Etiology of Multiple Non-EV71 and Non-CVA16 Enteroviruses Associated with Hand, Foot and Mouth Disease in Jinan, China, 2009—June 2013

Guan, Huaijin; Wang, Ji; Wang, Chunrong; Yang, Mengjie; Liu, Lanzheng; Yang, Guoliang; Ma, Xuejun

doi:10.1371/journal.pone.0142733

Cited by 52 publications

(43 citation statements)

References 22 publications

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“…Though EV71 was a major pathogen, other EVs, especially CVA6 and CVA10, are prevalent and have become the predominant causative agents. [12][13][14] In Jiangsu province, EV71 and CVA16 were the major etiologic agents of HFMD 20 from 2009 to 2012. For example, a previous study 21 showed that EV71 was the main pathogen causing HFMD in Suzhou, Jiangsu Province from April to July 2013.…”

Section: Discussionmentioning

confidence: 99%

“…Since 2008, other enteroviruses (EVs), such as CVA6 and CVA10, along with EV17 and CVA16, were also identified as the major pathogens in several HFMD outbreaks. [4][5][6][7][8][9][10][11][12][13][14] HFMD has been a major public health concern in China since the first case report 15 in Shanghai in 1982. In 2008, a huge outbreak of HFMD caused by EV71 in FuYang City, China, had a significant impact on the health of local infants and young children.…”

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confidence: 99%

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Profiles of Human Enteroviruses Associated with Hand, Foot, and Mouth Disease in Nanjing, China

Chen

Zhang

2019

Disaster med. public health prep.

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ObjectiveHand, foot, and mouth disease (HFMD) is a common infectious disease caused by a group of viruses. The causative viruses have changed over time, and there is a need for a more effective protective vaccine. In this study, we investigated the profiles of human enteroviruses that caused HFMD outbreaks in Nanjing in 2015, with the goal of guiding the future prevention and treatment of HFMD.MethodsSpecimens were collected from 1097 patients admitted to our hospital and diagnosed with HFMD. Enteroviruses in the specimens were identified by real-time polymerase chain reaction and epidemiological patterns were analyzed with the clinical data.ResultsAmong the 1097 clinically diagnosed HFMD cases, 916 cases were confirmed by laboratory tests. The results showed that the main infectious virus was coxsackievirus A6 (CVA6) (41.75%), followed by enterovirus 71 (EV71) (27.48%), coxsackievirus A16 (7.43%), coxsackievirus A10 (6.84%), and others (16.51%). Further investigation indicated that CVA6 caused mild cases of HFMD, while EV71 caused severe cases. More enterovirus positive cases were reported from rural areas than from urban areas.ConclusionsCA6 and EV71 were the chief pathogenic viruses of HFMD cases in the present study. Schools, childcare centers, and families from rural areas should be the major targets for prevention and awareness of HFMD. This study will provide information useful in the prevention and management of HFMD and the development of relevant vaccines for HFMD in the future. (Disaster Med Public Health Preparedness. 2019;13:740–744).

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Profiles of Human Enteroviruses Associated with Hand, Foot, and Mouth Disease in Nanjing, China

Chen

Zhang

2019

Disaster med. public health prep.

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“…Several studies on CV-A10 genotyping were based on 5′-UTR 10 , VP4 11 , or partial VP1 3 , 4 , 12 , 13 . However, VP1 plays a critical role in mediating binding receptor and the complete VP1 has been used widely to identify EV serotypes 14 – 18 as its coding region contains many important neutralizing antigenic sites.…”

Section: Introductionmentioning

confidence: 99%

The emerging sub-genotype C2 of CoxsackievirusA10 Associated with Hand, Foot and Mouth Disease extensively circulating in mainland of China

Guo

Huang

et al. 2018

Sci Rep

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Coxsackievirus A10 (CV-A10) associated with Hand, foot, and mouth disease (HFMD) cases emerged increasingly in recent years. In this study, the samples from nation-wide HFMD surveillance, including 27 out of 31 provinces in China were investigated, and the continuous and extensive virological surveillance, covered 13 years, were conducted to provide a comprehensive molecular characterization analysis of CV-A10. 855 CV-A10 viruses (33 severe cases included), were isolated from HFMD children patients during 2009 to 2016 in China. 164 representative sequences from these viruses, together with 117 CV-A10 sequences downloaded from GenBank based on entire VP1 were recruited in this study. Two new genotypes (F and G) and two sub-genotypes (C1 and C2) were identified. Among 264 Chinese sequences, 9 of them were genotype B, 8 of them were C1, and the other (247) were C2, the predominant sub-genotype in China since 2012. Chinese C2 viruses showed obvious temporal characteristics and can be divided into 3 clusters (cluster 1~3). Cluster 3 viruses was circulating extensively during 2014 and 2016 with more severe cases. It is very necessary and important to continuously conduct the extensive virological surveillance for CV-A10, and further evolutionary studies will provide more evidence on its evolution and virulence.

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“…In 2012, there were 4 young children reported with severe upper respiratory illness due to CV-A2 infections in Hong Kong, 2 of whom died [9]. In 2009–2013, CV-A2 was one of the most dominant types of the 12 circulating serotypes of EVs causing HFMD in Jinan, Shandong province [10]. In 2013, an epidemic of herpangina occurred in Shenzhen of Guangdong province due to CV-A2 infection.…”

Section: Introductionmentioning

confidence: 99%

Two Genotypes of Coxsackievirus A2 Associated with Hand, Foot, and Mouth Disease Circulating in China since 2008

Yang¹,

Zhang²,

Yan³

et al. 2016

PLoS ONE

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Coxsackievirus A2 (CV-A2) has been frequently detected and commonly associated with hand, foot, and mouth disease (HFMD) in China since 2008. However, limited sequences of CV-A2 are currently available. As a result, we have been focusing on the genetic characteristics of CV-A2 in the mainland of China during 2008–2015 based on national HFMD surveillance. In this study, 20 CV-A2 strains were isolated and phylogenetic analyses of the VP1 sequences were performed. Full-length genome sequences of two representative CV-A2 isolates were acquired and similarity plot and bootscanning analyses were performed. The phylogenetic dendrogram indicated that all CV-A2 strains could be divided into four genotypes (Genotypes A–D). The CV-A2 prototype strain (Fleetwood) was the sole member of genotype A. From 2008 to 2015, the CV-A2 strains isolated in China dispersed into two different genotypes (B and D). And the genotype D became the dominant circulating strains in China. Strains isolated in Russia and India from 2005 to 2011 converged into genotype C. Intertypic recombination occurred between the Chinese CV-A2 strains and other enterovirus-A donor sequences. This result reconfirmed that recombination is a common phenomenon among enteroviruses. This study helps expand the numbers of whole virus genome sequence and entire VP1 sequence of CV-A2 in the GenBank database for further researcher.

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Etiology of Multiple Non-EV71 and Non-CVA16 Enteroviruses Associated with Hand, Foot and Mouth Disease in Jinan, China, 2009—June 2013

Cited by 52 publications

References 22 publications

Profiles of Human Enteroviruses Associated with Hand, Foot, and Mouth Disease in Nanjing, China

Profiles of Human Enteroviruses Associated with Hand, Foot, and Mouth Disease in Nanjing, China

The emerging sub-genotype C2 of CoxsackievirusA10 Associated with Hand, Foot and Mouth Disease extensively circulating in mainland of China

Two Genotypes of Coxsackievirus A2 Associated with Hand, Foot, and Mouth Disease Circulating in China since 2008

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