Emergence and circulation of enterovirus B species in infants in southern China: A multicenter retrospective analysis

ABSTRACT

Background

Enteroviruses (EV) are common and can cause severe diseases, particularly in young children. However, the information of EV infection in infants in China is limited due to the vast population size and extensive geographical area of the country. Here, we conducted a retrospective multicenter analysis of available EV data to assess the current epidemiological situation in the infant population in southern China.

Methods

The study enrolled infants with suspected EV infection from 34 hospitals across 12 cities in southern China between 2019 to 2022, and the confirmation of EV was done using RT-PCR and VP1 gene sequencing.

Results

Out of 1221 infants enrolled, 330 (27.03%) were confirmed as EV-infected. Of these, 260 (78.79%) were newborns aged 0–28 days. The EV belonged to three species: EV-B (80.61%), EV-A (11.82%), and human rhinovirus (7.58%). Newborns were more susceptible to EV-B than older infants (p < 0.001). Within EV-B, we identified 15 types, with coxsackievirus (CV) B3 (20.91%), echovirus (E) 11 (19.70%), and E18 (16.97%) being the most common. The predominant EV types changed across different years. EV infection in infants followed a seasonal pattern, with a higher incidence from May to August. Furthermore, perinatal mother-to-child EV transmission in 12 mother-newborn pairs were observed.

Conclusion

Our study is the first to demonstrate the emergence and widespread circulation of EV-B species, mainly CVB3, E11, and E18, in southern China, primarily affecting young infants. This research provides valuable insights for future epidemic assessment, prediction, as well as the elimination of mother-to-child transmission.

KEYWORDS:

• Enterovirus
• epidemiology
• infants
• perinatal mother-to-child transmission
• southern China

Acknowledgements

We express our gratitude to all the participating hospitals and clinics for their contribution in providing specimens and gathering the necessary data for this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Xiaohan Yang and Aihua Yin designed the study. Xiaohan Yang and Yudan Wu analysed the data and performed the phylogenetic evolutionary analysis. Xiaohan Yang, Pan Liu, Hongyu Zhao, and Lihua Liang conducted the laboratory tests. The first draft of the manuscript was produced by Xiaohan Yang. Xiaohan Yang and Aihua Yin edited and reviewed the manuscript. All the authors approved the final version of the manuscript.

Ethics approval

This study was approved by the ethics committee of the Guangdong Women and Children Hospital [No. 202301319].

Data Availability statement

All the data supporting the findings of this study are provided in the article and its Supplementary file. Additional data are available upon request from the corresponding author.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/21505594.2024.2329569.

Additional information

Funding

This work was supported by the Guangdong Medical Science and Technology Research Fund [grant number A2023410].