Molecular epidemiology of acute hemorrhagic conjunctivitis caused by coxsackie A type 24 variant in China, 2004–2014

Figure 1. Heatmap of AHC surveillance data from 2004 to 2014 by Chinese province. The provinces were ordered by latitude from northernmost (top) to southernmost (bottom). Time series of weekly AHC cases standardized by the incidence of annual cases. Notes: A heat map created using the gplot package in R software (https://cran.r-project.org/web/packages/gplots/index.html).

Figure 2. Timeline by illness onset month of AHC cases from 2004 to 2014 in China. There was an obvious seasonal fluctuation of AHC with a single peak.

Figure 3. Geographic distributions of AHC cases from 2004 to 2014 in China. (A) for 2004; (B) for 2007; (C) for 2010; (D) for 2014. The numbers and colors in the legend represent the incidence of AHC cases. These maps were generated using the software ArcGIS (ArcMap, version10.2; ESRI Inc., Redlands, CA, USA, https://www.qgis.org/en/site/forusers/download.html). The world (http://openstreetmapdata.com/data/land-polygons) and China (https://mapzen.com/data/borders/) basemaps we used are all from OpenStreetMap. The cartography in the OpenStreetMap map tiles is licensed under CC BY-SA (www.openstreetmap.org/copyright). The license terms can be found on the following link: http://creativecommons.org/licenses/by-sa/2.0/.

Figure 4. Ring map of AHC cases from 2004-2014 standardized by the incidence of annual cases in Chinese provinces. Notes: The ring map toolbox in ArcGIS (Generated by ArcGIS 10.2, URL: http://www.esri.com/software/arcgis/arcgis-for-desktop, ESRI Inc., Redlands, CA, USA) was developed by the co-author Ta-Chien Chan. The toolbox was freely available from the website (http://www.esri.com/esri-news/arcuser/fall-2013/looking-at-temporal-changes). The world (http://openstreetmapdata.com/data/land-polygons) and China (https://mapzen.com/data/borders/) basemaps we used are all from OpenStreetMap. The cartography in the OpenStreetMap map tiles is licensed under CC BY-SA (www.openstreetmap.org/copyright). The license terms can be found on the following link: http://creativecommons.org/licenses/by-sa/2.0/.

Figure 5. Age distribution of AHC cases in China from 2004–2014.

Figure 6. Phylogenetic analyses based on the representative strains of the nonstructural protein 3C and the VP1 gene of Cox A24 viruses in China from 1985–2014. (A) for 3C (n = 113); (B) for VP1 gene (n = 119).