High proportion of coxsackievirus B3 genotype A in hand, foot and mouth disease in Zhenjiang, China, 2011–2016

Abstract

Background: Hand, foot and mouth disease (HFMD) is usually caused by EVA71 and CVA16 except for a few cases that are caused by non-EVA71 non-CAV16 enteroviruses. Coxsackievirus B3 (CVB3) is mostly associated with myocarditis, occasionally with HFMD. Methods: The partial VP1 gene of enteroviruses were amplified and sequenced from 610 throat swabs from clinically confirmed HFMD children. All available CVB3 near full-length genomic and VP1 sequences were downloaded from GenBank. Phylogenetic and distance analyses were performed using MEGA 7.0. Results: A total of 238 partial VP1 sequences were obtained, including 93 EVA71 (39%), 79 CAV16 (33%), 29 CVB3 (12%), 24 CVA6 (10%), and 13 other enterovirus serotypes (5.5%). CVB3 is classified into seven genotypes A-G according to phylogenetic and distance analyses. All CVB3 strains from Zhenjiang belonged to genotype A. In contrast to other genotypes that are prevalent in Europe and other regions of China, and often associated with aseptic meningitis and myocarditis, CVB3 genotype A strains identified in Zhenjiang were only detected among HFMD patients. Conclusions: This high prevalence of CVB3 genotype A among HFMD children has never been reported. This phenomenon has revealed a new epidemic trend of CVB3 among HFMD in China, and it has epidemiological implications for monitoring the epidemic risk of CVB3.

Whole-genome analysis of coxsackievirus B3 reflects its genetic diversity in China and worldwide

“…To date, CVB3 strains are associated with various diseases, and the manifestations vary from mild respiratory [ 33 ], gastrointestinal infections [ 34 , 35 ], herpangina [ 36 ], and hand, foot, and mouth disease [ 7 , 8 , 37 ], to more severe diseases such as heart disease (including viral myocarditis [ 6 , 38 ], pericarditis [ 39 ], and acute myocardial infarction [ 40 ]), CNS involvement (meningitis [ 30 , 36 , 41 – 43 ], meningo-cerebellitis [ 11 ], encephalitis [ 44 ], and AFP [ 45 – 47 ]), and pancreatic interrelated disease (pancreatitis [ 48 ], diabetes [ 49 ]). More seriously, the virus can cause neonatal sepsis-like illness and sudden death in infected infants [ 38 , 50 ] and adults with low immune function.…”

“…Coxsackievirus B3 (CVB3) was first reported in Connecticut, the USA in 1949, and has emerged as an active pathogen in myocarditis [ 6 ], aseptic meningitis (AM), HFMD [ 7 , 8 ], and pancreatitis [ 9 ], causing a heavy burden on society. CVB3 infection is the most common cause of viral myocarditis, characterized by viral infection and myocardial inflammation [ 10 , 11 ].…”

4-Iminooxazolidin-2-One as a Bioisostere of Cyanohydrin Suppresses EV71 Proliferation by Targeting 3C pro

“…Multiple enteroviruses, including EV71 (types A, B, and C), CA16, and CVB3, are associated with HFMD diseases ( 30 ). We detected the antiviral spectrums of FOPMC and FIOMC by infecting RD cells with five virus strains.…”

TLR3 polymorphisms are associated with the severity of hand, foot, and mouth disease caused by enterovirus A71 in a Chinese children population

“…3 Severe HFMD is often accompanied by neurological complications, including encephalitis, aseptic meningitis, pulmonary edema, and cardiorespiratory failure. 4 Toll-like receptors (TLRs) are an important class of protein molecules involved in nonspecific immunity that can recognize the conserved structure of biomolecules derived from microorganisms and induce antimicrobial immune responses. 5 After identifying the pathogens, TLRs can activate a variety of signaling pathways, including downstream MyD88-independent and MyD88-dependent pathways, which regulate the expression of a range of inflammatory cytokines and participate in inflammation and immune responses.…”

“…EV‐A71‐associated HFMD may lead to central nervous system damage and is associated with higher mortality and morbidity among infected patients, while CA16 infection is usually self‐limited with mild clinical symptoms 3 . Severe HFMD is often accompanied by neurological complications, including encephalitis, aseptic meningitis, pulmonary edema, and cardiorespiratory failure 4 …”