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Chi

nes
e Medi
cal
 Jour
nal
 201o:
123(13)
:1679—1684  1679 

Ori
ginal
 art
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e 


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ant
Jl

 1
Dodi
  1■
 
es 
agai

 
nst

 
 

ent
erovi
rus
 7 
1 and 
coxsacki
evi
rus
 A 
1 
6 i
n i
nfant
s 

MAO 
Qun—
ying,LI
AO 
Xue—
yan,
YU 
Xiang,LI
 Na
n,ZHU 
Feng—
cai
,ZENG 
Ying,LI
ANG 
Zheng—
lun,
 
LI
 Feng—
xiang,W AN G  
Jun-zhi
,LU 
Feng—
min 
and 
ZH U AN G 
Hui
 

Ke
ywor
ds:hu
man
 ent
erovi
rus
 71;hu
a n 
m coxs
acki
evi
rusA1
6;mat
ern
all
y—ac
qui
redi
mmuni
ty;han
d,f
ootandmout
h di
seas
e 

Back
gr ound  Enter
ovi
rus
 71(EV71)and coxsacki
evir
us 
A1 6(
Cox A1 
6)are maj
or 
causat

ve  
agent
s f
or 
han d,foot
 and 
mout
h diseas
e( HFMD).St
udi
es j
ndic
ate 
that 
the f
requent
 HFMD out
breaks
  r
esul

 in
 a 
few hundr
eds c
hil
dren’s
 dealh i
n 
Chi
na 
in r
ecent
 year
s.The 
vacci
ne 
and ot
her
 resear
ch 
for
 HFM D need 
to be 
devel
oped ur
gent
ly.The 
aim s 
of 
our
 st
udy 
wer
e:t
o expl
ore dynam i
c devel
opment
 of
 mot
her
-sour
ce neut
ral

zing ant
ibodi
es agai
nst
 EV71
 and Cox 
A1 
6 i
n i
nfant
s 

rom Ji
angsu Pr
ovi
nce, Chi
na, and t
o pr
ovi
de t
he f
undament
al dat
a f
or f
urt
her
 est
abl

shi
ng of
 cor
respondi
ng 

mm uni
zat
ion 
cour
se.
 
Methods  Per
ipher
al 
blood 
sam pl
es 
wer
e col
lect
ed 
from 1
 33 
of 
par
tur
ient
 women 
once 
imm edi
atel
y bef
ore 
del

ver
y and 

hei
r i
nfant
s at
 two and seven m ont
hs of
 age.Met
hod of
 m i
cro-
dose cyt
opat
hogeni
c efect
 was used t
o measur
e 
neut
ral
izi
ng 
ant
ibodi
es 
agai
nst
 EV71
 and 
Cox 
A1 
6.r
espect
ivel
y. 
Resul
ts  Ser
oposi

ive
 rat
es 
of 
ant
i-
EV71
 an
d ant
i—
Cox
 A1
 6 i
n pr
enat
al women
 wer
e 79-
7% (
1 
O6/
1 
33)and
 92.
5% 

1 
23/
1 
33)
,res
pec
tivel
y;geome
tri
c mean
 ti
ter
s(GM1
_s)wer
e 29.
0 and
 61.
9;75.
9% (
1 
01门33)pr
enat
al 
women
 wer
e bot
h 
posi
ti
ve i
n ant
i—EV71
 and ant
i—
Cox A1
 6:ser
oposi
ti
ve r
ates of
 ant
i-EV71
 and ant
i.Cox A1
 6 wer
e 25.
6% (
34/1
 33)and 
38.
3% (51/1
33)i n
 infants a
t two months
 of age;GMT s
 were 12.
3 and 18.0,respecti
vel
y.GMTs of
 ant
i.EV71 were 
si
gni
fi
cant

y higher 
for 
infant
s at 
seven 
mon t
hs(82.6)compared
 wit
h t
hat 
at wo
t  mont hs(P<O.
05),
showing i
nfants
 had
 

nappar
entl
y i
nfect
ed  
by  
EV71  duri
ng wo
t  to
 seven mont
hs.Alt
hough onl
y one 
ofspring(0.
75%)at se
ven mon t
hs was 

ound havi
ng ant
i-Cox A1
 6 t
ransf
ered f
rom mat
ernal
,thi
s obser
vat
ion suggest
ed no mat
ernal
 ant
ibody may r
emai
n i
n 

nfant
s at
 seven mont
hs.
 
Concl
usi
ons  The pr
eval
ence 
of 
EV71
 and 
Cox 
A1 
6 wer
e r
elat
ivel
y hi
gh i
n Ji
angsu
 Pr
ovi
nce.Bi
val
ent
 vacci
ne 
agai
nst
 
bot
h EV71
 and 
Cox 
A1 
6 shoul
d be devel
oped.and t
he 
ideal
 ti
me 
poi
nt 
for
 pr
ime i
mm uni
zat
ion 
for
 inf
ant
s i
s ar
ound 
2—5 
mont
hs 
of 
age.
 
Chi
n MedJ201o:
123f
13)
:1679.
1684 

71(
EV71)and 
coxs
acki
evi
rus
 A16(
Cox  i
n t
he popul
ati
on,Cox A 16 has
 al
so recei
ved i
ncreasi
ng 
ong  t
o  ent
erovi
rus
  and  ow n  si
mil
ar  at
tent
ions.
 
vi
rus
 par
ticl
e i
s 24—30 am,no envel
ope,
 

+)S
SRNA 
vius
r es
,four
 types
 of
 vi
us
r  pa
rti
cle
 pr
ote
ins
  Speci
fic  mat
ernal
  neut
ral
izi
ng  ant
ibody  ca
n  prot
ect
 

(VP1 一
re4)t o
 for
m pent
amer
,si
xty 
pent
ame
rs 
for
m vi
us
r   i
nfants
 agai
nst
 pat
hogen at
tack.
“ 。As 90% pat
ient
s of 

par
ticle ca
psid.
 ’
  EV71  and Cox A16 a
re major
  HFM D ar e bet
ween 1-3 year s age.
  and fat al
ity rat
e 
causat
ive agent
s f
or hand, f
o ot
 and mout
h di
sease  i
ncreas
es wi t
h the l
ower age of infa
n ts.
 ’ 。 appropriat
e 


HFM D). Except
 HFM D, EV7 
1  al
so caused asept
ic 
meni
ngi
tis, brai
n  st
em   encephal
iis, acut
t e  f
lacci
d 
DOI:10.
3760/cma.
j.
issn.
0366—6999.
201
0.13.01
2 
pa
ral
ysi
s,r
espi
rat
ory t
rac
t i
nfect
ion
  and nyoc
rdi
a ti
s  2nd 
Divi
sion 
of 
vira
1 Vacci
nes(Mao Q  Liao 
XY and 
Lin g 
a ZL)
. 
whi
ch 
have 
been r
epor
ted 
in 
Eur
ope.
厶 Japan.
 Tai
wan  of  Depar
tment
 of 
Biol
ogi
cal
 Cont
rol(
Li Fx 
and 
Wang 
JZ).Nat
iona
l 
Chi
na,
 M al
ays
ia。and Si
ngapor
e. I
n t
erm of Cox A 16.
  I
nst
itut
e f
or Cont
rol
 of 
Phar
maceut
ica
l and Bi
ologi
cal
 Pr
oduc ̄.
 
Be ̄
ji
ng l
00050.Chi
na 
al
though 
most
 of 
h e pat
t ients
 show sl
ight
 si
gns,wi
th key 
De
par
tme
nt of
 Vacci
ne Resea
rch,Hua
la
n  Bi
ologi
ca
l Engi
neer
ing 

eat
tires
 such as
 fever
 and ski
n rash or herpes on ha
n d,
  I
nc.
,Xi
nxi
n g,He
a nan 
453003,Chi
na(
Yu 
X n d 
a Li 
N) 

oOd.oral;
  appr
oxi
mat
ely 6% of cases
 were report
ed  J
in gs
a u Pr
ovi
nci
l Cent
a er f
or Di
sea
se Prevent
ion and Cont
rol
, 
havi
ng ser
iOUS
 compl
icat
ion mani
fes
tat
ions.
  A l
arge  Na
nii
ng,Ji
n gsu 
a 210009.Ch
ina(
Zhu 
FC)
 
Depa
rtment
 of Vacc
ine
 Resea
rch,Shenzhen Ka
n gt
ai Bi
ologi
ca
l 
out
break of H ⅥD due t o EV7 1 infect
ion occurred in 
Pr
oduct
s Co.
,Lt
d.Shenz
hen,Gua
n gdong
 5 
1 
8057,Ch
ina(
Zeng 
Y) 
Tai
wan  of 
Chi na i
n 1998.a tot
al of 129 106 cases were 
Peki
ng Univer
sit
y Hea
lth Sci
ence Ce
nte
r,Be
iji
ng 1
 001
 91
,Cl
1i
na 
report
ed,i
ncl
udi
ng 78 deat
h s.
  In recent
 years.H  ⅥD  (LuFM a
n dZhuan gH、 
has become as
 one of t
he most
 impor
tant
 infect
ious
  Correspondence 
to:Dr.LI
ANG  Zheng—
lun.2nd Divi
sion of Vira
l 
di
seas
e among chi
ldren i
n t
he mai
nland of Ch
i na.
 ”’
“  Vaccines.Nat
iona
l Ins
it
t ut
e f
or 
the 
Cont
rol of 
Phar
ma ceutica
l and 

Therefor
e,pr
ophyl
act
ic vacci
ne 
has s
ubsequent
ly 
brought
 
Bi
olog
ica
l 
ro
P duc
ts,Bei
ji
ng 
10005
0,Ch
ina(
Tel
:86
—10—
6709
535
7. 
Fax:86—10—67095357.Email
:lzlun@ya hoo.com) 
great
 at
tent
ions t
o agai
nst
 HF]
ⅥD. Consi
der
ing t
h e  The st
udy was supposed 
by a grant
 fr
om  Natura
l Key 
ro
P ject
s of
 
co-

infect
ion and cr
oss.

preval
ence of 
EV71
 and 
Cox A 16  China(No.2008B  69B01) .
 

© Chinese Medical Association Publishing House


Downloaded from medCentral.net on [June 05, 2022]. For personal use only.
1680  Chi
nM e
dJ20io;
l23(
13)
:l679—
1684 

prot
ect infants, but
 also avoid adverse effects
 f rom  ant
i.EV7l
 an d a
nti
—Cox A 16.
“,1
/5
 bl
ood sampl
es wer
e 
matem al
 anti
body 力, Us.under
stn di
a ng 
the s
eroprevalence.
  di
lut
ed 
rom l:
f 8 rat
io.i
nact
ive t
h e 
ser
u m on 56。C f
or 30 
as
 wel
l as
 the dynami
c change of mat
er
n al
 neut
ral
izi
ng  i nut
m es. St
art
ing f
rom 1:
8 t
O 1:
2048 s
erial
 di
lut
ions.
 
ant
ibodys 
for
 EV7 
1 f
ant
i EV7 l
 1
 and 
Cox A 1
 
6(ant
i—Cox  i xed 
m the di
lut
ed ser
u m wi
th 100 TCⅡ)
 n EV71a
n d 
Cox 
A16)a mong 
chi
ldr
en.ar
e of 
antecede
ntl
y i
mport
ance f
or  A 
1 
6 equal
ly,t
hen added t
hem i
nto a 96.
i cr
m o pl
ate on 

he development
 of
 pr
event
ive i
mmuni
zat
ion st
rategy t
o  37。C f
o r 2 hours.f
inal
ly added RD cel
1 sus
pens
ion 
contro1
 EV7  l
 and/or Cox A l 
6 infect
ion.However,the  f
l×l
 0 ce
lls
/m1
).Set
 cel
l c
ont
rol
。ser
um 
cont
rol
 and 
vir
us 
dynami c  devel
opm ent  of  m at
em al
  ant
i—EV7 
1  and  cont
rol
 on 
each 
plat
e,al
so 
set
 vi
us
r  
backdr
ops(
if 
res
ult
 of 
ant
i.Cox A 
1 
6 ant
ibody rem ai
ns l
argel
y unknown.In t
his
 
bac
kdr
ops
 was
 32-320 
TCI
D5dwel
1.t
he 
tes
t was
 suc
ces
s) 
prospect
ive  designed,
 long—ter
m  followed—up  study,
  in each 
test
 and put 
them i
nto CO,i ncubator 
on 35。C  or
f  
healt
hy  prenatal
  wom en  and  t
heir  i
nfants’
  serum  7 days,observed t
he cyt
opathogeni
c effect
 by m
i croscopy,
 
ant
i.EV7 
l and ant
i—Cox A 
1 
6 neut
ral
izi
ng ant
ibody were  def
ined  neut
ral
izi
ng  t
iters
  as  i
nhi
bit
ion  of  50% 
measured,the 
dynam
i c development 
of 
m ater
nal
 anti
body  cVt
Opat
hogeni
c eff
ect
.Thi
s met
hod had been pr
evi
ous
ly 
was analyzed.To t
he best of our
 knowledge.t
his study  measur
ed 
by r
eference serum s
 Of 
EV71
 an d Cox 
A 16.no 
was
 the f
irst
 report
 on t
he dynami
c devel
opment
 of  cross—
react
ion found.Neutralizi
ng ant
ibodies f
o r EV7  1 
m at
ernal ant
i.Cox 
A 1 
6 neut
ral
izi
ng a
nt i
body i
n neonat
es  and Cox A 1 
6 were de1
5ned positi
ve,i
f neutr
ali
zi ng t
iter 
and infants.Our study provi
des t
h e evi
dence for
 the  was
 equal
 and 
great
er 
than 1:
8 di
lut
ions.
 
est
abl
ishment
 of 
pr
imary 
immuni
zat
ion 
time 
poi
nt.
 

Stat
isti
ca
l anal
ysi
s 
M ETHoDS 
The ser
oposi
tive rat
es of ant
ibodies were compar
ed by 

hi—
squa
re t
est
.The
 ge
ome
tic
r  mea
n t
ite
rs(
GMTs
1 of
 
Subj
eet
s and 
sampl
es  anti
bodies
  were anal yzed with SPSS  10. 0 sof
tware 
Thi
s st
udy empl
oyed cohort
 st
udy.Bet
ween Sept
ember 
package.For m e st
ati
stical
 analysi
s of GM Ts.t
h e dat
a 
2007 and July 2009, 1 
62 par
tur
ient women and t hei
r 
wer
e t
rans
or
f m ed us
ing t
he Logl0 of 
h e or
t igi
nal
 val
ues,
 
neonat
es were enroll
ed from t
hree hospi
tals
 in Ji
angsu 

his
 transf
ormat
ion  i
s  ef
fect
ive  i
n  st
abi
lizi
ng  t
h e 
Provi
nce.Blood samples 
were coll
ected f
rom neonates
 at 
di
spersi
on and m akes
 the vari
ances
 independent
 of t
he 
2.7 mont
hs of age.Am ong 1
 62 
prenatal women and 1
 63 
means.f
f t
iter
s of neut
ral
izi
ng ant
ibody were negat
ive,
 
neonat
es,148 neonat
es were f
oll
owed up at
 2 m ont
hs of 

hen assumed t
he t
iter
 was
 1:
4 f
or cal
cul
ati
on.Then.a 
age and l
 35 neonates
 at
 7 months of age.Fi
nal
ly.t
he 
Pa
ired t
-tes
t was
 per
for
m ed.P <0.
05 was
 consi
dered 
blood of I  
33 Pair
s of part
ur
ient women  and their
 

tat
ist
ical
ly s
igni
icant
f . 
of
fspf
ing at
 2 and 7 mont
hs wer
e col
lect
ed.These 1
 33 
pairs
 of blood samples
 were measur
ed or
f  
EV7 
1 and 
Cox 
RESU1  S 
A 1
 6 neutr
alizi
ng ant
ibodi
es det
erminat
ion.
 

Seroposi
tive 
rate and GM Ts of 
anti.EV71 j
n bl
ood 
The st
u dy protocol
 was  appr
oved by Local Ethics
 
sam pl
es 
of prenatal wom en 
and infa
n t
s 
Comm i
ttee,prenatal
 women an d guardi
ans
 of i
nfants
 
As
 shown i
n 1’
abl
e 1.s
eroposi
tive rat
e of 
nt
a i
—EV7 
1 was
 
si
gned 
the 
infor
m ed 
consent
s.Dur
ing 
h e 
t st
u dy 
per
iod,no 
cl
ini
cal
 si
gn 
of 
HFM D 
in 
coho ̄ i
nfa
n ts
 was 
observed.
 
79.
7% f
106/
133)i
n pr
enat
al 
women
 and 
25.
6% (
34/
133)
 

n i
nfant
s at
 2 m ont
hs of
 age.GM Ts of a
nti—
EV71
 in 
pr
enat
al wom en was 
29.
0 a
n d 
in i
nfant
s at
 2 mont
hs was
 
Cel
ls 
and 
viI
 ns 
strai
ns 
l2_
3:GM Ts  of i
nfant
s at
 7 mont hs
 was signiicant
f ly 
Rhabdomyos
arc
oma
 ce
lls(
RD ce
lls
)we
re c
ult
ured
 in 

ncrease t
o 82.
6.Amongl9 infants
 at 7 months of age 
M EM  sol
uti
on (GIBC0L, USA) whi
ch added 1
 0% 
who wer
e pos
iti
ve f
or ant
i.EV7 
1. 1
 7 i
nfant
s’ant
ibody 
Newbovi
ne cal
f senl
m (
GIBC0L),2 mo1
/L L—
glut
amine 
ti
ter j
ncreased o ur_
f fold t
h an t
h at
 at
 2 months
 of 
age.a
n d 

GIBCOL1
. 1
00 I U/
ml peni
cill
in  and str
eptomyc
in 
2 i nfant
s tit
er i ncreased from  0 to f our fol
d. W i
th 

GIBCOL)
.EV7 
l/
Fuyang/
m01/2008 (C4 genotype
)and 
Cox A 16/
G.1Of
kindl
y provi
ded 
by 
Kunm
i ng I
nst
itut
e of  det
ermi
nat
ion cr
iteri
a of 
inappa
r ent
 inf
ect
ion 
as 
ant
ibody 

iter i
ncr
easi
ng four
fol
d and above t
han bef
ore. t
he 
Me
dica
l Bi
ology,Chi
nes
e Acade
my 
of 
Medi
cal
 Sci
ence)
 
wer
e adapt
ed t
o growt
h i
n RD cel
ls.Vi
rus 
tit
er was 10  i
nappa
rent
 inf
ect
ion r
ate
 was
 12.
8% f
17/
133)dur
ing a 
and 1
 0 一 TCID5
0/m1.respect
ivel
y.Befo re using,EV7  l  per
iod bet
ween 2 t
o 7 m ont
hs of 
age.Dur
ing f
oll
ow—
up 
and Cox A 1 
6 were measured by reference serum  of  per
iod,none of t
he 17 i
nfant
s who were i
napparent
ly 
anti
—EV71 a
n d a
nti.Cox A 16 and PCR.The vi
us
r  st
rain  infected showed any cli
nical
 si
gns of 
HFM D :continuous
 
used f
or ver
ificat
ion was  cul ur
t ed i
n RD cell
s an d  des cent of ser
um a
nt ibody was not f
o und i
n any inf
ant
 
enl
arged。f
reezi
ng and t
hawi
ng 3 t
imes
 to r
elease t
he  (
Tabl
e 2
 . 
vi
rus
。the
n ce
ntif
r uge
d(200 
xg 1
0 i nut
m es)at
 low 
spe
ed 

o get
 ri
d of cel
l debr
is,package t
h e s
upem at
ant
 and  Di
stri
buti
on 
of 
ant
i.EV71 
in 
Pairs 
of 
blood 
sam pl
es 
st
ored 
in 
reezer
f  approxi
mat
ely—70。C.
  col
lect
ed 
from 
prenat
al 
wom en 
and 
infant
s 
For fur
ther anal
ysi
s t
he rel
ati
onshi
p of
 ant
ibody t
iters
 
Determi
nati
on 
m et
hod 
of 
ant
i-EV71 
and 
ant
i-C0x 
A 16  bet
ween prenat
al women and 
h ei
t r ofspr
ing,i
nfa
nts
 at
 2 
neutral
izing antibody  mOnt
hs Of age wer
e al
lOcat
ed tO four
 grOups
 by GM Ts
 
Using  m
i cro—dose  cyt
opat
hogeni
c  ef
fect
 to  measur
e  l
evel
 0f ant
i EV7l
 of mei
r mOt
hers:negat
ive gr
oup Of 

© Chinese Medical Association Publishing House


Downloaded from medCentral.net on [June 05, 2022]. For personal use only.
Chi
nese 
Medi
cal
 Jour
nal
 2010;
123(
13)
.'
167
9—1684  1
681
 

Tabl
e 1.Dynami
c devel
opment
 of
 ser
opos
iti
ve 
rat
e a
nd 
GM Ts
 of 
neu ̄ i
zing 
nt
a i
bodi
es 
from 
133 
pai
rs 
of 
blood 
sampl
es 
of 
prena
tal
 women 
n d 
a neonat
es 

Ser
oposi
tive r
ate of 
anti
.EV7l i
n infa
nts
 at
 2 mont
hs ol
d w as
 obvi
ousl
y l
ow er
 tha
n t
llei
r m om ers,
  =78 17,P <O.
01.’
Seroposi
tive r
ate 
of 
nt
a i
—EV 71
 in i
nfant
s at
 7 
mont
hs ol
d w as
 obvi
ousl
y I
ow er
 tha
n i
nfa
nts at
 2 m ont
hs 
old a
n d t
hei
r m ot
hers,
  =5_
30,P <O.
05:
  1
 14.
23,尸 <0.
O1.
 Seroposi
tive 
rat
e of 
ant
i Cox 
A 16 
in i
nfant
s at
 2 
mont
hs ol
d w as
 obvi
ousl
y l
ower 
than t
hei
r m ot
l1ers,
  =86.1
4,尸 <0.
01.0
Ser
opos
iti
ve r
ate 
of 
nt
a i
.Cox 
A 16 
in 
inf
n ts
a  at
 7 
m or
tths
 ol
d was
 obvi
ousl
y l
ower 
tha
n  i
nfant
s at
 
2 
m ont
hs 
old a
n d 
thei
r mot
h ers,
  -45-
22,P <0.
Ol;
  =206.
o4,尸 <O.
01.“
GM Ts
 of 
nt
a i
.EV 71
 in 
inf
n ts
a  at
 2 
m ont
hs 
old wa
s obvi
ousl
y l
ow er 
tha
n t
heir
 m ot
hers,P <O 
O5.
 
1GM Ts
 of
 anti
.EV71
 in i
nfn ts
a  at
 7 mor
tths
 ol
d was obvi
ous
ly 
higher 
than 
infa
n ts
 at
 2 mont
hs ol
d and t
hei
r mother
s.P <O.
05.’’
GM r
rs of
 anti
.Cox A16 i
n i
nfa
n ts
 at
 2 
mont
hs 
old was
 obvi
ousl
y l
ower 
than 
thei
r m ot
hers
.尸 <O.
O5.
 

Tabl
e 2.Res
ult
s f
rom 
bot
h s
eropos
iti
ve 
of 
nt
a i
—EV71
 n d 
a nt
a i
—Cox 
A16 
in 
inf
ant
s at
 7 
mont
hs 
of 
age(
pai
rs 
of 
nt
a i
body)
 


f t
iters
 of neut
ral
izi
ng ant
ibody w a
s negat
ive.t
hen a
s sumed t
h e t
iter
 w as 1:
4 for
 ca
l cul
ati
on.
  :Ser
oposi
tive anti
—EV71
 in i
nfa
n ts
 at
 7 m ont
hs ol
d.十:Ser
opos
itive 

ant
i—Cox A 16 
in 
inf
nt
a s 
at 
7 moi
lt
hs ol
d. 

Tabl
e 3.Rel
ati
ons
hip 
of 
ant
ibody 
tit
ers(
ant
i—EV7 
1 a
n d 
nt
a i
—Cox 
A16 
in 
high,mi
ddl
e n d 
a low 
group)bet
ween 
prenat
al 
women 
and 

hei
rinf
nt
a s
 

ant
i-EV71 (<1:
8),we ak pos
iti
ve group (1:8
一),middl
e  2 m ont
hs of
 age and i
n t
hei
r Pai
red m ot
her
,w ere show n 
posi
tive
 gr
oup(1:32-)and hi
gh posi
tive 
group(>1:
128).
  i
n Fi
gure.Sor
ted by t
he a
n ti
—EV7 
1 l
evel
 of mot
hers
 by 
Si
ze and per
cent
age of
 infant
s i
n  each group w ere  ascending order,mean  anti—
EV7 1
 GM 1’
s of i
nfants at
 2 

abul
ated 
in 
Tabl
e 3.
  mont hs
 age i ncreased from 1:4 tO l:
1 2.
8. anti
—EV7  1
 
GM Ts
 of i
nfa
nts at
 2 m ont
hs w er
e di
rect
ly cor
rel
ated 
Of 
27 m ot
hers
 and 
thei
r i
nfant
s at
 2 m ont
hs of 
age w ere  wi
th t
hat
 of
 the m ot
hers.The r
esul
t i
ndi
cat
ed t
hat
 fo r 
bot
h ser
onegat
ive f
or ant
i.EV7 
1. Among 78 i
nfant
s  i
nfants
 at
 2 months.if 
mot hers
 owned the 
hi gher l
evel
 of 
whose 
mothers wer
e in weak 
posi
tive 
gr oup。6 
1(61/
78,
  nt
a i—EV7 
1.the 
tit
ers 
of ant
ibody t
ransf
ered  from  
mothers 
78.
2%1 were 
se r
onegati
ve f
or nt
a i
—EV71  and 17(17/
78.
  i
nto 
inf
ant
s wer
e als
o hi
gh.
 
21.
8%1  were weak  posi
tive;among 16 i nfant
s whose 
mothers  were  i
n  middle  pos
iti
ve  group, 8  were  Seroposit
ive 
rate and 
GM rl
1s 
of 
ant
i.Cox 
A 16 
in 
ser
onegat
ive.7 wer
e wea
k  posi
tive and l
 was mi
ddl
e  prenatal
 wom en and i
nfants 
pos
iti
ve;am ong 1 
2 inf
ants whose mothers
 were in high  Resul
ts of 
m easurement
 for
 Cox A 
1 
6 wer
e t
abul
ated i
n 
pos
iti
ve,3 
were seronegat
ive,6 were 
weak  pos
iti
ve and 3  Tabl
e 1.Seropos
iti
ve r
ate of ant
i—Cox A16 was
 92.
5% 
wer
e mi
ddl
e pos
iti
ve.
  (1
23/133)in pr
enata
l women,38.
3% ( 51
/133)in i
nfnt
a s 
at
 2 months of age
 and 4.5% (
6/133、in inf
ants
 at 7 
Correl
ati
on 
of 
cal
cul
ated 
GM 1’
s 
of 
ant
i—EV7 
1 i
n i
nfant
s at
  m ont
hs age.
 

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682  Chi
n Med 
J 2010;
123(
13)
:1679—
1684 

Tabl
e 4.Ser
opos
iti
ve 
rat
e of
 ant
i—
EV71
 and 
ant
i—Cox 
A16(%)
 

:Seroposi
tive r
ate
 of ant
i—EV71
 and ant
i—Cox A 16 i
n i
nfants
 at 
2 m ont
hs ol
d 

we
re 
obv
iou
sl
y 
lo
wer
 t
hn 
ath
eir
 
mot
her
s, ̄=1
10.
24,
P<o
.O1

 :S
ero
pos
it
iv
e r
at
e 
of 
nt
a i
--
EV7 
1 a
n d a
nti
・-
Cox 
A 16 
in 
inf
ants
 at
 7 m ont
hs 
old 
wer
e obvi
ous
ly 
lower
 

ha
t n
 be
for
e a
nd t
hei

 mo
the
rs, ̄=1
48.
05,P <o
.01

  =
7.7
9,P <
0.0
1, 
respect
ively.
 
<8  1:
8 

M ean GM Ts
 in pr
enat
al w om en was
 61,
9: G M 11
s i
n  ant
i EV7】& ant
i.CoxA 】
6 ofmot
hers
 

nfants
 at
 2 mont
hs of
 age was
 1 
8.0:whi
le t
he mean 
Fi
gur
e.Compar
ison of 
GM Ts
 among neonat
es gi
ven bi
rth 
by 
GM 11
s Of i
nfant
s at
 7 mont
hs of age increased t
o 35.
6 
m ot
her
s w ho owned di
fer
ent
 level
s of
 ant
ibodi
es at
 2 m ont
hs 
f1、
able 1
 1.Among 6 i
nrants
 at 
7 months
 of 
age who were  ol
d.。
:A nt
i—EV7 
1 GM Ts
 in i
nfn t
a s w hos
e mot
her
s cam e
 from 
posit
ive for ant
i.Cox  A 1
 6. 3 i
nfant
s’ ant
ibody  t
iter  gr
oup
 wi
tll
 l:
32一 of a
nti
—EV71
 w as
 si
gni
icant
f ly hi
gher
 than 

ncreas
ed more t
han four
-fbl
d compari
ng t
o t
hat
 at
 2  negat
ive group a
n d gr
oup w i
th 1:
8- of 
nt
a i—EV71.P <0.
05. : 
mol
lths
 of age.2 i
nfant
s’ant
i—Cox A 
1 
6 ant
ibody t
iter  Anti—
EV71  GM Ts  i
n inr
ant
s whos e mot
h ers
 came f
rom group 
wih great
t er 
than 1:1
 28 of
  Ant
i—EV7 1
 was  s
igniica
f ntl
y hi
gher 
increased from 0 to f
ourfol
d.The above resul
ts i
ndicat
ed 

han negat
ive gr
oup a
n d group 
wi m 1:8- a
nd  gr
oup wi
m l:32_ 
3 out of 133 had been i
napparent
ly i
nfect
ed by Cox A16, 
of
 ant
i—EV71.P <0.
05.
 :Ant
i—Cox 
A16 
GM Ts
 in i
nfnt
a s
 whos
e 
bet
ween 2 t
o 7 mont
hs of age.t
he i
nappar
ent
 infect
ion  m ot
h er
s’ant
i—Cox A 1
6 gr
eat
er t
hal
l 1:
128 was
 si
gni
icant
f ly 

ate of
 Cox A1
6 was
 2.
3% (
3/133)
.Dur
ing f
oll
ow—
uD  hi
gher
 tha
n gr
oup 
wit
h negat
ive
 and 1:
8-and 
1:32一of
 nt
a i
—Cox 
peri
od.t
here 
w ere 
no cl
ini
cal
 si
gns
 of 
HFM D occured 
in  A 16.P <0.
05.
 

 g  ul
 0∞l
1罢 0 

he above 
3 i
nfants
 who 
were 
inappar
ent
ly 
inf
ect
ed 
by 
the 
A1
 6 was
 lower
 thf
in t
hat
 at
 2 mont
h of 
age.meanwhi
le.
 
vi
ms;not
icea
6  
bly
,onl
y o
4  
ne 
inf

2  
nt
 r0.
75%.No:Y120036)
O   8   6 
  4  2   0  


howed 
a cont
inuous
 ti
ter
 decl
ine(
T{l
ble 
2 .
  t
he ant
i—EV7l
 ti
ter
 of t
his i
nfant
 increased fourf
old.
 

ndicaf
ing [he 
inapparent
 EV7 1
 infect
ion of 
this
 anti—Cox 
Di
stri
buti
on 
of 
ant
i.Cox 
A16 
in 
pai
rs 
of 
blood 
sam pl
es  A1 
6 rem ai
ned positi
ve in i
nfant.W l
e also noticed that
 

from  
prenat
a1 wom en 
and 
thei
r i
nfants  f
our
fol
d ant
ibody t
iter i
ncreas
e of
 bot
h a
nti
.EV7 
1 a
n d 

The 
ant
i.Cox A16 
level
 of 
infants
 at
 2 
mont
hs of 
age was
  nt
a i
—Cox A l6 i
n 2 i
nfants;t
hey were i
nfect
ed by bot
h 

st
rat
ined 
by 
mot
her’
s serum 
ant
ibody t
iti
ers.As
 shown i
n  EV71
 and 
Cox 
A 16 between 2 t
o 7 
mont
hs of 
age.whi
ch 

1、abl
e 3.10 mot hers
 and their
 2一
mont h—old infants
 were  sugges
ted t
he i
nci
dence of 
dual
 inappar
ent
 inf
ect
ion rat
e 
seronegat
ive f
o r ant
i.Cox A l6.w hi
le am ong 3 1
 infant
s  by 
EV71
 and 
CoxA16 
was
 1.
5% (
2/133)(
11ab1
e 4)
. 
whose mot
her
s wer
e i
n weak posi
tive group,l
 7(
55%)
 
DISCUSSION 
wer
e s
eronegat
ive
 and 1
4(45%、we
re weak pos
iti
ve;
 
among 57 i
nfant
s whose mot
her
s wer
e mi
ddl
e posi
tive.
 
HFM D has
 been emer
ging as
 a 
m ost
 import
ant
 infect
ious
 
36 (
63%1
 wer
e s
eronegat
ive, 1
 8 (
32%) wer
e wea
k 
posi
tive a
n d 3 f
5% 1
 were m
i ddl
e posi
tive;among 35  di
sease among chi
ldren i
n recent
 years
 in Chi
na.A t
otal
 


nfant
s whose 
mot
hers
 wer
e hi
gh 
posi
tive,1
 9(54% )were  of
 488 
955 cases
 wer
e r
eport
ed,i
ncl
udi
ng 126 deat
hs i
n 


eronega
tive,8(
23%)wer
e wea
k pos
iti
ve,7(
20%)wer
e  2008.i
n t
he year af
ter
 HFM D was
 int
egr
ated i
nto t
he 
i ddl
m e posi
tive 
and 1
 f3%)was
 hi
gh 
posi
tive.
  Nat
ional
  Not
iiabl
f e  Di
seas
es  Repor
ting  Syst
em 

NNDRS1.
  A 
number
 of 
evi
dences
 have shown 
that
 the 
As
 shown 
in 
Figure.a corr
elat
ion s
im il
ar 
to 
that
 of 
GM Ts
  causat
ive 
pat
hogens
 are 
EV71
 and/
or 
Cox 
Al 
6,Theref
o re.
 
of nt
a i—EV7 1 bet
ween infant
s at
 2 months
 ol
d and t
hat 
of  devel
opi
ng pr
ophyl
act
ic  vacci
ne f
or t
he  cont
rol
 of 
thei
r paired mother at
 pregnancy was demonstr
ated f
or  epi
dem
i c  EV71
  a
n d/
or  Cox  A 16  i
nfect
ion  i
s  i
n 
ant
i—Cox A16.乃 e mean ant
i—Cox A 16 GM Ts
 of 
infant
s  i
m m edi
atel
y ur
gent.
 
at
 2 mont
hs of age i
ncr
eased f
rom 1:
4.0 t
0 1:
10.
2.wi
th 

he i
ncr
eas
e of ant
i.Cox A 
1 
6 GM Ts
 in ser
um of pai
red  The EV7 
1 vi
rus
 st
rai
n used i
n neut
ral
izat
ion t
est
 may 
m ot
hers
 at
 pregnancy.
  i
nfluence t
he meas
urement
 of
 neut
ral
izi
ng ant
ibody.Our 

esul
ts(
unpubl
ishe
d) s
hown
 tha
t t
her
e was
 si
gni
ic
f ant
 
Dual
 seroposi
tive 
of 
anti
・-
EV71 
and 
anti
--
Cox 
A16 
in  di
fference bet
l ween 
usi
ng 
C4 or 
A genot
ype;even i
f t
hey 
pai
rs 
of 
blood 
sampl
es col
lected 
from prenatal
 wom en  are bot
h of 
C4 subt
ype,di
ferent
 resul
ts 
may be acqui
red 
and 
thei
r i
nfant
s  by using di
ffer
ent
 viu s s
r train.M izut
a et
 al
  had used si
x 
The dual
 seroposi
tive rat
e of bot
h ant
i.EV7 
l and  subtypes Of EV7 1
 virus stains t
o measure the ti
cers
 Of 


nti
—Cox 
Al6 
in 
prenat
a1 
women 
was
 75.
9% (
101
/133)
,  neut
ra1
izi
ng ant
ibOdi
es i
n bl
OOd s
ampl
es col
1ect
ed f
 om 
whi
le t
he dual
 seropos
iti
ve rat
e i
n i
nfants
 at
 2 
m ont
hs of  pOpu1
ati
On, t
he di
虢 r
ence cont
ained i
n f
ouff
0ld.
  T0 


ge 
was
 12.
1%f
l6/1
33)a
nd 
it
 dec
reas
ed 
to 
3.0% (
4/l33)
  ens
ure t
he accuracy Of meas
urement
 0f neut
mli
zing 

n i
nfant
s at
 7 mont
hs of 
age.Among 4 
infant
s wi
th 
bot
h  ant
ibodV, a er pe  r
ming of pre.
neut
ral
izat
i0n test
 bV 
ant
ibodi
es posi
tive at
 7 m ont
hs of age, one’
s ant
i—Cox  usi
ng  di
fl
fer
ent
  s
ubt
ype  s
trai
ns,
  we  sel
ect
ed 

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Chi
nese 
Medi
cal
 Jour
nal
 2010;
123(
13)
:167
9—1684  1
683
 

EV71/
Fuyang/
m01
/2008 and Cox A 16 /G一10 st
rai
n f
or  t
ime—
poi
nts
 for
 immunizat
ion of pol
io, measl
es and 
neut
ral
izat
iOn  t
est
 to  m eas
ure  ei
ther  ant
i—EV 7 
l  Or
  hepat
iti
s A 
vir
us vacci
nes.So 
expl
oring 
the weaken t
rend 
ant
i—Cox 
A1 
6.  of 
m aternal
 ant
ibody f
or 
EV 7 
1 a
n d 
Cox 
A 16 wer
e cruci
al 
or
f  est
abl
ishment
 of pr
ime i
m unizat
ion course,and i
t 
Res
ult
s fr
om  t
his
  st
udy  show n, seroposi
tive rat
e of
  w as
 als
o hel
pful
 to avoi
d t
he i
nter
rupt
ion of m at
ernal
 
ant
i—EV7 
l i
n Ji
angs
u provi
nce was
 79.
7%.whi
ch was
  ant
ibody 
and 
prot
ect
 suscept
ibl
e popul
ati
on.
 
si
gni
icant
f ly hi
gher 
than t
he 50% —60% rat
e i
n Tai
w an of 
Chi
na  and 44% rat
e i
n Si
ngapore.
  t
his
 suggest
ed  It
 was
 report
ed t
hat
 HFM D even 
occur
red i
n i
nrant
s aged 
higher rat
e  of EV7 1 i
nf ecti
on exist
ing in Chinese  no m or
e t
han 3 mont
hs,even as young as
 4 weeks
 ol
d, 
populati
on Up t o no  there were only a f
ew s
tudies  and l
eaded t
o seri
OUS
 compl
icat
ions.
 。Thi
s st
u dy s
hown 

ocused  on  m at
em al
  ant
i—EV 7 
1  and  ant
i.Cox  A  
1 
6  t
hat
 seroposi
tive rat
es of 
ant
i—EV7 
1 and ant
i.Cox A 
l 
6 i
n 
ant
ibody i
n i
nfants.A ccordi
ng to t
he resul
ts cam e f
rom   i
nfants at 2 months of 
age were signiicant
f l
y lower t
han 
EV7 
l neut
ral
izi
ng ant
ibody assay i
n a popul
ati
on aged  t
he l
evel  
i n 
prenatal
 wom en.Rates of 
inapparent 
inf
ecti
on 
bet
w een 1
 and 22 m ont
hs i
n Si
ngapore.t
he m ater
nal
  i
n i
nfant
s dur
ing a per
iod bet
ween 2 and 7 mont
hs age 
ant
ibody agai
nst
 EV7 
1 decr
eased rapi
dly i
n i
nfant
s.and  wer
e 12.
8% and 2.
3% . res
pect
ivel
y. Consi
der
ing t
hat
 
becam e negat
ive aft
er one m ont
h age.
  I
n cont
rast
,the  al
tem at
ive and m
i x i
nfect
ion r
ate were hi
gher i
n t
he 
pr
esent
 st
udy s
howed t
he t
ransferr
ed EV7 
l mater
nal
  mai
nland of Chi
na, we recomm end t
hat
 the bi
val
ent
 

nti
body 
was
 hi
ghe
r(25.
6%)
。even 
in 
inf
ant
s a
t 2 
mont
hs  vacci
ne whi ch contains EV71 and Cox A16 ant igens 
of  age. The  diference  may  attibut
r e  t
o  di
ffer
ent  shoul
d be 
devel oped t
o prot
ect
 chi
ldren f
rom  
HFM D ,and 
ser
opositive r
ates
 an d GM Ts of ant
i.EV 7 
1 bet
ween the  bas
ed on l
ocal
 epi
demi
ology, we suggest
s sel
ect
ion 

wo  count
ies (
r 79.7% vs .44.
O% a nd 29.0 vs.17.
8.  bet
ween 
2 t
o 5 mont
hs of
 age 
as 
the 
prim e 
immuni
zat
ion 

especti
vel
y).No infant
 at
 7 
months
 of 
age 
was  
obse
rved  t
im epoi
nt.
 
m at
ernal
 ant
i—EV7 a
nti
body out
,w hi
ch was
 si
mil
ar 
wit
h 

he 1% resul
ts 
of 
infant
s at
 6 mont
hs of 
age i
n Tai
wan 
of  REFERENCES 
China  — 
1.
  Chan 
YF 
A buBaker
 S.Recom bi
nant
 hum an 
ent
erovi
rus
 7 
1 i
n 
ha
nd,f
oot
 n d 
a mout
h di
sease
 Pa
tient
s.Em e职 I
nfect
 Di
s 2004;
 
Cox 
A 1
 
6 i
s a
not
her
 maj
or 
caus
ati
ve 
agent
 or
f  
HFM D.As
 

t onl
y causes
 sl
ight
 si
gns.few st
udi
es wer
e r
eport
ed on  1
0:1468—1
470.
 


his
 pat
hogen i
n t
he past
.But
 st
udy cam e 
from  
Tai
w an 
of  2.
  Chum akov M , Voros
hil
ova M , Shi
ndar
ov  L, Lavr
ova
 I,
 

China shown that i
nfect
ion of Cox A16 could lead t
o  Gra
cheva
 L.Kor
oleva
 G  et
 a
1 .Ent
erovi
rus
 71
 is
olat
ed 
from 

seri
OUS compl
icati
ons.。U nt
il t
o no 
w.t
her
e are no r
eports
  cas
es 
of 
epi
dem i
c pol
iomyel
iti
s—l
ike 
dis
eas
e i
n Bul
gari
a.Arc
h 

on 
the 
dynamic 
changes
 of
 mat
ern al
 ant
ibody 
agai
nst
 Cox  Vi
rol
 1979;60:329—
340.
 

A 
1 
6 i
n i
nrant
s.Thi
s s
tudy 
showed 
the s
eroposi
tive 
rat
e of  3.
  Na
gy 
G Tak ̄t
sy 
S,Kukgn 
E,M i
hfi
ly 
I,D6m6k 
I.Vi
rol
ogi
cal
 
ant
i—Cox 
A16 i
n pr
enat
al 
women 
canl
e fr
om 
invest
igat
ion  di
agnosi
s  of
 ent
erovi
rus
 type  7 
1 i
nfect
ions: exper
iences
 

area was
 92.
5%.ser
oposi
tive r
ate i
n i
nfant
s at
 2 and 7  gai
ned dur
ing 
an 
epi
demi
c of 
acut
e CNS di
seases
 in Hunga
ry 

m ont
hs of age was
 38-
3% and 4.
5% .res
pect
ivel
y.The  i
n 1
978.Ar
ch 
Vir
ol 1
982;71:217—
227.
 

decl
ine pat
ter
n  of 
mat
ernal
 ant
i—CoxA 
1 
6 was
 the s
ame as
  4.
  I
shi
mar
u Y Na
kan o S.Yamaoka K.
  I
kami
 S.Out
breaks
 of
 


hat of ant
i—EV7 
1.although seroposi
tive rate and GM Ts
  ha
n d. f
oot
, a
nd m ont
h  di
seas
e by ent
erovi
rus
 7 
1. Hi
gh 

of mother’s
 and thei
r inf
ants in 2 mont hs wer e hi
gher
  i
nci
dence 
of 
compl
icat
ion 
dis
orde
rs 
of 
cent
ral
 ner
vous
 sys
tem.
 


han t
hose of ant
i—EV7 
1.meanwhi
le one i
nfant
 st
ill
 has
  Ar
ch 
Dis
 Chi
ld 1
980;55:583—
588.
 

mot
her-
source ant
i—CoxA 16 rl:
81 i
n 7 mont
hs of are.
  5. Wa
n g 
JR,TuanYC,TsaiHP,Yan 
JJ,Li
uCC,SuI
J.Changeof
 

A m ong 1
 9 inr
ant
s w hos
e ant
i—EV7 
1 w ere seroposi
tive  mai
or  genot
ype
  of
  ent
erovi
rus
  7 

  i
n  out
breaks
  of
 
and 6 i
nrants
 whose a
nti
—Cox 
A 1
 6 wer
e s
eropos
iti
ve 
at 
7  hand—
foot
—andmout
h di
seas
e i
n Tai
wan bet
ween 1
 998 and 

months of are.ant i
.EV7 1 i
n 1
 7 i
nfan ts
 and anti—CoxA 1  
6  2000.J
 Cl
in 
Micr
obi
ol 
2002;40:1
0—1
5. 


n 3 i
nfants increased si
rniicant
f ly t
han  l
evel at
  2 
m or
tths  6.
  Chan 
LG 
Para
sha
r UD,Ll
ye 
M S,0ng
 FG 
Zaki
 SR,Al
ex.
皿 der
 

P et
 a1
.Deat
hs 
of 
chi
ldr
en 
du  g
 aJ
1 out
breal
(ofh.
dnd,f
0ot
, 
of
 age,respe
cti
vely(>f
o ur
-fol
d),whi
ch suggest
ed tha
t 
maior
 caus
ati
ve age
nt of
 H ⅥD i s
 EV7 
1.as compared  a
nd  moum  di
seas
e i
n  s
arawak.
  ma
lavsi
a:  cl
ini
ca1
 and 

wi
th 
sporadi
c out
breaks
 of
 Cox 
A16 
in 
thi
s st
udy area.
  口at
hol
ogi
cal
 char
act
eri
sti
cs 0f山e
 di
seas
e.F0r
 the 0ut
break 
St
udv 
Gm up.Cl
in 
Inf
ect
 Di
s 2000:3 
1:678—
683.
 

Ma
ter
nal
 ant
ibody 
is 
the
 maj
or 
immune
 bar
rier
 to
 pr
otec
t  7.
  M cM i
nn  Li
nds
av K.Pe
rer
a D,Chan HM ,Ch,
dn K 
neonates
 agai nst att
ack of pathogens,but it
 also ca
n  Car
dosa
 M J.Phvl
ogenet
ic a
J1al
Vsi
s of
 ent
er0vi
ms 7 
1 st
rai
ns 
int
err
upt the effect
l  of 
im m uni
zat
ion.W it
h t
he i
ncrease 
of  i
sO1
ated 
dur
ing 1
inked 
epi
dem i
cs i
n M a1
ays
ia,Si
ngapOr
e,and 

m et
abol
ism 
am ount
s and 
bodywei
ght
 gai
ns i
n i
nfant
s. 。一
‘  W es
tem 
Aust
ral
ia.
J Vi
rol
 2001:75:7732—
7738.
 

m at
er
n al
 ant
ibody becam e weak.D ue t
o di
ferent
 level
s  8.
  ChangL  Li
nT  Hu.
dngYC,Ts
aoKC,Shi
h SR,KuoM L,et
 

of 
infect
ion 
rat
es and t
iters 
in vari
ous
 ar
eas.weaken 
rat
e  a
1.ComDa s
On Of ent
erOvi
ms 71
 and cOxsac
kie—
virus
 A16
 


n  neonat
es i
s  di
fferent.
  For
  exampl
e.  based  on  cl
ini
cal
 il
lnes
ses
 dur
ing me
 T i
wan e
nter
ovi
rus
 epi
demi
c, 

epi
dem
i ol
ogy and weaken r
ates
 of mat
ernal
 ant
ibody,
  l
998.
Pedi
a虹 I
nfb
ct 
Dis 
J 1999:18:l
092—1
096.
 

Wl
orl
d Hea
lth 
Organi
zat
ion (
W HO1
 re
commende
d t
he 
2.  9.
  HoM ,ChenER,HsuKH,Twu 
SJ,ChenK  11
sai
 SF,et
 a1
.An 
9 and 12 mont
hs of age a
r e t
he appr
opr
iat
e pr
ime  eDi
demi
c Of ent
em vi
rus
 7 

 inf
ect
ion i
n  ra
iwan. r
I wa
n 

© Chinese Medical Association Publishing House


Downloaded from medCentral.net on [June 05, 2022]. For personal use only.

684  Chi
n Me
d J 
2010;
123(
13)
:1679—
1684 

Ent
erovi
rus
 Epi
demi
c W orki
ng Group.N Engl
 J Med 1
999;
  19. N at
ional
 not
iiabl
f e di
seases
 announced i
n Ja
n ua
ry 2009 and 
341:929—
935.
  h e 2008 by M i
t nist
ry of
 Heal
th of
 h e Peopl
t e’s
 Republ
ic of
 

10.Di
ng NZ,Wang XM ,Sun SW,Song Q,Li
 SN,He
 CQ.
  Chi
na.(
Access
ed Febr
uar
y 10,2009 a
t ht
tp:
//www.
moh.
gov
. 
Appear
ance
 of
 m osai
c ent
erovi
rus
 7 
1 i
n t
he 
2008 
out
break 
of  c
n/pu
bli
cfi
les
/bu
sine
ss/
html
il
f e
s/moh
bgt
/s
358
2/2
009
02/
3907
9. 
Chi
na.
Vies
r  
Ras
 2009:1
45:
】57—
161.
  ht
m.)
 
11. Yang E Ren L,Xi
ong Z,Li
 J,Xi
ao Y,Zhao
 R, et
 a1
.  20. M i
zut
a K,Aoki
 Y,Sut
o A,Oot
ani
 K,Kat
sus
hima 
N,I
tagaki
 
Ent
erovi
rus
 7 
l out
break i
n t
he 
Peopl
e’s
 Republ
ic of
 Chi
na 
in  et
 a1.Cr
oss
—ant
igeni
cit
y among EV7 
1 s
tra
ins
 from di
fer
ent
 
2008.J
 Cl
in 
Micr
obi
o】2009;47:235
 1—
2352.
  genogroups
 isol
ated i
n Yamagat
a,Ja
pan ,bet
ween 1
 990 a
n d 
12. Bl
ack 
FL.The r
ole
 of
 her
d i
m m uni
ty i
n cont
rol
 of
 m eas
les.
  2007.Va
cci
ne 
2009;27:3 
153—
3 158.
 
Yal
e J
 Bi
o1 
M ed 1
982;55:351
-360.
  21. Ooi
 EE,Phoon M C,I
shak 
B,Chan 
SH.Ser
oepi
dem
i ol
ogy 
of 

13. YU 
CK,Che
n CC,Chen 
CL,W ang J
R,Li
u CC,Yan 
JJ,et
 a1
.  Human 
Ent
erovi
rus
 7 
1.Si
ngapor
e.Emer
g I
nfect
 Di
s 2002;8:
 
Neut
ral
izi
ng 
ant
ibody pr
ovi
ded 
prot
ect
ion agai
nst
 ent
erovi
rus
  995—
997.
 

ype 
71 l
et
h a1
 cha
llenge
 in 
neonat
al 
mice.J
 Bi
omed 
Scj
 2O00:
  22. Luo 
ST,Chi
ang 
PS,Chao 
AS,Li
ou 
G  Li
n R,Li
n T  et
 a1
. 
7:523—
528.
  Ent
erovi
rus
 7 
l M at
erna
l Ant
ibodi
es 
in 
Inf
ant
s.Tai
wan.Em er
g 
14. Cha
ngLY,Ki
ngCC,Hs
uKH,Ni
ngHC,Tsa
oKC,LiCC,et
 a1
.  l
nfect
 Di
s 2009;15:581-
584.
 
Ri
sk 
fact
ors
 of
 ent
erovi
rus
 7 
1 i
nfecf
ion and as
soci
ated hand.
  23. Chri
sti
e CD,Lee—
Hir
sh J,Rogal
l B,M e
rri
l1
 S,Raml
al AA,
 

oot
,an d m out
h di
seas
e/her
pangi
na i
n c
hil
dren dur
ing an  K ar
ian V. et
 a1
. Dura
bil
ity of
 pas
sive
 m eas
les
n t
a ibody i
n 
epi
demi
c i
n Tai
w an.Pedi
atr
ics
 2002;1
09:e88。
e93.
  Ja
mai
can 
chi
ldr
en.I
nt 
J Epi
demi
ol 1
 
990;19:698.
702.
 
15. Chen SC,Chang HL,Yan TR,Cheng Y  Che
n KT.An  24. Sar
vas
 H,Seppal
a I
,Kur
ikka
 S,Si
egbe
rg R, M a
keBi
 O.
 
ei
ght
—yea
r s
tudy of 
epi
demi
ologi
c f
eat
ures
 of
 ent
erovi
rus
 7 
1  Ha1
f-l
ife
 of
 me mat
ernal
 IgG1
 al
lot
ype
 in i
nfant
s.J
 Cl
in 

nfect
ion 
in 
Tai
wan.Am 
J Tr
0P 
Med 
Hyg 
2007;77:188—
191.
  I
m m unol
 1993;13:145—
151.
 
16. Lu CY Lee
 C  Kao CL,Shao W  
Y'Lee 
PI,Twu SJ
,et
 a1
.  25. Har
tter
 HK, Oyedel
e OI,Di
etz K.Kr
eis
 S,Hofm a
n J
P, 


nci
dence and cas
e—f
atal
ity r
ates
 resul
ting f
rom t
he 1
 
998
  M ul
ler
 CR 
P1acent
al 
trans
fer
 and 
decay 
of 
mat
erna
lly 
acqui
red 
ent
erovi
rus
 7 
l out
break i
n Tai
wan.J
 M ed Vi
ro1
 2002;67:
  a
nti
meas
les
 ant
ibodi
es 
in 
Niger
in chi
a ldr
en.Pedi
atr
 Inf
ect
 Di
s 
217—
223.
  J
 20o0:1
9:635—
641.
 

17.
  n—
Mur
phy M,Ta
n KL,Li
a 
r GN,Quek 
JH,I
shak B,Phoon  26. Pdmz—
V61
ez 
CM ,Ander
son 
M S,Robi
nson 
CC M cFar
tand 
EJ,
 
M C. Pol
iovi
rus
 neut
ral
izi
ng a
nti
body i
n i
nfa
nts
 and cor
d  Ni
x W A. Pal
lns
a ch MA. e
t a
1. Out
break of neurol
ogi
c 

bl
ood.Ann 
Aca
d M ed 
Singapor
e 1993;22:281—
285.
  ent
erovi
ms 
type
 7 

 di
seas
e:a 
diagnos
tic
 chal
lenge.Cl
in 
Inf
ect
 

 8. Gr
n di
a en M .Fos
gren M ,Ehm e
t A .Ent
erovi
rua.I
n:Lenneae
  Di
s 2007;45:950—
957.
 

EH 
Lennet
te DA,
Lenne ̄e 
ET.eds.Di
agnost
ic pr
ocedur
es f
or 
Vi
ra1
.  Ri
cket
tsi
al  and  Chi
amydi
aI I
nfect
ions,
  7t
h  e
d. 
Washi
ngt
on.DC:Amer
ica
n Publ
ic 
Heal
h 
t As
soci
ati
on;1
 995:
  f
Rec
eive
d J
anuar
y 22,2010J
 
279—
298.
  Edi
tedby CHEN Li
—mi
n 

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