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The changing seroepidemiology of enterovirus 71 infection among children and adolescents in Singapore.

Ang LW, Phoon MC, Wu Y, Cutter J, James L, Chow VT - BMC Infect. Dis. (2011)

Bottom Line: We compared our EV71 seroepidemiologic findings with a previous study conducted in 1996-1997.Statistical significance was taken as P < 0.05.It increased significantly from 14.3% in children aged 1-6 years to 27.8% in those aged 7-12 years, and reached 38.8% in adolescents aged 13-17 years.

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Affiliation: Epidemiology and Disease Control Division, Ministry of Health, CollegeRoad,169854, Singapore.

ABSTRACT

Background: Enterovirus 71 (EV71) has caused recurrent epidemics of hand, foot and mouth disease among children in Singapore. Between August 2008 and July 2010, we conducted a survey to estimate the seroprevalence of EV71 infection among children and adolescents aged 1-17 years. We compared our EV71 seroepidemiologic findings with a previous study conducted in 1996-1997.

Methods: The survey involved the prospective collection of 1,200 residual sera from Singapore residents aged 1-17 years in two hospitals. Neutralizing antibodies to EV71 were detected by the microneutralization test. The geometric mean titer (GMT) of EV71 antibodies and 95% confidence intervals (CI) were calculated and compared by age groups. Statistical significance was taken as P < 0.05.

Results: The overall EV71 antibody prevalence was 26.9% (95% CI: 24.5-29.5%). It increased significantly from 14.3% in children aged 1-6 years to 27.8% in those aged 7-12 years, and reached 38.8% in adolescents aged 13-17 years. The seroconversion rate differed by about 12% between the consecutive age groups. The GMT of EV71 antibodies was higher among primary school children aged 7-12 years in our study than that among the 6-12 year age group in the 1996-1997 study.

Conclusions: Higher antibody titers were observed in children aged 1-6 years than those in the other two age groups, indicating that most of the infections had been acquired during early childhood. EV71 infection is common among children and adolescents in Singapore, with 39% infected by the time they are in secondary school (13-17 years of age).

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Distribution (%) of neutralizing antibody titer of EV71-seropositive individuals by age group. The bars indicate 95% confidence intervals.
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Figure 2: Distribution (%) of neutralizing antibody titer of EV71-seropositive individuals by age group. The bars indicate 95% confidence intervals.

Mentions: Three EV71 antibody titer ranges were defined, i.e. low titer (8-16), moderate titer (32-64) and high titer (128-512). Moderate EV71 antibody levels dominated in all three age groups (Figure 2). About half (49.8%, 95% CI: 44.4--55.3%) of all seropositive subjects displayed moderate levels of EV71 antibody. The proportion of subjects with moderate EV71 antibody levels increased with age, and the difference in proportions (16.1%, 95% CI: 0.9--29.8%) between the age groups of 1-6 years and 13-17 years was significant. On the other hand, the proportion of subjects with high EV71 antibody levels decreased with age, and the differences in proportions between the age group of 1-6 years and the other two older age groups were significant. About one-third (33.3%) of those seropositive in the age group of 1-6 years possessed high EV71 antibody levels, compared to 18.9% in the age group of 7-12 years, and 16.8% in the adolescent group of 13-17 years.


The changing seroepidemiology of enterovirus 71 infection among children and adolescents in Singapore.

Ang LW, Phoon MC, Wu Y, Cutter J, James L, Chow VT - BMC Infect. Dis. (2011)

Distribution (%) of neutralizing antibody titer of EV71-seropositive individuals by age group. The bars indicate 95% confidence intervals.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198955&req=5

Figure 2: Distribution (%) of neutralizing antibody titer of EV71-seropositive individuals by age group. The bars indicate 95% confidence intervals.
Mentions: Three EV71 antibody titer ranges were defined, i.e. low titer (8-16), moderate titer (32-64) and high titer (128-512). Moderate EV71 antibody levels dominated in all three age groups (Figure 2). About half (49.8%, 95% CI: 44.4--55.3%) of all seropositive subjects displayed moderate levels of EV71 antibody. The proportion of subjects with moderate EV71 antibody levels increased with age, and the difference in proportions (16.1%, 95% CI: 0.9--29.8%) between the age groups of 1-6 years and 13-17 years was significant. On the other hand, the proportion of subjects with high EV71 antibody levels decreased with age, and the differences in proportions between the age group of 1-6 years and the other two older age groups were significant. About one-third (33.3%) of those seropositive in the age group of 1-6 years possessed high EV71 antibody levels, compared to 18.9% in the age group of 7-12 years, and 16.8% in the adolescent group of 13-17 years.

Bottom Line: We compared our EV71 seroepidemiologic findings with a previous study conducted in 1996-1997.Statistical significance was taken as P < 0.05.It increased significantly from 14.3% in children aged 1-6 years to 27.8% in those aged 7-12 years, and reached 38.8% in adolescents aged 13-17 years.

View Article: PubMed Central - HTML - PubMed

Affiliation: Epidemiology and Disease Control Division, Ministry of Health, CollegeRoad,169854, Singapore.

ABSTRACT

Background: Enterovirus 71 (EV71) has caused recurrent epidemics of hand, foot and mouth disease among children in Singapore. Between August 2008 and July 2010, we conducted a survey to estimate the seroprevalence of EV71 infection among children and adolescents aged 1-17 years. We compared our EV71 seroepidemiologic findings with a previous study conducted in 1996-1997.

Methods: The survey involved the prospective collection of 1,200 residual sera from Singapore residents aged 1-17 years in two hospitals. Neutralizing antibodies to EV71 were detected by the microneutralization test. The geometric mean titer (GMT) of EV71 antibodies and 95% confidence intervals (CI) were calculated and compared by age groups. Statistical significance was taken as P < 0.05.

Results: The overall EV71 antibody prevalence was 26.9% (95% CI: 24.5-29.5%). It increased significantly from 14.3% in children aged 1-6 years to 27.8% in those aged 7-12 years, and reached 38.8% in adolescents aged 13-17 years. The seroconversion rate differed by about 12% between the consecutive age groups. The GMT of EV71 antibodies was higher among primary school children aged 7-12 years in our study than that among the 6-12 year age group in the 1996-1997 study.

Conclusions: Higher antibody titers were observed in children aged 1-6 years than those in the other two age groups, indicating that most of the infections had been acquired during early childhood. EV71 infection is common among children and adolescents in Singapore, with 39% infected by the time they are in secondary school (13-17 years of age).

Show MeSH
Related in: MedlinePlus