Co-circulation and genomic recombination of coxsackievirus A16 and enterovirus 71 during a large outbreak of hand, foot, and mouth disease in Central China.
Co-circulation and genomic recombination of coxsackievirus A16 and enterovirus 71 during a large outbreak of hand, foot, and mouth disease in Central China.
复制标题
华中地区手足口病大暴发期间柯萨奇病毒A16型和肠道病毒71型的共循环和基因组重组
DOI：
10.1371/journal.pone.0096051
复制
发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Wu J
中科院分区：
文献类型：
--
作者：
Liu W;Wu S;Xiong Y;Li T;Wen Z;Yan M;Qin K;Liu Y;Wu J
2011 - 2012年华中地区手足口病住院患者1844例，以1 - 3岁儿童为主。其中柯萨奇病毒A16 （CVA16）感染422例，肠病毒71 （EV71）感染334例，EV71与CVA16合并感染38例，其他肠道病毒感染35例。分子流行病学分析显示，全年均有EV71和CVA16的检出，但EV71主要在7月流行，CVA16主要在11月流行，手足口病发病率在1、2月下降，3月上升。临床资料显示，ev71感染患者高血糖和神经系统并发症明显高于cva16感染患者，而cva16相关患者上呼吸道感染和c反应蛋白明显高于ev71感染患者。共分离到EV71和CVA16菌株124株，其中C4a和C4b分别为56株和68株，B1a和B1b分别为25株和55株。基于全基因组序列的相似性图和bootcan分析显示，3株C4a亚基因型EV71在2B-2C区与C4b亚基因型EV71重组，3株CVA16在2A-2B区与EV71重组。因此，CVA16和EV71是此次华中地区手足口病大暴发的主要病原体。家庭接触者中儿童手足口病发病率较高，全年均有发现，但疫情有季节性依赖。CVA16 B1b和EV71 C4b在沉寂多年后再次出现，并在中国造成了大规模流行。此外，EV71和CVA16在疫情期间共同传播，这可能有助于病原体之间的基因组重组。这应该引起更多的关注，因为两种病原体在全球范围内的共循环可能呈上升趋势，并且重组在新的肠道病毒变体的出现中起着新的作用。
A total of 1844 patients with hand, foot, and mouth disease (HFMD), most of them were children of age 1–3-year-old, in Central China were hospitalized from 2011 to 2012. Among them, 422 were infected with coxsackievirus A16 (CVA16), 334 were infected with enterovirus 71 (EV71), 38 were co-infected with EV71 and CVA16, and 35 were infected with other enteroviruses. Molecular epidemiology analysis revealed that EV71 and CVA16 were detected year-round, but EV71 circulated mainly in July and CVA16 circulated predominantly in November, and incidence of HFMD was reduced in January and February and increased in March. Clinical data showed that hyperglycemia and neurologic complications were significantly higher in EV71-infected patients, while upper respiratory tract infection and C-reactive protein were significantly higher in CVA16-associated patients. 124 EV71 and 80 CVA16 strains were isolated, among them 56 and 68 EV71 strains were C4a and C4b, while 25 and 55 CVA16 strains were B1a and B1b, respectively. Similarity plots and bootscan analyses based on entire genomic sequences revealed that the three C4a sub-genotype EV71 strains were recombinant with C4b sub-genotype EV71 in 2B–2C region, and the three CVA16 strains were recombinant with EV71 in 2A–2B region. Thus, CVA16 and EV71 were the major causative agents in a large HFMD outbreak in Central China. HFMD incidence was high for children among household contact and was detected year-round, but outbreak was seasonal dependent. CVA16 B1b and EV71 C4b reemerged and caused a large epidemic in China after a quiet period of many years. Moreover, EV71 and CVA16 were co-circulated during the outbreak, which may have contributed to the genomic recombination between the pathogens. It should gain more attention as there may be an upward trend in co-circulation of the two pathogens globally and the new role recombination plays in the emergence of new enterovirus variants.
登录
查看更多内容
DOI：
10.1016/s1684-1182(10)60016-3
发表时间：
2010-04-01
影响因子：
7.4
作者：
Chen, Shih-Perng;Huang, Yhu-Chering;Lin, Tzou-Yien
通讯作者：
Lin, Tzou-Yien
影响因子：
8.8
作者：
Blomqvist, Soile;Klemola, Paivi;Roivainen, Merja
通讯作者：
Roivainen, Merja
影响因子：
5
作者：
AbuBakar, S;Chee, HY;Lam, SK
通讯作者：
Lam, SK
影响因子：
2.6
作者：
Fujimoto, T;Chikahira, M;Nishio, O
通讯作者：
Nishio, O
影响因子：
5.1
作者：
GOLDBERG, MF;MCADAMS, AJ
通讯作者：
MCADAMS, AJ