Updates on the molecular epidemiology of Enterovirus D68 after installation of screening test among acute flaccid paralysis patients in Taiwan.

In respond to acute flaccid paralysis (AFP) in association with Enterovirus D68 (EV-D68) infection, Taiwan Centers for Disease Control began to screen EV-D68 infection among each AFP patient since July 2015 and detected the first case in August 2016. This article updated the molecular epidemiology trends of EV-D68 from the national surveillance data.

Molecular and epidemiological study of human parechovirus infections in Taiwan, 2007-2012.

BACKGROUND/PURPOSE: As routine diagnostic assays for human parechoviruses (HPeVs) have not been included in the enteroviruses surveillance network in Taiwan, HPeVs may be the actual pathogens of hundreds of untypeable enteroviruses-suspected isolates. METHODS: In this study, these untypeable isolates collected from 2007 through 2012 were examined by reverse transcription-polymerase chain reaction (RT-PCR)-based methods to survey the epidemiology of HPeVs in Taiwan. RESULTS: Thirty-eight HPeV isolates were identified from 575 untypeable isolates, including 23 HPeV type1 (HPeV1), 13 HPeV3, and two HPeV6. Most of the patients were Taiwanese children under 5 years of age and their infections were generally prevalent in summer and autumn, with the highest peak occurring in September. The ratio of male to female patients was 1.56 and 2.25 for HPeV1 and HPeV3, respectively. Fever and respiratory symptoms were reported in significantly more patients infected with HPeV1. The results of phylogenetic analyses showed that HPeV isolates between 2007 and 2012 belonged to different lineages, indicating that endemic circulation of HPeV existed in Taiwan. CONCLUSION: This study showed that HPeVs have been endemic in Taiwan for some years despite a low positive rate. The detection tests of HPeVs are needed to correct a diagnostic deficit in the surveillance system. The epidemiological and genetic information obtained from the present study would contribute to the understanding of the etiology and epidemiology of HPeVs.

Bedside immunochromatographic test for enterovirus 71 infection in children.

BACKGROUND: Enterovirus 71 (EV71) causes frequent outbreaks worldwide, particularly in the Asia-Pacific area. Its quick spread is a critical challenge for public health and timely preventive measures and clinical management therefore rely on early detection. There is a need for a rapid, easy-to-use, and reliable method for detecting EV71 infections. OBJECTIVE: The study aimed to evaluate a bedside immunochromatography (ICT) kit for diagnosing acute EV71 infection in children. STUDY DESIGN: Pediatric patients with herpangina or hand-foot-mouth disease were randomly and prospectively enrolled from hospitals across Taiwan. Throat or rectal swabs were collected for viral culture and reverse-transcriptase polymerase chain reaction (RTPCR). For the ICT kit, whole blood was obtained by ear piercing, finger-sticking, or venipuncture. The results of ICT, virus isolation and RTPCR in clinical samples were compared. RESULTS: Of the 156 patients enrolled, 91 (58%), 64 (41%) and 72 (46%) had positive results of the ICT kit, viral culture and RTPCR, respectively. Laboratory-confirmed infection with either positive EV71 culture or RTPCR was used as the diagnostic standard. The sensitivity and specificity of the ICT kit was 84% and 77%, respectively. The viral culture and RTPCR had relatively lower sensitivity but higher specificity. The patient's age did not affect the performance of the ICT, viral culture and RTPCR. However, a low sensitivity of ICT kit was noted before the second day of disease onset. CONCLUSIONS: The ICT kit may serve as a simple, quick and reliable method for the bedside diagnosis of acute EV71 infection in children.