Key result
CV-A5 emerged as a major pathogen of hand, foot and mouth disease, accounting for 4.56% of cases, driven by a novel recombination event between CV-A5 and CV-A2.
Why the study?
Hand, foot and mouth disease is caused by various enterovirus serotypes, and the worldwide etiological spectrum has changed since large-scale outbreaks in 1997.
Observational (n=4,415)
Yes
The emergence of a novel recombinant between CV-A5 and CV-A2 may explain the outbreak of CV-A5-associated HFMD in Xiangyang, highlighting the need for multivalent vaccines.
CV-A5 recombination signals need for HFMD surveillance; leaves open multivalent vaccine strain selection.
BACKGROUND: Hand, foot and mouth disease (HFMD) is caused by a variety of enterovirus serotypes and the etiological spectrum worldwide has changed since a large scale of outbreaks occurred in 1997. METHODS: A large number of clinical specimens of HFMD patients were collected in Xiangyang and genotyping was performed by qRT-PCR, conventional PCR amplification and sequencing. Among the 146 CV-A5 detected cases, the complete genome sequences of representative strains were determined for genotyping and for recombination analysis. RESULTS: It was found that CV-A5 was one of the six major serotypes that caused the epidemic from October 2016 to December 2017. Phylogenetic analyses based on the VP1 sequences showed that these CV-A5 belonged to the genotype D which dominantly circulated in China. Recombination occurred between the CV-A5 and CV-A2 strains with a breakpoint in the 2A region at the nucleotide 3791. CONCLUSIONS: The result may explain the emergence of CV-A5 as one of the major pathogens of HFMD. A multivalent vaccine against HFMD is urgently needed to control the disease and to prevent emerging and spreading of new recombinants.
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Yu et al. (2021) conducted an observational in Hand, foot and mouth disease (HFMD) (n=4,415). CV-A5 was evaluated on Detection rate of CV-A5 among typeable non-EV-A71 enterovirus cases. CV-A5 emerged as a major pathogen of hand, foot and mouth disease, accounting for 4.56% of cases, driven by a novel recombination event between CV-A5 and CV-A2.
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