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Detection of human enterovirus 71 and Coxsackievirus A16 in an outbreak of hand, foot, and mouth disease in Henan Province, China in 2009

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Abstract

During 2009, an outbreak of hand, foot, and mouth disease (HFMD) enrolled 490 people in Henan Province, causing the death of two children. In order to investigate the pathogens responsible for this outbreak and characterize their genetic characteristics, a total of 508 clinical specimens (stool, throat swab, and vesicle fluid) were collected from the Center for Disease Control and Prevention of Henan Province. Virological investigations (virus isolation, conventional reverse transcription PCR, and real-time reverse transcription PCR) and phylogenetic analysis were performed. It was found that human enterovirus 71 (EV71) was the main pathogen causing this outbreak, while Coxsackievirus A16 (CoxA16) played only a subsidiary role. Phylogenetic analysis of 24 EV71 isolates collected during the period from March 11 to July 24, 2009 showed that they belonged to subgenotypes C4 and C5. Our study for the first time characterizes the epidemiology of HFMD and EV71 infection in Henan Province in 2009 and provides the first direct evidence of the genotype of EV71 circulating in Henan Province at that time. Our study should facilitate the development of public health measures for the control and prevention of HFMD and EV71 infection in at-risk individuals in China.

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References

  1. T.Y. Lin, L.Y. Chang, S.H. Hsia, Y.C. Huang, C.H. Chiu, C. Hsueh, S.R. Shih, C.C. Liu, M.H. Wu, The 1998 enterovirus 71 outbreak in Taiwan: pathogenesis and management. Clin. Infect. Dis. Suppl. 2, S52–S57 (2002)

    Article  Google Scholar 

  2. M.J. Cardosa, D. Perera, B.A. Brown, D. Cheon, H.M. Chan, K.P. Chan, H. Cho, P. McMinn, Molecular epidemiology of human enterovirus 71 strains and recent outbreaks in the Asia-Pacific region: comparative analysis of the VP1 and VP4 genes. Emerg. Infect. Dis. 9, 461–468 (2003)

    PubMed  Google Scholar 

  3. J.J. Yan, I.J. Su, P.F. Chen, C.C. Liu, C.K. Yu, J.R. Wang, Complete genome analysis of enterovirus 71 isolated from an outbreak in Taiwan and rapid identification of enterovirus 71 and coxsackievirus A16 by RT-PCR. J. Med. Virol. 2, 331–339 (2001)

    Article  Google Scholar 

  4. L.J. Herrero, C.S. Lee, R.J. Hurrelbrink, B.H. Chua, K.B. Chua, P.C. McMinn, Molecular epidemiology of enterovirus 71 in peninsular Malaysia, 1997–2000. Arch. Virol. 7, 1369–1385 (2003)

    Article  Google Scholar 

  5. S. Singh, V.T. Chow, M.C. Phoon, K.P. Chan, C.L. Poh, Direct detection of enterovirus 71 (EV71) in clinical specimens from a hand, foot, and mouth disease outbreak in Singapore by reverse transcription-PCR with universal enterovirus and EV71-specific primers. J. Clin. Microbiol. 8, 2823–2827 (2002)

    Article  Google Scholar 

  6. Y. Wu, A. Yeo, M.C. Phoon, E.L. Tan, C.L. Poh, S.H. Quak, V.T. Chow, The largest outbreak of hand; foot and mouth disease in Singapore in 2008: the role of enterovirus 71 and coxsackievirus A strains. Int J Infect Dis 12, e1076–e1781 (2010)

    Article  Google Scholar 

  7. P.V. Tu, N.T. Thao, D. Perera, T.K. Huu, N.T. Tien, T.C. Thuong, O.M. How, M.J. Cardosa, P.C. McMinn, Epidemiologic and virologic investigation of hand, foot, and mouth disease, southern Vietnam, 2005. Emerg. Infect. Dis. 11, 1733–1741 (2007)

    Google Scholar 

  8. T. Fujimoto, M. Chikahira, S. Yoshida, H. Ebira, A. Hasegawa, A. Totsuka, O. Nishio, Outbreak of central nervous system disease associated with hand, foot, and mouth disease in Japan during the summer of 2000: detection and molecular epidemiology of enterovirus 71. Microbiol. Immunol. 9, 621–627 (2002)

    Google Scholar 

  9. Y.M. Jee, D.S. Cheon, K. Kim, J.H. Cho, Y.S. Chung, J. Lee, S.H. Lee, K.S. Park, J.H. Lee, E.C. Kim, H.J. Chung, D.S. Kim, J.D. Yoon, H.W. Cho, Genetic analysis of the VP1 region of human enterovirus 71 strains isolated in Korea during 2000. Arch. Virol. 9, 1735–1746 (2000)

    Google Scholar 

  10. H.K. Cho, N.Y. Lee, H. Lee, H.S. Kim, J.W. Seo, Y.M. Hong, S.J. Lee, S.W. Lee, D.S. Cheon, J.Y. Hong, B.H. Kang, J.H. Kim, K.H. Kim, Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009. Korean J. Pediatr. 5, 639–643 (2010)

    Article  Google Scholar 

  11. N.Z. Ding, X.M. Wang, S.W. Sun, Q. Song, S.N. Li, C.Q. He, Appearance of mosaic enterovirus 71 in the 2008 outbreak of China. Virus Res. 1, 157–161 (2009)

    Article  Google Scholar 

  12. L.X. Mao, B. Wu, W.X. Bao, F.A. Han, L. Xu, Q.J. Ge, J. Yang, Z.H. Yuan, C.H. Miao, X.X. Huang, C. Zhang, H. Xu, Epidemiology of hand, foot, and mouth disease and genotype characterization of enterovirus 71 in Jiangsu. China J. Clin. Virol. 2, 100–104 (2010)

    Article  Google Scholar 

  13. F. Yang, Q. Jin, Y. He, L. Li, Y. Hou, The complete genome of enterovirus 71 China strain. Sci. China C Life Sci. 2, 178–183 (2001)

    Google Scholar 

  14. C. Yoke-Fun, S. AbuBakar, Phylogenetic evidence for inter-typic recombination in the emergence of human enterovirus 71 subgenotypes. BMC Microbiol. 6, 74 (2006)

    Article  PubMed  Google Scholar 

  15. J.D. Thompson, G.D. Higgins, T.J. Gibson, CLUSTAL W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position-specific gap penalties and weight matrix choice. Nucleic Acids Res. 22, 4673–4680 (1994)

    Article  PubMed  CAS  Google Scholar 

  16. S. Kumar, M. Nei, J. Dudley, K. Tamura, MEGA: a biologist-centric software for evolutionary analysis of DNA and protein sequences. Brief. Bioinform. 4, 299–306 (2008)

    Article  Google Scholar 

  17. R.D. Page, TreeView: an application to display phylogenetic trees on personal computers. Comput. Appl. Biosci. 12, 357–358 (1996)

    PubMed  CAS  Google Scholar 

  18. L.G. Chan, U.D. Parashar, M.S. Lye, F.G. Ong, S.R. Zaki, J.P. Alexander, Deaths of children during an outbreak of hand, foot, and mouth disease in Sarawak, Malaysia: clinical and pathological characteristics of the disease. Clin. Infect. Dis. 31, 678–683 (2000)

    Article  PubMed  CAS  Google Scholar 

  19. S.M. Wang, C.C. Liu, H.W. Tseng, J.R. Wang, C.C. Huang, J.Y. Chen, Clinical spectrum of enterovirus 71 infection in children in southern Taiwan, with emphasis on neurological complications. Clin. Infect. Dis. 29, 184–190 (1999)

    Article  PubMed  CAS  Google Scholar 

  20. C.C. Huang, C.C. Liu, Y.C. Chang, C.Y. Chen, S.T. Wang, T.F. Yeh, Neurologic complications in children with enterovirus 71 infection. N. Engl. J. Med. 341, 936–942 (1999)

    Article  PubMed  CAS  Google Scholar 

  21. M.H. Ooi, T. Solomon, Y. Podin, A. Mohan, W. Akin, M.A. Yusuf, S. del Sel, K.M. Kontol, B.F. Lai, D. Clear, C.H. Chieng, E. Blake, D. Perera, S.C. Wong, J. Cardosa, Evaluation of different clinical sample types in diagnosis of human enterovirus 71-associated hand-foot-and-mouth disease. J. Clin. Microbiol. 6, 1858–1866 (2007)

    Article  Google Scholar 

  22. B.A. Brown, M.S. Oberste, J.P. Alexander, M.L. Kennett, M.A. Pallansch, Molecular epidemiology and evolution of enterovirus 71 strains isolated from 1970 to 1998. J. Virol. 73, 9969–9975 (1999)

    PubMed  CAS  Google Scholar 

  23. Y.P. Huang, T.L. Lin, C.Y. Kuo, M.W. Lin, C.Y. Yao, H.W. Liao, L.C. Hsu, C.F. Yang, J.Y. Yang, P.J. Chen, H.S. Wu, The circulation of subgenotypes B5 and C5 of enterovirus 71 in Taiwan from 2006 to 2007. Virus Res. 2, 206–212 (2008)

    Article  Google Scholar 

  24. J.T. Ma, H. Chen, X.M. Ma, G.Y. Guan, Q. Hao, Q.F. Wen, X.Q. Sun, D.Z. Yang, Z.L. Wu, J. Zhan, X.J. Tan, W.B. Xu, Genetic characteristics of enterovirus 71 isolated in Ningxia Hui Autonomous region in 2009. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi 5, 324–326 (2010)

    Google Scholar 

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Acknowledgments

The work was supported by research funding from the Infectious Diseases Special Project, Minister of Health of China (2008ZX10004-103 and 2009ZX10004-109).

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Correspondence to Weili Wu or Bianli Xu.

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Xingliang Fan, Jun Jiang and Yanjing Liu contributed equally to this article.

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Fan, X., Jiang, J., Liu, Y. et al. Detection of human enterovirus 71 and Coxsackievirus A16 in an outbreak of hand, foot, and mouth disease in Henan Province, China in 2009. Virus Genes 46, 1–9 (2013). https://doi.org/10.1007/s11262-012-0814-x

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  • DOI: https://doi.org/10.1007/s11262-012-0814-x

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