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The role of enterovirus 71 and coxsackievirus A strains in a large outbreak of hand, foot, and mouth disease in 2012 in Changsha, China.
Int J Infect Dis. 2014 Nov; 28:17-25.IJ

Abstract

BACKGROUND

During 2012, Changsha experienced a large outbreak of hand, foot, and mouth disease (HFMD), resulting in 25,438 cases, including 42 severe cases and eight deaths.

METHODS

Seven hundred and forty-six clinical specimens were collected from hospital-based surveillance for HFMD in 2012. The detection and genotyping of enterovirus were performed by real-time RT-PCR and sequencing of the VP1 regions; phylogenetic analysis was performed based on the VP1 sequences.

RESULTS

A total of 545 (73.1%) enterovirus-positive samples were identified, with the most frequently presenting serotype being enterovirus 71 (EV-71; n=364, 66.8%), followed by coxsackievirus A16 (CV-A16; n=84, 15.4%), CV-A6 (n=22, 4.0%), and CV-A10 (n=19, 3.5%). Most of the affected patients were children aged ≤5 years (n=524, 96.1%). EV-71 was the major pathogen in the severe and fatal cases (n=22, 78.6%). Phylogenetic analysis of VP1 gene sequences showed the EV-71 isolates to belong to subgenotype C4a, and the CV-A16 isolates to belong to subgenotype B1. The Changsha CV-A6 and CV-A10 circulating strains were homologous to strains circulating in other areas of mainland China.

CONCLUSIONS

Our results demonstrate that EV-71 was the primary causative agent responsible for the HFMD outbreak in Changsha in 2012, and the co-circulation of other coxsackievirus A strains posed a potential risk to public health.

Authors+Show Affiliations

Laboratory of Microbiology, Changsha Center for Disease Control and Prevention, 149 Weier Road, Changsha 410001, China.Laboratory of Microbiology, Changsha Center for Disease Control and Prevention, 149 Weier Road, Changsha 410001, China.Laboratory of Microbiology, Changsha Center for Disease Control and Prevention, 149 Weier Road, Changsha 410001, China.Laboratory of Microbiology, Changsha Center for Disease Control and Prevention, 149 Weier Road, Changsha 410001, China.Laboratory of Microbiology, Changsha Center for Disease Control and Prevention, 149 Weier Road, Changsha 410001, China. Electronic address: sunbiancheng2013@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25236389

Citation

Chen, Jing-Fang, et al. "The Role of Enterovirus 71 and Coxsackievirus a Strains in a Large Outbreak of Hand, Foot, and Mouth Disease in 2012 in Changsha, China." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 28, 2014, pp. 17-25.
Chen JF, Zhang RS, Ou XH, et al. The role of enterovirus 71 and coxsackievirus A strains in a large outbreak of hand, foot, and mouth disease in 2012 in Changsha, China. Int J Infect Dis. 2014;28:17-25.
Chen, J. F., Zhang, R. S., Ou, X. H., Chen, F. M., & Sun, B. C. (2014). The role of enterovirus 71 and coxsackievirus A strains in a large outbreak of hand, foot, and mouth disease in 2012 in Changsha, China. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 28, 17-25. https://doi.org/10.1016/j.ijid.2014.07.024
Chen JF, et al. The Role of Enterovirus 71 and Coxsackievirus a Strains in a Large Outbreak of Hand, Foot, and Mouth Disease in 2012 in Changsha, China. Int J Infect Dis. 2014;28:17-25. PubMed PMID: 25236389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of enterovirus 71 and coxsackievirus A strains in a large outbreak of hand, foot, and mouth disease in 2012 in Changsha, China. AU - Chen,Jing-Fang, AU - Zhang,Ru-Sheng, AU - Ou,Xin-Hua, AU - Chen,Fa-Ming, AU - Sun,Bian-Cheng, Y1 - 2014/09/16/ PY - 2014/05/28/received PY - 2014/07/07/revised PY - 2014/07/30/accepted PY - 2014/9/20/entrez PY - 2014/9/23/pubmed PY - 2015/12/15/medline KW - Coxsackievirus A KW - Enterovirus 71 KW - Etiology KW - Hand KW - and mouth disease KW - foot SP - 17 EP - 25 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 28 N2 - BACKGROUND: During 2012, Changsha experienced a large outbreak of hand, foot, and mouth disease (HFMD), resulting in 25,438 cases, including 42 severe cases and eight deaths. METHODS: Seven hundred and forty-six clinical specimens were collected from hospital-based surveillance for HFMD in 2012. The detection and genotyping of enterovirus were performed by real-time RT-PCR and sequencing of the VP1 regions; phylogenetic analysis was performed based on the VP1 sequences. RESULTS: A total of 545 (73.1%) enterovirus-positive samples were identified, with the most frequently presenting serotype being enterovirus 71 (EV-71; n=364, 66.8%), followed by coxsackievirus A16 (CV-A16; n=84, 15.4%), CV-A6 (n=22, 4.0%), and CV-A10 (n=19, 3.5%). Most of the affected patients were children aged ≤5 years (n=524, 96.1%). EV-71 was the major pathogen in the severe and fatal cases (n=22, 78.6%). Phylogenetic analysis of VP1 gene sequences showed the EV-71 isolates to belong to subgenotype C4a, and the CV-A16 isolates to belong to subgenotype B1. The Changsha CV-A6 and CV-A10 circulating strains were homologous to strains circulating in other areas of mainland China. CONCLUSIONS: Our results demonstrate that EV-71 was the primary causative agent responsible for the HFMD outbreak in Changsha in 2012, and the co-circulation of other coxsackievirus A strains posed a potential risk to public health. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/25236389/The_role_of_enterovirus_71_and_coxsackievirus_A_strains_in_a_large_outbreak_of_hand_foot_and_mouth_disease_in_2012_in_Changsha_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(14)01609-9 DB - PRIME DP - Unbound Medicine ER -