Epidemiology and Sequence-Based Evolutionary Analysis of Circulating Non-Polio Enteroviruses

Abstract

Enteroviruses (EVs) are positive-sense RNA viruses, with over 50,000 nucleotide sequences publicly available. While most human infections are typically associated with mild respiratory symptoms, several different EV types have also been associated with severe human disease, especially acute flaccid paralysis (AFP), particularly with endemic members of the EV-B species and two pandemic types—EV-A71 and EV-D68—that appear to be responsible for recent widespread outbreaks. Here we review the recent literature on the prevalence, characteristics, and circulation dynamics of different enterovirus types and combine this with an analysis of the sequence coverage of different EV types in public databases (e.g., the Virus Pathogen Resource). This evaluation reveals temporal and geographic differences in EV circulation and sequence distribution, highlighting recent EV outbreaks and revealing gaps in sequence coverage. Phylogenetic analysis of the EV genus shows the relatedness of different EV types. Recombination analysis of the EV-A species provides evidence for recombination as a mechanism of genomic diversification. The absence of broadly protective vaccines and effective antivirals makes human enteroviruses important pathogens of public health concern.

How Viruses Use the VCP/p97 ATPase Molecular Machine

“…Enterovirus 71 (EV71) and poliovirus (PV) are non-enveloped neurotropic viruses with a positive-sense RNA genome in the Picornaviridae family [ 93 ]. EV71 is the causative agent of recurring hand, foot, and mouth disease (HFMD) that usually affects infants and young children [ 94 ].…”

Coxsackievirus A16 in Southern Vietnam

“…In recent years, CVA6 and CVA10 have also been recognized as emerging pathogens of HFMD. EV-A71 and CVA16 are phylogenetically closely related ( Brown et al, 2020 ). Genetically, CVA16 is divided into 2 genogroups A and B, with genogroup B being further divided into B1a, B1b, B1c, and B2 ( Noisumdaeng et al, 2019 ).…”

First evidence of enterovirus A71 and echovirus 30 in Uruguay and genetic relationship with strains circulating in the South American region

“…On the other hand, echovirus 30 (E30), an Enterovirus B species member, is frequently associated with neurological symptoms, mainly AM [ 17 , 18 ]. Its presence among a population seems to be cyclic, characterised by repeated epidemics -frequently over large geographic areas- every 3 to 5 years [ 19 , 20 ].…”

“…South America is often described as a region with scarce available genetic information regarding EVs [ 20 , 27 ]. Particularly in Uruguay, knowledge about molecular diversity of circulating EVs is limited [ 28 ].…”