Human enterovirus 71 strains in the background population and in hospital patients in Finland

Hanna Honkanen, Sami Oikarinen, Outi Pakkanen, Tanja Ruokoranta, Minna M. Pulkki, Olli H. Laitinen, Sisko Tauriainen, Sanna Korpela, Maija Lappalainen, Tytti Vuorinen, Anna Maija Haapala, Riitta Veijola, Olli Simell, Jorma Ilonen, Mikael Knip, Heikki Hyöty

Research output: Contribution to journalArticleScientificpeer-review

29 Citations (Scopus)


Background: Human enterovirus 71 (HEV71) is a common cause of severe outbreaks of hand-foot- and mouth disease, aseptic meningitis and encephalitis in Asian populations but has not caused such epidemics in all populations. Objectives: To analyze the frequency of HEV71 in the background childhood population in Finland by screening in stool and serum samples and by measuring neutralizing antibodies against HEV71 in serum and to compare the genetic relationship of virus strains detected in asymptomatic children and those causing severe illness in Finland to the strains found in other countries. Study design: 4185 stool samples and 5686 serum samples were collected and clinical symptoms recorded from children who were observed from birth. Additional stool samples were available from four children hospitalized due to EV71 infection. Samples were screened for the presence of RNA of human enteroviruses using RT-PCR and HEV71 amplicons were identified by sequencing. Phylogenetic analyses were carried out to study genetic relationships between different virus strains. Neutralizing antibodies against HEV71 were screened from 522 children. Results: A total of 0.3% of stool samples and two serum samples from healthy children were positive for HEV71 genome. 1.6% of the children had neutralizing antibodies against HEV71. Most infections were asymptomatic or mild in contrast to the clear symptoms in the children hospitalized due to HEV71. All viruses were C strains. Conclusions: HEV71 is circulating in Finland but it is rare. No clear difference was seen between strains circulating in the Finnish background population and those found in hospitalized patients or those causing severe outbreaks worldwide.

Original languageEnglish
Pages (from-to)348-353
Number of pages6
Issue number4
Publication statusPublished - 2013
Publication typeA1 Journal article-refereed


  • Epidemiology
  • Human enterovirus 71
  • Neutralization assay
  • RT-PCR

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