Thao Nguyen Thi Thanh, Donato Celeste, Trang Vu Thi Huyen, Kien Nguyen Trung, Trang Ph M Mai Thuy, Khanh Tran Quoc, Nguyet Dang Thi, Sessions October M, Cuong Hoang Quoc, Lan Phan Trong, Huong Vu Thi Que, van Doorn H Rogier, Vijaykrishna Dhanasekaran
Immunology and Microbiology Department, Pasteur Institute, Ho Chi Minh City, Vietnam.
Program in Emerging Infectious Diseases, Duke-NUS Medical School Singapore.
J Infect Dis. 2017 Dec 12;216(11):1371-1379. doi: 10.1093/infdis/jix500.
Enterovirus A71 (EV-A71) is the major cause of severe hand, foot, and mouth disease and viral encephalitis in children across the Asia-Pacific region, including in Vietnam, which has experienced a high burden of disease in recent years. Multiple subgenogroups (C1, C4, C5, and B5) concurrently circulate in the region with a large variation in epidemic severity. The relative differences in their evolution and epidemiology were examined within Vietnam and globally.
A total of 752 VP1 gene sequences were analyzed (413 generated in this study combined with 339 obtained from GenBank), collected from patients in 36 provinces in Vietnam during 2003-2013, along with epidemiological metadata. Globally representative VP1 gene datasets of subgenogroups were used to coestimate time-resolved phylogenies and relative genetic diversity to infer virus origins and regional transmission network.
Despite frequent virus migration between countries, the highest genetic diversity of individual subgenogroups was maintained independently for several years in specific Asian countries representing genogroup-specific sources of EV-A71 diversity.
This study highlights a persistent transmission network of EV-A71, with specific Asian countries seeding other countries in the region and beyond, emphasizing the need for improved EV-A71 surveillance and detailed genetic and antigenic characterization.
肠道病毒A71型（EV - A71）是亚太地区儿童严重手足口病和病毒性脑炎的主要病因，包括越南在内，近年来该国疾病负担较重。多个亚基因群（C1、C4、C5和B5）在该地区同时传播，流行严重程度差异很大。在越南国内和全球范围内研究了它们在进化和流行病学方面的相对差异。
共分析了752个VP1基因序列（本研究产生的413个序列与从GenBank获得的339个序列相结合），这些序列来自2003 - 2013年越南36个省份的患者，同时收集了流行病学元数据。使用具有全球代表性的亚基因群VP1基因数据集共同估计时间分辨系统发育和相对遗传多样性，以推断病毒起源和区域传播网络。
尽管各国之间病毒频繁迁移，但在代表EV - A71多样性特定基因组来源的特定亚洲国家，各个亚基因群的最高遗传多样性独立维持了数年。
本研究突出了EV - A71持续的传播网络，特定亚洲国家向该地区及其他地区的其他国家传播病毒，强调了改进EV - A71监测以及详细的基因和抗原特征分析的必要性。
