Fig. 1 Structure and genome of Enterovirus 71 (Yee PTI, et al. 2016)
Fig. 2 Schematic overview of the enterovirus life cycle (Baggen J, et al. 2018)
The Enterovirus genus consists of a large number of RNA viruses belonging to the family Picornaviridae, including human enterovirus groups A, B, C, and D as well as non-human enteroviruses. Enteroviruses are non-enveloped, spherical viruses with a diameter ranging from 28 to 30 nm, and single-stranded RNA. The genome of these enteroviruses is approximately 7.5–8.0 kb in length and contains one open reading frame, flanked by a highly structured 5' UTR and a 3' UTR with a poly tail. This polyprotein is proteolyzed into P1, P2, and P3 precursor proteins.
Enteroviruses spread either through the faecal–oral route or via respiratory transmission. From their primary sites of replication in the gastrointestinal or respiratory tract, they can disseminate and infect other tissues and organs, including the central nervous system. Although most infections go unnoticed, they can cause a wide range of disorders with varying presentation and severity, most often in infants, young children and immunocompromised individuals. Furthermore, they can cause neonatal sepsis-like disease, encephalitis, acute flaccid paralysis, non-specific febrile illness, hand-foot-and-mouth disease (HFMD), herpangina, pleurodynia, pericarditis and myocarditis. Some of them have emerged as serious public health threats, particularly EV-A71 and EV-D68.
EV71 is a causative viral agent associated with significant morbidity and mortality, owing to its involvement of the central nervous system (CNS). Therefore, EV71 is widely considered as one of the most important virulent neurotropic enteroviruses after the eradication of poliomyelitis. The development of efficacious vaccine is a top priority to effectively prevent EV71. There are three inactivated, EV-A71 whole-virus vaccines approved by the China National Medical Products Administration (NMPA) and are commercially available in China. Learn more about EV71 antigens.
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