Key result
Genomic analysis links Kenya's 2024 CV-A24v outbreak to distinct genotype IV clusters with 3Dpol recombination.
Why the study?
Limited genomic data exist to elucidate the sources, epidemiology, and evolution of coxsackievirus A24 variant in Africa during acute hemorrhagic conjunctivitis outbreaks.
Observational (n=245)
This study provides the first detailed genomic analysis of the coxsackievirus A24 variant causing acute hemorrhagic conjunctivitis in Africa, identifying its genotype and evolutionary timeline.
Supports expanded genomic surveillance for conjunctivitis outbreaks in Africa; leaves open questions on strain transmissibility and clinical impact.
Several African countries experienced a surge in acute hemorrhagic conjunctivitis (AHC) cases in 2024. Investigations in Kenya, Mayotte and Tanzania identified coxsackievirus A24 variant (CV-A24v) as the causative agent. To date, limited genomic data exist to elucidate the sources, epidemiology, and evolution of CV-A24v in Africa. We generated 245 CV-A24v genomes from samples collected between January and September 2024 in coastal Kenya. Phylogenetic analysis showed that these viruses belonged to genotype IV, with two major clusters identified that differed by 52 nucleotides and five amino acids, with recombination detected in the 3D pol gene. The sequences clustered closely with contemporaneous Mayotte and Malawi sequences but were distinct from Asian sequences from 2023. Molecular clock dating revealed that the Kenyan sequences had a Most Recent Common Ancestor (MRCA) between June and October 2023. Our study provides the first detailed genomic analysis of CV-A24v from Africa to inform its future control strategies.
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Morobe et al. (2025) conducted an observational in Acute Hemorrhagic Conjunctivitis (AHC) / Coxsackievirus A24 variant infection (n=245). Coxsackievirus A24 variant (CV-A24v) infection was evaluated on Genomic characterization and phylogenetic clustering. Genomic analysis of 245 CV-A24v genomes from the 2024 outbreak in coastal Kenya revealed they belonged to genotype IV, forming two major clusters distinct from 2023 Asian strains, with evidence of recombination in the 3Dpol gene.
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