Co-circulation of coxsackieviruses A-6, A-10, and A-16 causes hand, foot, and mouth disease in Guangzhou city, China

Abstract

Background: Hand, foot, and mouth disease (HFMD) is a common infectious disease occurring in children under 5 years of age worldwide, and Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CVA-16) are identified as the predominant pathogens. In recent years, Coxsackievirus A6 (CVA-6) and Coxsackievirus A10 (CVA-10) have played more and more important role in a series of HFMD outbreaks. This study aimed to understand the epidemic characteristics associated with HFMD outbreak in Guangzhou, 2018. Methods: The clinical and laboratory data of 1220 enterovirus-associated HFMD patients in 2018 were analysed in this study. Molecular diagnostic methods were performed to identify its serotypes. Phylogenetic analyses were depicted based on the complete VP1 gene. Results: There were 21 enterovirus serotypes detected in Guangzhou in 2018. Three serotypes of enterovirus, CVA-6 (364/1220, 29.8%), CVA-10 (305/1220, 25.0%), and CVA-16 (397/1220, 32.5%), were identified as the causative pathogens and accounted for 87.3% among all 1220 HFMD patients. In different seasons, CVA-6 was the predominant pathogen of HFMD during autumn, and CVA-10 as well as CVA-16 were more prevalent in summer. Patients infected by CVA-6, CVA-10 or CVA-16 showed similar clinical features and laboratory characteristics, and the ratios of severe HFMD were 5.8, 5.9, and 1.5% in the three serotypes. Phylogenetic analyses of VP1 sequences showed that the CVA-6, CVA-10, and CVA-16 sequences belonged to the sub-genogroup E2, genogroup E, and genogroup B1, respectively. Conclusions: CVA-6, CVA-10, and CVA-16 were the predominant and co-circulated serotypes in Guangzhou China, 2018, which should be the new target for prevention and control of HFMD. Our findings provide useful information for diagnosis, treatment, and prevention of HFMD.

Surveillance for Enteroviruses Associated with Hand, Foot, and Mouth Disease, and Other Mucocutaneous Symptoms in Spain, 2006–2020

“…Data coincide with those observed in template countries for EV infections overall, including Spain, although the autumn peak is usually not as pronounced [ 22 , 26 , 30 ]. They are also similar to those described in a study conducted in China [ 39 ], in which cases of HFMD by CVA6 seem to have a characteristic peak in autumn–winter that in Spain can be associated with the beginning of the school year.…”

Epidemiological and molecular characteristics of circulating CVA16, CVA6 strains and genotype distribution in hand, foot and mouth disease cases in 2017 to 2018 from Western India

“…The other small peak was noticed in the months of January and November in the year 2018, and probably it could be explained due to the cold climatic conditions. Similar observations were noticed from other countries including India 22,37,38 . The explanation for seasonality of these cases is unclear, however, it could be explained that the climatic conditions such as high humidity and cold weather might have been contributed to the increase in the occurrence of HFMD incidence 39 …”

Meteorological Factors and the Transmissibility of Hand, Foot, and Mouth Disease in Xiamen City, China

“…In future research, we can consider nationwide data collection to further explore the main meteorological factors related to the transmissibility of HFMD. Related studies have also shown that the main pathogens of HFMD change in different seasons and years, as well as a high mutation rate of human enterovirus (38,39). Besides, as current research on the temperature threshold of transmissibility is relatively limited, there is no unified threshold judgment standard.…”