Epidemiological and genetic analysis concerning the coxsackievirus A6 related endemic outbreak of hand-foot-mouth disease in Taizhou, China, during 2013

Abstract

A total of 1,098 strains of human enteroviruses (HEV), falling into 14 serotypes were detected upon analysis of 1,509 hand-foot-mouth disease (HFMD) samples collected in Taizhou during the period from July 2010 to December 2013. And a CV-A6 related HFMD outbreak was identified in Taizhou during 2013. Phylogenic analyses of complete VP1 sequences indicate that this outbreak of HFMD in Taizhou is closely related to the global outbreaks of CV-A6 related HFMD since 2008, but the analyses also indicate that the outbreak in Taizhou is rather an endemic outbreak in which a phylogenic sub-group of CV-A6 was identified whose members commonly acquired a mutation R→K at site 254 of VP1 protein. It is interesting that the emergence of the sub-group was inferred to contribute to the endemic outbreak in Taizhou in 2013.

Keywords: coxsackievirus-A6 (CV-A6); hand-foot-mouth disease (HFMD); positively selected mutation.