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Molecular epidemiology of enteroviruses associated with severe hand, foot and mouth disease in Shenzhen, China, 2014-2018.
- Source :
-
Archives of virology [Arch Virol] 2020 Oct; Vol. 165 (10), pp. 2213-2227. Date of Electronic Publication: 2020 Jul 14. - Publication Year :
- 2020
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Abstract
- In this study, we investigated the epidemiology and molecular characteristics of enteroviruses associated with severe hand, foot and mouth disease (HFMD) in Shenzhen, China, during 2014-2018. A total of 137 fecal specimens from patients with severe HFMD were collected. Enterovirus (EV) types were determined using real-time reverse transcription polymerase chain reaction (RT-PCR), RT nested PCR, and sequencing. Sequences were analyzed using bioinformatics programs. Of 137 specimens tested, 97 (70.8%), 12 (8.8%), and 10 (7.3%) were positive for EV-A71, coxsackievirus A6 (CVA6), and CVA16, respectively. Other pathogens detected included CVA2 (2.9%, 4/137), CVA10 (2.9%, 4/137), CVA5 (0.7%, 1/137), echovirus 6 (E6) (0.7%, 1/137) and E18 (0.7%, 1/137). The most frequent complication in patients with proven EV infections was myoclonic jerk, followed by aseptic encephalitis, tachypnea, and vomiting. The frequencies of vomiting and abnormal eye movements were higher in EV-A71-infected patients than that in CVA6-infected or CVA16-infected patients. Molecular phylogeny based on the complete VP1 gene revealed no association between the subgenotype of the virus and disease severity. Nevertheless, 12 significant mutations that were likely to be associated with virulence or the clinical phenotype were observed in the 5'UTR, 2A <superscript>pro</superscript> , 2C, 3A, 3D <superscript>pol</superscript> and 3'UTR of CVA6. Eight significant mutations were observed in the 5'UTR, 2B, 3A, 3D <superscript>pol</superscript> and 3'UTR of CVA16, and 10 significant mutations were observed in the 5'UTR, VP1, 3A and 3C <superscript>pro</superscript> of CVA10. In conclusion, EV-A71 is still the main pathogen causing severe HFMD, although other EV types can also cause severe complications. Potential virulence or phenotype-associated sites were identified in the genomes of CVA6, CVA16, and CVA10.
- Subjects :
- Child
Child, Preschool
China epidemiology
Encephalitis diagnosis
Encephalitis physiopathology
Encephalitis virology
Enterovirus C, Human classification
Enterovirus C, Human isolation & purification
Feces virology
Female
Gene Expression
Genotype
Hand, Foot and Mouth Disease diagnosis
Hand, Foot and Mouth Disease physiopathology
Hand, Foot and Mouth Disease virology
Humans
Infant
Infant, Newborn
Male
Molecular Epidemiology
Mutation
Myoclonus diagnosis
Myoclonus physiopathology
Myoclonus virology
Phenotype
Phylogeny
Severity of Illness Index
Tachypnea diagnosis
Tachypnea physiopathology
Tachypnea virology
Virulence
Vomiting diagnosis
Vomiting physiopathology
Vomiting virology
Capsid Proteins genetics
Encephalitis epidemiology
Enterovirus C, Human genetics
Hand, Foot and Mouth Disease epidemiology
Myoclonus epidemiology
Tachypnea epidemiology
Vomiting epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-8798
- Volume :
- 165
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Archives of virology
- Publication Type :
- Academic Journal
- Accession number :
- 32666145
- Full Text :
- https://doi.org/10.1007/s00705-020-04734-z