Age-specific incidence rates of HFMD cases in Kuala Lumpur and Malaysia.

<p>Incidence rates (per 1000 population) of HFMD cases in (A) Kuala Lumpur and (B) Malaysia, only available for 2011 to 2014, and obtained from Ministry of Health, Malaysia.</p

Age-dependent seroprevalence rates of EV-A71 infection in Kuala Lumpur, Malaysia from 1995–2012 and EV-A71 genetic diversity.

<p>(A) Seroprevalence rates of EV-A71 infection in 1–6 years (pre-school) and 7–12 years (primary school) age groups are shown. The asterisks indicate significant differences (<i>P</i><0.05) in seroprevalence between the two age groups after Bonferroni correction for multiple comparisons across individual years. The black squares indicate reported EV-A71 epidemic years. The black line indicates the overall incidence rates of HFMD as reported by the Ministry of Health, Malaysia from 2007 (the statutory notification of HFMD was enforceable only from October 2006). (B) Bayesian Skyride plot estimating the genetic diversity of EV-A71 over time. (C) Maximum clade credibility tree based on VP1 sequences showing the EV-A71 subgenotypes present in Malaysia since the first epidemic in 1997. Posterior probability values are shown at the key nodes. EV-A71 BrCr from genotype A was used as the outgroup.</p

Monthly distribution of the number of HFMD cases in every state of Malaysia from 2008–2014.

<p>Data were obtained from Ministry of Health, Malaysia.</p

Age-specific seroprevalence and geometric mean titers of EV-A71 infection.

<p>(A) Seroprevalence rates and (B) geometric mean titers of EV-A71 infection by age, in epidemic and non-epidemic years (<i>P</i><0.05*; <i>P</i><0.01**; <i>P</i><0.001***).</p

Association between EV-A71 epidemics and seroprevalence in children from 1995–2012.

<p>Association between EV-A71 epidemics and seroprevalence in children from 1995–2012.</p