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Circulation of Coxsackievirus A10 and A6 in hand-foot-mouth disease in China, 2009-2011.
PLoS One. 2012; 7(12):e52073.Plos

Abstract

Coxsackieviruses A10 (CV-A10) and A6 (CV-A6) have been associated with increasingly occurred sporadic hand-foot-mouth disease (HFMD) cases and outbreak events globally. However, our understanding of epidemiological and genetic characteristics of these new agents remains far from complete. This study was to explore the circulation of CV-A10 and CV-A6 in HFMD and their genetic characteristics in China. A hospital based surveillance was performed in three heavily inflicted regions with HFMD from March 2009 to August 2011. Feces samples were collected from children with clinical diagnosis of HFMD. The detection and genotyping of enteroviruses was performed by real-time PCR and sequencing of 5'UTR/VP1 regions. Phylogenetic analysis and selection pressure were performed based on the VP1 sequences. Logistic regression model was used to identify the effect of predominant enterovirus serotypes in causing severe HFMD. The results showed 92.0% of 1748 feces samples were detected positive for enterovirus, with the most frequently presented serotypes as EV-71 (944, 54.0%) and CV-A16 (451, 25.8%). CV-A10 and CV-A6 were detected as a sole pathogen in 82 (4.7%) and 44 (2.5%) cases, respectively. Infection with CV-A10 and EV-71 were independently associated with high risk of severe HFMD (OR = 2.66, 95% CI: 1.40-5.06; OR = 4.81, 95% CI: 3.07-7.53), when adjusted for age and sex. Phylogenetic analysis revealed that distinct geographic and temporal origins correlated with the gene clusters based on VP1 sequences. An overall ω value of the VP1 was 0.046 for CV-A10 and 0.047 for CV-A6, and no positively selected site was detected in VP1 of both CV-A10 and CV-A6, indicating that purifying selection shaped the evolution of CV-A10 and CV-A6. Our study demonstrates variety of enterovirus genotypes as viral pathogens in causing HFMD in China. CV-A10 and CV-A6 were co-circulating together with EV-71 and CV-A16 in recent years. CV-A10 infection might also be independently associated with severe HFMD.

Authors+Show Affiliations

Department of Epidemiology and Health Statistics, Shandong University, Jinan, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Historical Article
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23272213

Citation

Lu, Qing-Bin, et al. "Circulation of Coxsackievirus A10 and A6 in Hand-foot-mouth Disease in China, 2009-2011." PloS One, vol. 7, no. 12, 2012, pp. e52073.
Lu QB, Zhang XA, Wo Y, et al. Circulation of Coxsackievirus A10 and A6 in hand-foot-mouth disease in China, 2009-2011. PLoS One. 2012;7(12):e52073.
Lu, Q. B., Zhang, X. A., Wo, Y., Xu, H. M., Li, X. J., Wang, X. J., Ding, S. J., Chen, X. D., He, C., Liu, L. J., Li, H., Yang, H., Li, T. Y., Liu, W., & Cao, W. C. (2012). Circulation of Coxsackievirus A10 and A6 in hand-foot-mouth disease in China, 2009-2011. PloS One, 7(12), e52073. https://doi.org/10.1371/journal.pone.0052073
Lu QB, et al. Circulation of Coxsackievirus A10 and A6 in Hand-foot-mouth Disease in China, 2009-2011. PLoS One. 2012;7(12):e52073. PubMed PMID: 23272213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circulation of Coxsackievirus A10 and A6 in hand-foot-mouth disease in China, 2009-2011. AU - Lu,Qing-Bin, AU - Zhang,Xiao-Ai, AU - Wo,Ying, AU - Xu,Hong-Mei, AU - Li,Xiu-Jun, AU - Wang,Xian-Jun, AU - Ding,Shu-Jun, AU - Chen,Xiao-Dan, AU - He,Cui, AU - Liu,Li-Juan, AU - Li,Hao, AU - Yang,Hong, AU - Li,Ting-Yu, AU - Liu,Wei, AU - Cao,Wu-Chun, Y1 - 2012/12/18/ PY - 2012/09/14/received PY - 2012/11/08/accepted PY - 2012/12/29/entrez PY - 2012/12/29/pubmed PY - 2013/6/12/medline SP - e52073 EP - e52073 JF - PloS one JO - PLoS One VL - 7 IS - 12 N2 - Coxsackieviruses A10 (CV-A10) and A6 (CV-A6) have been associated with increasingly occurred sporadic hand-foot-mouth disease (HFMD) cases and outbreak events globally. However, our understanding of epidemiological and genetic characteristics of these new agents remains far from complete. This study was to explore the circulation of CV-A10 and CV-A6 in HFMD and their genetic characteristics in China. A hospital based surveillance was performed in three heavily inflicted regions with HFMD from March 2009 to August 2011. Feces samples were collected from children with clinical diagnosis of HFMD. The detection and genotyping of enteroviruses was performed by real-time PCR and sequencing of 5'UTR/VP1 regions. Phylogenetic analysis and selection pressure were performed based on the VP1 sequences. Logistic regression model was used to identify the effect of predominant enterovirus serotypes in causing severe HFMD. The results showed 92.0% of 1748 feces samples were detected positive for enterovirus, with the most frequently presented serotypes as EV-71 (944, 54.0%) and CV-A16 (451, 25.8%). CV-A10 and CV-A6 were detected as a sole pathogen in 82 (4.7%) and 44 (2.5%) cases, respectively. Infection with CV-A10 and EV-71 were independently associated with high risk of severe HFMD (OR = 2.66, 95% CI: 1.40-5.06; OR = 4.81, 95% CI: 3.07-7.53), when adjusted for age and sex. Phylogenetic analysis revealed that distinct geographic and temporal origins correlated with the gene clusters based on VP1 sequences. An overall ω value of the VP1 was 0.046 for CV-A10 and 0.047 for CV-A6, and no positively selected site was detected in VP1 of both CV-A10 and CV-A6, indicating that purifying selection shaped the evolution of CV-A10 and CV-A6. Our study demonstrates variety of enterovirus genotypes as viral pathogens in causing HFMD in China. CV-A10 and CV-A6 were co-circulating together with EV-71 and CV-A16 in recent years. CV-A10 infection might also be independently associated with severe HFMD. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/23272213/Circulation_of_Coxsackievirus_A10_and_A6_in_hand_foot_mouth_disease_in_China_2009_2011_ L2 - https://dx.plos.org/10.1371/journal.pone.0052073 DB - PRIME DP - Unbound Medicine ER -