title: Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide.
abstract: Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are the predominant pathogens causing outbreaks of hand, foot and mouth disease (HFMD) worldwide. Other human enterovirus A (HEV-A) serotypes tend to cause only sporadic HFMD cases. However, since a HFMD caused by coxsackievirus A6 broke out in Finland in 2008, CA6 has been identified as the responsible pathogen for a series of HFMD outbreaks in Europe, North America and Asia. Because of the severity of the clinical manifestations and the underestimated public health burden, the epidemic of CA6-associated HFMD presents a new challenge to the control of HFMD. This article reviewed the epidemic characteristics, molecular epidemiology, clinical features and laboratory diagnosis of CA6 infection. The genetic evolution of CA6 strains associated with HFMD was also analyzed. It indicated that the development of a multivalent vaccine combining EV71, CA16 and CA6 is an urgent necessity to control HFMD.
authors.affiliation: National Institutes for Food and Drug Control, Beijing 100050, China.
authors.forename: Lianlian
authors.initials: L
authors.lastname: Bian
authors.forename: Yiping
authors.initials: Y
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Yao
authors.forename: Qunying
authors.initials: Q
authors.lastname: Mao
authors.forename: Miao
authors.initials: M
authors.lastname: Xu
authors.forename: Zhenglun
authors.initials: Z
authors.lastname: Liang
mesh_terms: D003384:Coxsackievirus Infections / Q000175:diagnosis / Q000453:epidemiology; D004196:Disease Outbreaks / Q000517:prevention & control; D004770:Enterovirus / Q000302:isolation & purification*; D014943:Global Health / Q000639:trends*; D006232:Hand, Foot and Mouth Disease / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans
keywords: coxsackievirus A16; coxsackievirus A6; enterovirus 71; hand, foot and mouth disease; vaccine