Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.

Enterovirus A71 (EV-A71) and coxsackievirus A6 (CVA6) primarily cause hand, foot and mouth disease and have emerged to cause potential fatal neurological and systemic manifestations. However, limited surveillance data collected through passive surveillance systems hampers characterization of their e...

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Main Authors: Everlyn Kamau, Ben Lambert, David J Allen, Cristina Celma, Stuart Beard, Heli Harvala, Peter Simmonds, Nicholas C Grassly, Margarita Pons-Salort
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-11-01
Series:PLoS Pathogens
Online Access:https://doi.org/10.1371/journal.ppat.1012703
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author Everlyn Kamau
Ben Lambert
David J Allen
Cristina Celma
Stuart Beard
Heli Harvala
Peter Simmonds
Nicholas C Grassly
Margarita Pons-Salort
author_facet Everlyn Kamau
Ben Lambert
David J Allen
Cristina Celma
Stuart Beard
Heli Harvala
Peter Simmonds
Nicholas C Grassly
Margarita Pons-Salort
author_sort Everlyn Kamau
collection DOAJ
description Enterovirus A71 (EV-A71) and coxsackievirus A6 (CVA6) primarily cause hand, foot and mouth disease and have emerged to cause potential fatal neurological and systemic manifestations. However, limited surveillance data collected through passive surveillance systems hampers characterization of their epidemiological dynamics. We fit a series of catalytic models to age-stratified seroprevalence data for EV-A71 and CVA6 collected in England at three time points (2006, 2011 and 2017) to estimate the force of infection (FOI) over time and assess possible changes in transmission. For both serotypes, model comparison does not support the occurrence of important changes in transmission over the study period, and we find that a declining risk of infection with age and / or seroreversion are needed to explain the seroprevalence data. Furthermore, we provide evidence that the increased number of reports of CVA6 during 2006-2017 is unlikely to be explained by changes in surveillance. Therefore, we hypothesize that the increased number of CVA6 cases observed since 2011 must be explained by increased virus pathogenicity. Further studies of seroprevalence data from other countries would allow to confirm this. Our results underscore the value of seroprevalence data to unravel changes in the circulation dynamics of pathogens with weak surveillance systems and large number of asymptomatic infections.
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spelling doaj-art-1ef8d9a3ad854a25b9f10f95244d83a62025-08-20T02:23:15ZengPublic Library of Science (PLoS)PLoS Pathogens1553-73661553-73742024-11-012011e101270310.1371/journal.ppat.1012703Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.Everlyn KamauBen LambertDavid J AllenCristina CelmaStuart BeardHeli HarvalaPeter SimmondsNicholas C GrasslyMargarita Pons-SalortEnterovirus A71 (EV-A71) and coxsackievirus A6 (CVA6) primarily cause hand, foot and mouth disease and have emerged to cause potential fatal neurological and systemic manifestations. However, limited surveillance data collected through passive surveillance systems hampers characterization of their epidemiological dynamics. We fit a series of catalytic models to age-stratified seroprevalence data for EV-A71 and CVA6 collected in England at three time points (2006, 2011 and 2017) to estimate the force of infection (FOI) over time and assess possible changes in transmission. For both serotypes, model comparison does not support the occurrence of important changes in transmission over the study period, and we find that a declining risk of infection with age and / or seroreversion are needed to explain the seroprevalence data. Furthermore, we provide evidence that the increased number of reports of CVA6 during 2006-2017 is unlikely to be explained by changes in surveillance. Therefore, we hypothesize that the increased number of CVA6 cases observed since 2011 must be explained by increased virus pathogenicity. Further studies of seroprevalence data from other countries would allow to confirm this. Our results underscore the value of seroprevalence data to unravel changes in the circulation dynamics of pathogens with weak surveillance systems and large number of asymptomatic infections.https://doi.org/10.1371/journal.ppat.1012703
spellingShingle Everlyn Kamau
Ben Lambert
David J Allen
Cristina Celma
Stuart Beard
Heli Harvala
Peter Simmonds
Nicholas C Grassly
Margarita Pons-Salort
Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.
PLoS Pathogens
title Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.
title_full Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.
title_fullStr Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.
title_full_unstemmed Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.
title_short Enterovirus A71 and coxsackievirus A6 circulation in England, UK, 2006-2017: A mathematical modelling study using cross-sectional seroprevalence data.
title_sort enterovirus a71 and coxsackievirus a6 circulation in england uk 2006 2017 a mathematical modelling study using cross sectional seroprevalence data
url https://doi.org/10.1371/journal.ppat.1012703
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