National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China; School of Public Health, Xiamen University, Xiang'an Campus of Xiamen University, South Xiang'an Rd., Xiamen, China.
Xiamen Center for Disease Control and Prevention, Shengguang Rd., Jimei District, Xiamen, China.
J Clin Virol. 2017 Aug;93:20-24. doi: 10.1016/j.jcv.2017.05.011. Epub 2017 May 11.
Coxsackievirus A10 (CV-A10) is one of the etiological agents associated with hand, foot and mouth disease (HFMD) and usually causes mild cases. During 2009-2014, no severe cases caused by CV-A10 was reported in Xiamen, China, however, an increase in cases was seen in 2015.
We aimed to perform a retrospective molecular epidemiological analysis of HFMD associated with CV-A10 infections in Xiamen.
CV-A10 VP1 (n=41) capsid and full-length or near full-length genomes (n=14) were sequenced. Phylogenetic trees were constructed based on these sequences and other reference sequences and nucleotide and amino acid changes were characterized.
From 2009-2014, no laboratory-confirmed CV-A10 infections associated with severe cases were identified, however, in 2015, 39% (7/18) of severe HFMD cases were CV-A10 infections. Sequence analysis of severe and non-severe CV-A10 HFMD cases determined that severe cases predominantly clustered with an emerging clade E lineage A strain which contained 4 nucleotide changes in 5' UTR and 5 amino acid substitutions in structural and non-structural proteins.
The results indicate CV-A10 infection may be emerging as a new and major cause of severe HFMD and CV-A10 surveillance should be increased and considered in HFMD prevention and control strategies.
柯萨奇病毒 A10（CV-A10）是引起手足口病（HFMD）的病原体之一，通常引起轻症病例。2009-2014 年期间，中国厦门未报告由 CV-A10 引起的重症病例，但 2015 年病例有所增加。
对厦门地区 CV-A10 相关 HFMD 进行回顾性分子流行病学分析。
对 41 株 CV-A10 VP1 衣壳和 14 株全长或近全长基因组进行测序。基于这些序列和其他参考序列构建系统进化树，并对核苷酸和氨基酸变化进行特征分析。
2009-2014 年期间，未发现与重症病例相关的实验室确诊 CV-A10 感染，但 2015 年，18 例重症 HFMD 病例中有 39%（7/18）为 CV-A10 感染。对重症和非重症 CV-A10 HFMD 病例的序列分析表明，重症病例主要与新兴的 E 谱系 A 株聚集，该株在 5'UTR 中有 4 个核苷酸变化，结构蛋白和非结构蛋白中有 5 个氨基酸取代。
结果表明 CV-A10 感染可能成为新的、主要的重症 HFMD 致病原因，应加强 CV-A10 监测，并考虑将其纳入 HFMD 防控策略。
