Key result
Coxsackieviruses A-6, A-10, and A-16 were the predominant pathogens causing hand, foot, and mouth disease in Guangzhou in 2018, accounting for 87.3% of all laboratory-confirmed cases.
Why the study?
With Coxsackievirus A6 and A10 increasingly driving HFMD outbreaks, this study aimed to understand the epidemic characteristics of the 2018 HFMD outbreak in Guangzhou.
Cross-Sectional (n=1,220)
No
CVA-6, CVA-10, and CVA-16 were the predominant co-circulating serotypes causing HFMD in Guangzhou in 2018, highlighting the need for multi-serotype vaccines.
CVA-6/10 co-circulation drove the 2018 Guangzhou HFMD outbreak; leaves open whether surveillance and vaccines must expand beyond EV-A71.
BACKGROUND: Hand, foot, and mouth disease (HFMD) is a common infectious disease occurring in children under 5 years of age worldwide, and Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CVA-16) are identified as the predominant pathogens. In recent years, Coxsackievirus A6 (CVA-6) and Coxsackievirus A10 (CVA-10) have played more and more important role in a series of HFMD outbreaks. This study aimed to understand the epidemic characteristics associated with HFMD outbreak in Guangzhou, 2018. METHODS: The clinical and laboratory data of 1220 enterovirus-associated HFMD patients in 2018 were analysed in this study. Molecular diagnostic methods were performed to identify its serotypes. Phylogenetic analyses were depicted based on the complete VP1 gene. RESULTS: There were 21 enterovirus serotypes detected in Guangzhou in 2018. Three serotypes of enterovirus, CVA-6 (364/1220, 29.8%), CVA-10 (305/1220, 25.0%), and CVA-16 (397/1220, 32.5%), were identified as the causative pathogens and accounted for 87.3% among all 1220 HFMD patients. In different seasons, CVA-6 was the predominant pathogen of HFMD during autumn, and CVA-10 as well as CVA-16 were more prevalent in summer. Patients infected by CVA-6, CVA-10 or CVA-16 showed similar clinical features and laboratory characteristics, and the ratios of severe HFMD were 5.8, 5.9, and 1.5% in the three serotypes. Phylogenetic analyses of VP1 sequences showed that the CVA-6, CVA-10, and CVA-16 sequences belonged to the sub-genogroup E2, genogroup E, and genogroup B1, respectively. CONCLUSIONS: CVA-6, CVA-10, and CVA-16 were the predominant and co-circulated serotypes in Guangzhou China, 2018, which should be the new target for prevention and control of HFMD. Our findings provide useful information for diagnosis, treatment, and prevention of HFMD.
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Xie et al. (2020) conducted a cross-sectional in Hand, foot, and mouth disease (HFMD) (n=1,220). Enterovirus infection (CVA-6, CVA-10, CVA-16) was evaluated on Proportion of HFMD cases caused by specific enterovirus serotypes. Coxsackieviruses A-6, A-10, and A-16 were the predominant pathogens causing hand, foot, and mouth disease in Guangzhou in 2018, accounting for 87.3% of all laboratory-confirmed cases.
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