Chen Wei, Weng Yu-wei, He Wen-xiang, Zhang Yong-jun, Yang Xiu-hui, Meng Huang, Xie Jian-feng, Wang Jin-zhang, Zheng Kui-cheng, Yan Yan-sheng
Bing Du Xue Bao. 2014 Nov;30(6):624-9.
In order to characterize the molecular epidemiology of HFMD-associated Coxsackievirus A6 (CVA6) in Fujian Province, a total of 1340 specimens from non-EV71 non-CVA16 HFMD patients were collected during 2011-2013. Isolated virus strains were identified and subtyped. Full-length coding regions for the VP1 gene of the predominant serotype CVA6 isolates were amplified and sequenced. Among the 375 non-EV71 non-CVA16 HFMD cases confirmed by virus isolation and molecular subtyping, 182 (48.5%) were found to be caused by CVA6, accounting for 7.9%, 16.2% and 39.6% HFMD-associated enteroviruses in FujianProvince during 2011, 2012, and 2013, respectively. Compared with general features observed in the HFMD epidemic, no difference in CVA6-specificity or severity rates was observed between geographical origins, gender, or age groups. Nucleotide sequence analyses of VP1 genes revealed high diversity levels of 16.2%-18.6% among CVA6 strains from Fujian Province, in contrast to the prototype CVA6 strain, and showed low levels of diversity in the amino acid sequences (4.3%-6.2%). Phylogenetic analysis also indicated that CVA6 isolates from Fujian Province were distinct from the prototype strain and other isolates from abroad; however, it was homologous to domestic strains, although the Fujian isolates clustered into multiple branches. These results suggested that significant changes in the pathogenic spectrum of HFMD in Fujian Province occurred during 2011-2013, as CVA6 was one of the predominant serotypes of HFMD. CVA6 isolates from Fujian Province were co-circulating and co-evolving with other domestic strains as multiple closely related CVA6 transmission chains were observed in Fujian Province overall and within each prefecture.
为了阐明福建省手足口病相关柯萨奇病毒A6型（CVA6）的分子流行病学特征，于2011年至2013年期间，共收集了1340份来自非EV71、非CVA16型手足口病患者的标本。对分离出的病毒株进行鉴定和分型。对优势血清型CVA6分离株的VP1基因全长编码区进行扩增和测序。在通过病毒分离和分子分型确诊的375例非EV71、非CVA16型手足口病病例中，发现182例（48.5%）由CVA6引起，分别占2011年、2012年和2013年福建省手足口病相关肠道病毒的7.9%、16.2%和39.6%。与手足口病流行的总体特征相比，在地理来源、性别或年龄组之间，未观察到CVA6特异性或严重程度的差异。VP1基因的核苷酸序列分析显示，福建省CVA6毒株之间的多样性水平较高，为16.2% - 18.6%，与CVA6原型毒株相比，氨基酸序列的多样性水平较低（4.3% - 6.2%）。系统发育分析还表明，福建省的CVA6分离株与原型毒株及其他国外分离株不同；然而，与国内毒株同源，尽管福建分离株聚为多个分支。这些结果表明，2011年至2013年期间福建省手足口病的致病谱发生了显著变化，因为CVA6是手足口病的主要血清型之一。福建省的CVA6分离株与其他国内毒株共同循环和共同进化，因为在福建省整体及每个辖区内均观察到多个密切相关的CVA6传播链。
