title: [Analysis on the epidemiological and genetic characteristics of enterovirus type 71 and Coxsackie A16 virus infection in Jiangsu, China].
abstract: OBJECTIVE
  To determine the epidemiological features of hand-foot-and-mouth disease (HFMD) outbreaks and the genetic characteristics of enterovirus type 71(EV71) isolates from patients in Lianyungang, Jiangsu province in May, 2008.
  
  
  METHODS
  Epidemiological, microbiological, cellular and molecular methods were performed to investigate pathogens and to describe the homogeneity of isolated strains.
  
  
  RESULTS
  21 cases were reported in this HFMD outbreak with the attack rate as 20.0%. 3 EV71 virus strains were isolated from 10 stool samples. The nucleotide and amino acid homogeneity of these 3 Jiangsu strain with Anhui Fuyang strains were 97.9%-100.0% and 99.7%-100.0%, respectively. These 4 Jiangsu strains were within genotype C sub-geno group C4 in phylogenetic tree. Data from the follow-up study showed that shedding of EV71 and Coxsackie A16 virus (CA16) in the latent period appeared in the outbreak of HFMD. Human beings could be infected by both EV71 virus and CA16 at the same time and could also carry the two viruses. We also discovered that EV71 virus could be expelled out of the human body through stool in the first week and last for 10 weeks.
  
  
  CONCLUSIONS
  The recently identified EV71 isolates from this HFMD outbreak belonged to sub-geno group C4. Facts as: the release of viruses in the latent period, co-infection or coexisting of two viruses at the same time and super long period of expulsion of toxin exist in EV71 and CA16 did exist.
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Pan
authors.forename: Ye-fei
authors.initials: YF
authors.lastname: Zhu
authors.forename: Xian
authors.initials: X
authors.lastname: Qi
authors.forename: Yong-jie
authors.initials: YJ
authors.lastname: Zhang
authors.forename: Liang
authors.initials: L
authors.lastname: Li
authors.forename: Fei
authors.initials: F
authors.lastname: Deng
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.forename: Shen-jiao
authors.initials: SJ
authors.lastname: Wang
authors.forename: Feng-cai
authors.initials: FC
authors.lastname: Zhu
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D029821:Enterovirus A, Human / Q000235:genetics* / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D017201:Virus Shedding; D055815:Young Adult