Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China.
Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control, Beijing, China.
J Med Virol. 2023 Aug;95(8):e28991. doi: 10.1002/jmv.28991.
Coxsackievirus A16 (CV-A16) is a significant pathogen responsible for causing hand foot and mouth disease (HFMD) and herpangina (HA). This study aimed to investigate the recent evolution and spread of CV-A16 by monitoring HFMD and HA cases in 29 hospitals across 16 districts in Beijing from 2019 to 2021. The first five cases of HFMD and the first five cases of HA each month in each hospital were included in the study. Real-time reverse transcription polymerase chain reaction was used to identify CV-A16, CV-A6, and EV-A71. From each district, two to four CV-A16 positive samples with a relatively long sampling time interval every month were selected for sequencing. A total of 3344 HFMD cases and 2704 HA cases were enrolled in this study, with 76.0% (2541/3344) of HFMD and 45.4% (1227/2704) of HA cases confirmed to be infected by enterovirus. Among the EV-positive samples, CV-A16 virus was detected in 33.61% (854/2541) of HFMD cases and 13.4% (165/1227) of HA cases, with the predominant cluster being B1a. Both B1a and B1b had a co-circulation of local and imported strains, with different origin time (1993 vs. 1995), different global distribution (14 countries vs. 10 countries), and different transmission centers but mainly distributed in the southern and eastern regions of Beijing. Strengthening surveillance of HFMD in southern and eastern regions will improve the prevention and control efficiency of enterovirus infections.
柯萨奇病毒 A16（CV-A16）是引起手足口病（HFMD）和疱疹性咽峡炎（HA）的重要病原体。本研究旨在通过监测 2019 年至 2021 年北京 16 个区 29 家医院的 HFMD 和 HA 病例，了解 CV-A16 的近期进化和传播情况。每家医院每月选取前 5 例 HFMD 和前 5 例 HA 病例纳入研究。采用实时逆转录聚合酶链反应（RT-PCR）方法对 CV-A16、CV-A6 和 EV-A71 进行检测。每月从每个区选取 2 至 4 例具有较长采样时间间隔的 CV-A16 阳性样本进行测序。本研究共纳入 3344 例 HFMD 病例和 2704 例 HA 病例，76.0%（2541/3344）的 HFMD 和 45.4%（1227/2704）的 HA 病例确定为肠道病毒感染。在 EV 阳性样本中，HFMD 病例中 CV-A16 病毒检出率为 33.61%（854/2541），HA 病例中为 13.4%（165/1227），主要流行株为 B1a。B1a 和 B1b 均存在本地和输入株的共同流行，起源时间不同（1993 年 vs. 1995 年），全球分布不同（14 个国家 vs. 10 个国家），传播中心不同，但主要分布在北京的南部和东部地区。加强对南部和东部地区 HFMD 的监测，将提高肠道病毒感染的防控效率。
