title: An emerging recombinant human enterovirus 71 responsible for the 2008 outbreak of hand foot and mouth disease in Fuyang city of China.
abstract: Hand, foot and mouth disease (HFMD), a common contagious disease that usually affects children, is normally mild but can have life-threatening manifestations. It can be caused by enteroviruses, particularly Coxsackieviruses and human enterovirus 71 (HEV71) with highly variable clinical manifestations. In the spring of 2008, a large, unprecedented HFMD outbreak in Fuyang city of Anhui province in the central part of southeastern China resulted in a high aggregation of fatal cases. In this study, epidemiologic and clinical investigations, laboratory testing, and genetic analyses were performed to identify the causal pathogen of the outbreak. Of the 6,049 cases reported between 1 March and 9 May of 2008, 3023 (50%) were hospitalized, 353 (5.8%) were severe and 22 (0.36%) were fatal. HEV71 was confirmed as the etiological pathogen of the outbreak. Phylogenetic analyses of entire VP1 capsid protein sequence of 45 Fuyang HEV71 isolates showed that they belong to C4a cluster of the C4 subgenotype. In addition, genetic recombinations were found in the 3D region (RNA-dependent RNA polymerase, a major component of the viral replication complex of the genome) between the Fuyang HEV71 strain and Coxsackievirus A16 (CV-A16), resulting in a recombination virus. In conclusion, an emerging recombinant HEV71 was responsible for the HFMD outbreak in Fuyang City of China, 2008.
authors.affiliation: Key Laboratory for Molecular Virology & Genetic Engineering, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhu
authors.forename: Weizhong
authors.initials: W
authors.lastname: Yang
authors.forename: Jun
authors.initials: J
authors.lastname: Ren
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Tan
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Naiying
authors.initials: N
authors.lastname: Mao
authors.forename: Songtao
authors.initials: S
authors.lastname: Xu
authors.forename: Shuangli
authors.initials: S
authors.lastname: Zhu
authors.forename: Aili
authors.initials: A
authors.lastname: Cui
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
authors.forename: Dongmei
authors.initials: D
authors.lastname: Yan
authors.forename: Qun
authors.initials: Q
authors.lastname: Li
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Dong
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Yueping
authors.initials: Y
authors.lastname: Zhao
authors.forename: Junfeng
authors.initials: J
authors.lastname: Wan
authors.forename: Zijian
authors.initials: Z
authors.lastname: Feng
authors.forename: Junling
authors.initials: J
authors.lastname: Sun
authors.forename: Shiwen
authors.initials: S
authors.lastname: Wang
authors.forename: Dexin
authors.initials: D
authors.lastname: Li
authors.forename: Wenbo
authors.initials: W
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000821:virology; D004196:Disease Outbreaks; D029821:Enterovirus A, Human / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D011995:Recombination, Genetic; D014764:Viral Proteins / Q000235:genetics
chemical_list: D014764:Viral Proteins
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