title: Emergence, circulation, and spatiotemporal phylogenetic analysis of coxsackievirus a6- and coxsackievirus a10-associated hand, foot, and mouth disease infections from 2008 to 2012 in Shenzhen, China.
abstract: Sporadic hand, foot, and mouth disease (HFMD) outbreaks and other infectious diseases in recent years have frequently been associated with certain human enterovirus (HEV) serotypes. This study explored the prevalences and genetic characteristics of non-HEV71 and non-coxsackievirus A16 (CV-A16) human enterovirus-associated HFMD infections in Shenzhen, China. A total of 2,411 clinical stool specimens were collected from hospital-based surveillance for HFMD from 2008 to 2012. The detection of HEV was performed by real-time reverse transcription-PCR (RT-PCR) and RT-seminested PCR, and spatiotemporal phylogenetic analysis was performed based on the VP1 genes. A total of 1,803 (74.8%) strains comprising 28 different serotypes were detected. In the past 5 years, the predominant serotypes were HEV71 (60.0%), followed by CV-A16 (21.2%) and two uncommon serotypes, CV-A6 (13.0%) and CV-A10 (3.3%). However, CV-A6 replaced CV-A16 as the second most common serotype between 2010 and 2012. As an emerging pathogen, CV-A6 became as common a causative agent of HFMD as HEV71 in Shenzhen in 2012. Phylogenetic analysis revealed that little variation occurred in the Chinese HEV71 and CV-A16 strains. The genetic characteristics of the Chinese CV-A6 and CV-A10 strains displayed geographic differences. The CV-A6 and CV-A10 strains circulating in Shenzhen likely originated in Europe. It was found that human enteroviruses have a high mutation rate due to evolutionary pressure and frequent recombination (3.2 × 10(-3) to 6.4 ×10(-3) substitutions per site per year for HEV71, CV-A6, CV-A16, and CV-A10). Since certain serotypes are potential threats to the public health, this study provides further insights into the significance of the epidemiological surveillance of HFMD.
authors: Major Infectious Disease Control Key Laboratory, Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
authors: Ya-Qing
authors: YQ
authors: He
authors: Long
authors: L
authors: Chen
authors: Wen-Bo
authors: WB
authors: Xu
authors: Hong
authors: H
authors: Yang
authors: Han-Zhong
authors: HZ
authors: Wang
authors: Wen-Ping
authors: WP
authors: Zong
authors: Hui-Xia
authors: HX
authors: Xian
authors: Hui-Ling
authors: HL
authors: Chen
authors: Xiang-Jie
authors: XJ
authors: Yao
authors: Zhang-Li
authors: ZL
authors: Hu
authors: Min
authors: M
authors: Luo
authors: Hai-Long
authors: HL
authors: Zhang
authors: Han-Wu
authors: HW
authors: Ma
authors: Jin-Quan
authors: JQ
authors: Cheng
authors: Qian-Jin
authors: QJ
authors: Feng
authors: De-Jian
authors: DJ
authors: Zhao
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004770:Enterovirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D019143:Evolution, Molecular; D005243:Feces / Q000821:virology; D005260:Female; D005838:Genotype; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D059645:Mutation Rate; D058974:Phylogeography; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
chemical_list: D012367:RNA, Viral
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