Response to Comment on Shih et al. Increased Incidence of Pediatric Type 1 Diabetes With Novel Association With Coxsackievirus A Species in Young Children but Declined Incidence in Adolescents in Taiwan. Diabetes Care 2021;44:1579 –1585

We appreciate the comments from Dr. Yen and Dr. Wei (1). Here is our response to their concerns. First, we agree that the yearly positive isolation numbers of enterovirus (EV) serotypes from 2001 to 2015 from the nationwide laboratory surveillance system of the Taiwan Centers for Disease Control show no decreasing trend (2). This laboratory surveillance system selected some patients with respiratory tract infections or hand, foot, and mouth disease to perform viral isolation and reported the most common circulating viruses in Taiwan, but the isolation numbers of EV did not reflect the EV incidence of the general population. For the general population, seroepidemiology or nationwide database studies are more appropriate to measure serostatus or the incidence rate of certain infections. From the EV-A71 seroepidemiology studies, we demonstrated that the EV71 seropositive rates in children decreased markedly in 2017 compared with those in 1999 and 2007. For example, the EV-A71 seropositive rate of adolescents aged 12 –19 years decreased from 65% in 1997 to 46% in 2017 (3).
Source: Diabetes Care - Category: Endocrinology Source Type: research