Two models for changes of EV71 immunity in infants and young children

Abstract

Human enterovirus 71 (EV71) has been associated with outbreaks of hand-foot-and-mouth disease (HFMD) in China. Susceptibility to EV71 is associated with age, but few studies have been accomplished to measure such a relationship. A better understanding of the connection between susceptibility and age is necessary to develop strategies for control of HFMD. In 2010, a survey of an epidemic of EV71 was conducted in a northern city of Jiangsu Province in China. Samples were tested serologically to identify the EV71 neutralizing antibody. Two different mathematical models have now been employed to describe how this antibody varied with age, and parameters in the model were estimated from survey data. Both models depicted the variations in EV71-neutralizing antibody. Seroprevalence was high for neonates but decreased to near zero at 5 months of age. Subsequently, the EV71 antibody levels increased and then remained stable after about 36 months. For models 1 and 2, values for the coefficient of determination (R²) were 0.9458 and 0.9576, and values for root mean square error (RMSE) were 0.0755 and 0.0752, respectively. Model 2, formulated from the characteristics of development of the immune system, was more reliable than model 1, formulated from survey data, because the impact of the survey on the structure of the model was removed. Moreover, model 2 provided the possibility to define the parameters in a biological sense.

Keywords:

• dynamical model
• enterovirus 71
• statistical analysis
• susceptibility

Abbreviations:

• HFMD, Hand foot-and-mouth disease
• EV71, enterovirus 71
• R², coefficient of determination
• RMSE, root mean square error
• CoxA16, coxsackievirus A16
• Eq., Equation
• ODE, ordinary differential equation

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Acknowledgments

The authors wish to thank Donald L. Hill (University of Alabama at Birmingham, USA) for editing.

Funding

This work was supported by the National Natural Science Foundation of China [grant number 81273184].