Key result
EV71-associated HFMD decreased greatly in Beijing from 2009 to 2019, with the virus exhibiting a low mean effective reproductive number of 1.007, implying effective prevention and control strategies.
Why the study?
EV71-associated hand, foot and mouth disease decreased dramatically in Beijing from 2009 to 2019, prompting investigation into its epidemiological characteristics, evolutionary dynamics, and geographic diffusion pathway.
Observational (n=348,535)
EV71 is no longer the primary causative agent of HFMD in Beijing, and its low effective reproductive number suggests that current prevention and control strategies are effective.
EV71 HFMD decline in Beijing may ease local burden; retrospective data leaves open drivers and generalizability.
BACKGROUND: Enterovirus 71(EV71)-associated hand, foot and mouth disease (HFMD) decreased dramatically in Beijing from 2009 to 2019. This study was to investigate the epidemiological characteristics, evolutionary dynamics, geographic diffusion pathway, and other features of EV71 in Beijing, China. METHODS: We conducted a retrospective study of EV71-associated HFMD and its causative agent in Beijing, China, from 2009 to 2019. Phylogenetic and phylogeographic methods based on the EV71 genome were used to determine the evolution features, origin, and spatiotemporal dynamics. Positive selection sites in the VP1 gene were identified and exhibited in the tertiary structure. Bayesian birth-death skyline model was used to estimate the effective reproductive number (Re). RESULTS: substitutions per site per year. The genetic diversity of EV71 first increased and peaked in 2012 and then decreased with fluctuations. The time to the most recent common ancestor (TMRCA) of EV71 in Beijing was estimated around 2003 when the EV71 strains were transmitted to Beijing from east China. Beijing played a crucial role in seeding EV71 to central China as well. Two residues (E145Q/G, A293S) under positive selection were detected from both the VP1 dataset and the P1 dataset. They were embedded within the loop of the VP1 capsid and were exposed externally. Mean Re estimate of EV71 in Beijing was about 1.007. CONCLUSION: In recent years, EV71 was not the primary causative agent of HFMD in Beijing. The low Re estimate of EV71 in Beijing implied that strategies for preventing and controlling HFMD were performed effectively. Beijing and east China played a crucial role in disseminating EV71 to other regions in China.
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Li et al. (2023) conducted an observational in Hand, foot and mouth disease (HFMD) (n=348,535). Enterovirus 71 (EV71) was evaluated on Mean effective reproductive number (Re) of EV71 (1.007, 95% CI 0.996-1.019). EV71-associated HFMD decreased greatly in Beijing from 2009 to 2019, with the virus exhibiting a low mean effective reproductive number of 1.007, implying effective prevention and control strategies.
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