southeast Asia. - Epidemiological Bulletin 20/2008 PDF file
Individual evidence
- ↑ ICTV Master Species List 2018b.v2 . MSL # 34, March 2019
- ↑ a b c d ICTV: ICTV Taxonomy history: Enterovirus C , EC 51, Berlin, Germany, July 2019; Email ratification March 2020 (MSL # 35)
- ↑ Robert Koch Institute: On the outbreak of hand, foot and mouth disease in Southeast Asia due to enterovirus 71. Online advance publication from Epidemiological Bulletin 20/2008 of May 16, 2008
- Peter C. McMinn: Enterovirus vaccines for an emerging cause of brain-stem encephalitis . New England Journal of Medicine 2014, Volume 370, Issue 9, Feb. 27, 2014, pages 792-794.