The Epidemiological Study of Coxsackievirus A6 revealing Hand, Foot and Mouth Disease Epidemic patterns in Guangdong, China - PubMed (original) (raw)

Jing Lu 2, Huanying Zheng 1, Lina Yi 2, Xue Guo 1, Leng Liu 1, Shannon Rutherford 3, Limei Sun 4, Xiaohua Tan 4, Hui Li 1, Changwen Ke 1, Jinyan Lin 1

Affiliations

The Epidemiological Study of Coxsackievirus A6 revealing Hand, Foot and Mouth Disease Epidemic patterns in Guangdong, China

Hanri Zeng et al. Sci Rep. 2015.

Abstract

Enterovirus A71 (EVA71) and Coxsackievirus A16 (CVA16) are regarded as the two major causative pathogens in hand, foot and mouth disease (HFMD) epidemics. However, CVA6, previously largely ignored, became the predominant pathogen in China in 2013. In this study, we describe the epidemiological trends of CVA6 during the annual HFMD outbreaks from 2008 to 2013 in Guangdong, China. The study results show that CVA6 has been one of three major causative agents of HFMD epidemics since 2009. The periodic rotation and dominance of the three pathogens, EVA71, CVA16 and CVA6, may have contributed to the continuously increasing HFMD epidemics. Moreover, phylogenetic analysis of the VP1 gene shows that major circulating CVA6 strains collected from 2009 to 2013 are distinct from the earlier strains collected before 2009. In conclusion, the discovery from this research investigating epidemiological trends of CVA6 from 2008 to 2013 explains the possible pattern of the continuous HFMD epidemic in China. The etiological change pattern also highlights the need for improvement for pathogen surveillance and vaccine strategies for HFMD control in China.

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Figures

Figure 1

Figure 1

Enterovirus assoicated HFMD cases and enterovirus distribution in Guangdong Province, China, from 2008 to 2013. The continuous line describes the total number of HFMD cases collected from 28 sentinel hospitals each year in 21 cities of Guangdong; the histogram shows the percentage of EVA71, CVA16, CVA6 and other untyped enterovirus (EVs) isolates in EV positive samples.

Figure 2

Figure 2

Phylogenetic analysis of coxsackievirus A6 viral capsid protein 1 nucleotide sequences (nt 2441 to 3355 according to Gdula strain AY421764) showing the relationships between CVA6 strains. Genbank accession numbers and location as well as year for virus isolation are included. Scale bar indicates branch distances; solid circles indicate strains sequenced in this study. Only bootstrap values of over 75% are shown.

References

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