Hand, Foot and Mouth Disease Caused By Coxsackievirus A6, Beijing, 2013

Abstract

Specimens and clinical data were collected from 243 hand, foot and mouth disease patients in Beijing in 2013. In total, 130 stool specimens were genotyped for enterovirus. Hand, foot and mouth disease was mainly detected in suburban areas and at the edges of urban areas between May and August. Coxsackievirus (CV) A6 replaced enterovirus (EV) 71 and CVA16, becoming the main causative agent of hand, foot and mouth disease. CVA6 infection led to significantly reduced fever duration and glucose levels compared with EV71 infection.

Fourteen types of co-circulating recombinant enterovirus were associated with hand, foot, and mouth disease in children from Wenzhou, China

“…Our data indicates that most of HFMD cases in Wenzhou were caused by CV-A6. Given the presence of CV-A6 in other parts of China [18,20,38] and abroad [30][31][32][33][34][39][40][41][42][43][44][45], it is clear that more widespread surveillance is needed to determine its potential to ignite a global pandemic.…”

“…Although EV-A71 and Coxsackievirus A16 (CV-A16) are considered to be the two most comment agents [12][13][14][15][16], other human enterovirus (HEV) types, such as CV-A10, CV-A6, as well as HEV-B, have been identified during the past 5 years in some parts of China [17][18][19][20]. Moreover, in some regions, the number of HFMD cases caused by non-EV-A71 and non-CV-A16 viruses has increased.…”

Yeast-produced recombinant virus-like particles of coxsackievirus A6 elicited protective antibodies in mice

“…Individuals infected with CA6 often present with typical HFMD symptoms as well as atypical manifestations including herpangina, onychomadesis and desquamation (Lo et al, 2011;Osterback et al, 2009;Sinclair et al, 2014;Vuorinen et al, 2014;Wei et al, 2011). A proportion (up to 10.7%) of the patients infected with CA6 could develop severe neurological complications, such as brainstem encephalitis and aseptic meningitis Hongyan et al, 2014;Logotheti et al, 2009;Richter et al, 2006). Apparently, the increasing prevalence and disease severity of CA6 infection pose a serious threat to public health, underscoring the necessity to develop vaccines for CA6.…”

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

“…In Asia, CA6 has become one of the main pathogens responsible for causing HFMD outbreaks and CA6 has replaced EV71 and CA16 as the primary pathogen causing HFMD since 2009. CA6 was responsible for HFMD outbreaks in Singapore in 2009 [11], Taiwan in 2009-2010 [12], Japan in 2011 [13], Thailand in 2012 [14] and mainland China in 2013 [15][16][17][18][19][20][21]. In North America, CA6-associated HFMD outbreaks have been reported in the USA [22] and Cuba [23] from 2011 to 2013.…”