Genome Sequence of Coxsackievirus A6, Isolated during a Hand-Foot-and-Mouth Disease Outbreak in Finland in 2008

Abstract

Reports of hand-foot-and-mouth disease (HFMD) outbreaks caused by coxsackievirus A6 have increased worldwide after the report of the first outbreak in Finland in 2008. The complete genome of the first outbreak strain from a vesicle fluid specimen was determined.

Genetic characterization of human coxsackievirus A6 variants associated with atypical hand, foot and mouth disease: a potential role of recombination in emergence and pathogenicity

“…The current study obtained complete genome sequences and paired VP1/3Dpol sequences from a large number of CVA6 variants from Edinburgh and Finland, allowing associations between recombination group and clinical presentations to be compared. Our search of GenBank and PubMed databases identified four other studies from Finland ( Österback et al , 2014 ), Taiwan ( Chen et al , 2012 ; Chung et al , 2013 ) and Japan ( Fujimoto et al , 2012 ) in which nine complete genome sequences were obtained from CVA6 infections with clinical descriptions ( Table 1 ). Although comparing clinical descriptions from different sources was problematic, it was possible to broadly divide presentations into three categories: (1) herpangina and other non-HFMD presentations; (2) aHFMD with lesions extending to the hands, feet and perioral area, often clinically resembling chickenpox and being occasionally associated with onychomadesis (nail loss); and (3) extensive vesicular rash on the arms, legs and trunk, clinically resembling either eczematous dermatitis or eczema herpeticum (also termed eczema coxsackium; Mathes et al , 2013 ) and occasionally being associated with onychomadesis.…”

The Epidemiological Study of Coxsackievirus A6 revealing Hand, Foot and Mouth Disease Epidemic patterns in Guangdong, China

“…As a result, almost all of the CVA6 strains isolated during the 2012 and 2013 HFMD epidemic in Guangdong, Shanghai, Jiangsu, Shandong, and Fujian were segregated into one major genetic cluster A ( Fig. 2 ), and displayed a close genetic relationship with the 2008 Finland strain, 2009/2010 Taiwan strains, 2010 French strains and 2011 Japanese strains associated with HFMD outbreaks 19 27 28 29 .…”

“…CVA6, increasingly detected in some European countries since 2008, has been associated with the major cause of several HFMD outbreaks in Europe and Asia 7 16 17 18 19 28 29 30 31 32 . In mainland China, CVA6 was not a great concern until the outbreak of HFMD in 2013.…”

Characterization of genome sequences and clinical features of coxsackievirus A6 strains collected in Hyogo, Japan in 1999‐2013

“…Besides herpangina and HFMD, CV‐A6 can cause a wide range of diseases including nonspecific febrile illness, respiratory infections, enteritis, and fever convulsions, without ulceration and skin symptoms. An outbreak of HFMD caused by CV‐A6 was first reported in Finland in 2008 . Subsequent outbreaks of HFMD caused by CV‐A6 have occurred worldwide at an increasing rate, and were reported in Taiwan in 2010, in Spain in 2011, in Thailand in 2012, in China in 2013, in New Zealand in 2014, in the United Kingdom in 2014, and in Singapore in 2015 .…”

“…An outbreak of HFMD caused by CV-A6 was first reported in Finland in 2008. 10,11 Subsequent outbreaks of HFMD caused by CV-A6 have occurred worldwide at an increasing rate, and were reported in Taiwan in 2010, 12 in Spain in 2011, 13 in Thailand in 2012, 14 in China in 2013, 15,16 in New Zealand in 2014, 17 in the United Kingdom in 2014, 18 and in Singapore in 2015. 19,20 In Japan, the detection rate of CV-A6 in HFMD patients has increased since 2009.…”