A global surveillance network to monitor the emergence of new EV-A71 strains after the introduction of the vaccine should be established. a cost-effective immunogen, while VLPs contain an arrangement of epitopes that can elicit neutralizing antibodies against the virus. As each type of vaccine has its advantages and disadvantages, increased studies are required in the development of such vaccines, whereby high efficacy, long-lasting immunity, minimal risk to those vaccinated, safe and easy production, low cost, dispensing the need for refrigeration and convenient delivery are the major goals in their design. Keywords: Enterovirus 71, hand, foot and mouth disease, inactivated vaccine, viral like particles == 1 . Introduction == Vaccination for various viral diseases has markedly reduced mortality Chaetominine and morbidity worldwide for more than 200 years. Indeed, the greatest public health success can be attributed to vaccination. Nevertheless, the future is abound with challenges as there remains many diseases that do not yet have effective vaccines against Human Immunodeficiency virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), Dengue virus, Ebola, Hepatitis C, and the Enterovirus 71 which causes hand, foot and mouth disease. Every year, two new species of viruses are added to the list of approximately 200 different infectious viruses [1]. In addition , some viruses, particularly RNA viruses, can emerge as new pathogens as they have high mutation rates due to their error-prone RNA dependent RNA polymerase. The existing viruses can evolve to become more virulent through recombinations or mutations and the mutated strains often do not have any effective vaccines against them. Currently, there are only an estimated 15 vaccines to combat the 200 viruses known to infect man [1]. Although there are more vaccines undergoing clinical trials, it is worrying to note that humans remain vulnerable to the existing 180 or so viruses that have no effective vaccines. Therefore , increased research is required to develop new and better vaccines, whereby high efficacy, long-lasting immunity, minimal Chaetominine risk to those vaccinated, safe and easy production, low cost, dispensing the need for refrigeration and convenient delivery are the major goals in their design. == 2 . Enterovirus 71 == The World Health Organization (WHO) and the scientific community have been addressing challenges unprecedented in public health posed by Enteroviruses in the post-poliovirus era. Enteroviruses such as Enterovirus 71 (EV-A71), Coxsackie type A16 (CV-A16) and other enteroviruses causing hand, foot and mouth disease (HFMD) have led to over seven million infections, including 2457 fatalities in China from 2008 to 2012 [2]. However , due to increasing travels and rapid globalization, outbreaks in other parts of Chaetominine the world have also appeared in other regions in cyclical epidemics [3]. Table 1summarizes the various clinical symptoms associated with enteroviral infections. Within the familyPicornaviridae, the genusEnteroviruscomprises 12 species. The species Enterovirus A consists of 25 serotypes and includes Rabbit Polyclonal to ATRIP the enteroviruses causing HFMD such as EV-A71, CV-A16, CV-A5, CV-A6, CV-A8 and CV-A10 [4]. Serotypes such as CV-A4 and CV-A5 are more often associated with herpangina. Five years of virological surveillance in China (20082014) showed that 43. 73%, 22. 04%, and 34. 22% of HFMD cases were due to EV-A71, CV-A16 and other enteroviruses, respectively [5]. == Table 1 Chaetominine . == Clinical manifestations of enteroviruses. Each symptom may potentially be caused by more than one enterovirus [6]. However , Coxsackieviruses which are common etiological agents of HMFD do not generally cause neurological or cardiopulmonary disease and EV-A71 is the main causative agent of fatal HFMD infections [7]. In major outbreaks, EV-A71 could contribute to 80%85% of HFMD-related deaths as observed during the HFMD outbreak in Taiwan in 1998 [8]. In an epidemiological survey in Shanghai from May 2010 to April 2011, it was reported that 83. 8% of HFMD cases were due to EV-A71, 9% to CV-A10, 8. 3% to CV-A6 and CV-A16 accounted for 6. 9% of total HFMD cases [9]. The EV-A71 virus is classified as a Human enterovirus A (HEV-A) species, belonging to the genusEnterovirusin the familyPicornaviridae, together with some Coxsackie A viruses [10]..