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WHO Collaborating Centre

for Modelling, Evolution and Control of Emerging Infectious Diseases

EV71-2 (Custom).pngEnterovirus-71 (EV-71) is another example of an antigenically variable pathogen, where surveillance is critical for early detection and prevention of outbreaks. First isolated in California in 1969, EV-71 has been the cause of numerous outbreaks of hand, foot and mouth disease, which can cause severe neurological disease, most recently becoming prevalent around the Asia-Pacific region.

Outbreaks can vary being small and localised ones to large epidemics, with hundreds of thousands of people being infected. In Taiwan, the reemergence of EV-71 in 2008 resulted in the largest outbreak in the country for the past 11 years. Several molecular epidemiology studies of EV-71 have revealed the genetic evolution of EV-71 isolates by using partial- or whole-genome sequencing. However, little had been reported about the antigenic evolution of EV-71.

In a 2009 study in collaboration with colleagues in Taiwan, we used antigenic cartography to analyse samples from over 15 years of outbreaks. This analysis revealed that the re-emerging EV-71 strains formed a separate cluster which was antigenically distinct from previous strains. Vaccines against EV-71 are now in development, and we are involved in the evaluation of EV-71 vaccine clinical trials and selection of vaccine strains.


Reemergence of Enterovirus 71 in 2008 in Taiwan: Dynamics of Genetic and Antigenic Evolution from 1998 to 2008

Sheng-Wen Huang, Yun-Wei Hsu, Derek J. Smith, David Kiang, Huey-Pin Tsai, Kuei-Hsiang Lin, Shih-in Wang, Ching-Chung Liu, Ih-Jen Su and Jen-Ren Wang J. Clin. Microbiol. November 2009 vol. 47 no. 11 3653-3662