Abstract:This is the first report describing the phylogenetic relatedness of recent CV-B3 strains in Taiwan. An indirect IFA kit was developed by the Taiwan CDC for detecting CV-B3 viruses that are untypeable by commercial IFA kits.
“…Genetically linked CV-B3 was identified in HFMD patients and healthy individuals, which is in line with the characteristics of enterovirus infection and transmission. The different levels of outbreaks associated with CV-B3 in China, which formed the peak in 2000–2002 (aseptic meningitis), 2004–2005 (aseptic meningitis), 2008 (aseptic meningitis), and 2012 (symptoms related to enterovirus infection), were also reported in addition to the two outbreaks described in this study [14, 41, 42]. Different areas, though far away, might experience CV-B3 outbreaks over a similar timescale, such as the Shandong Province and Hong Kong of China experienced the similar aseptic meningitis outbreaks in 2008.…”
Section: Discussionsupporting
confidence: 52%
“…Within the group E, strains sampled from the different regions were observed, showing a certain level of geographical gene flow, whereas most gene groups may persist in a particular location, with occasional movement of viral lineages among locations. Groups F and G, which circulated in Taiwan of China, have circulated for about 20 years and caused an outbreak in 2012 (unfortunately, not all entire VP1 sequences could be obtained from GenBank databases for this analysis) [42]. Group H comprised a number of sequences isolated from acute flaccid paralysis cases in India.…”
Background
Coxsackievirus B3 (CV-B3) is usually associated with aseptic meningitis and myocarditis; however, the association between CV-B3 and hand, foot, and mouth disease (HFMD) has not been clearly demonstrated, and the phylogenetic dynamics and transmission history of CV-B3 have not been well summarized.
Method
Two HFMD outbreaks caused by CV-B3 were described in Hebei Province in 2012 and in Shandong Province in 2016 in China. To analyze the epidemiological features of two CV-B3 outbreaks, a retrospective analysis was conducted. All clinical specimens from CV-B3 outbreaks were collected and disposed according to the standard procedures supported by the WHO Global Poliovirus Specialized Laboratory. EV genotyping and phylogenetic analysis were performed to illustrate the genetic characteristics of CV-B3 in China and worldwide.
Results
Two transmissible lineages (lineage 2 and 3) were observed in Northern China, which acted as an important “reservoir” for the transmission of CV-B3. Sporadic exporting and importing of cases were observed in almost all regions. In addition, the global sequences of CV-B3 showed a tendency of geographic-specific clustering, indicating that geographic-driven adaptation plays a major role in the diversification and evolution of CV-B3.
Conclusions
Overall, our study indicated that CV-B3 is a causative agent of HFMD outbreak and revealed the phylogenetic dynamics of CV-B3 worldwide, as well as provided an insight on CV-B3 outbreaks for effective intervention and countermeasures.
Electronic supplementary material
The online version of this article (10.1186/s12879-019-4107-z) contains supplementary material, which is available to authorized users.
“…Genetically linked CV-B3 was identified in HFMD patients and healthy individuals, which is in line with the characteristics of enterovirus infection and transmission. The different levels of outbreaks associated with CV-B3 in China, which formed the peak in 2000–2002 (aseptic meningitis), 2004–2005 (aseptic meningitis), 2008 (aseptic meningitis), and 2012 (symptoms related to enterovirus infection), were also reported in addition to the two outbreaks described in this study [14, 41, 42]. Different areas, though far away, might experience CV-B3 outbreaks over a similar timescale, such as the Shandong Province and Hong Kong of China experienced the similar aseptic meningitis outbreaks in 2008.…”
Section: Discussionsupporting
confidence: 52%
“…Within the group E, strains sampled from the different regions were observed, showing a certain level of geographical gene flow, whereas most gene groups may persist in a particular location, with occasional movement of viral lineages among locations. Groups F and G, which circulated in Taiwan of China, have circulated for about 20 years and caused an outbreak in 2012 (unfortunately, not all entire VP1 sequences could be obtained from GenBank databases for this analysis) [42]. Group H comprised a number of sequences isolated from acute flaccid paralysis cases in India.…”
Background
Coxsackievirus B3 (CV-B3) is usually associated with aseptic meningitis and myocarditis; however, the association between CV-B3 and hand, foot, and mouth disease (HFMD) has not been clearly demonstrated, and the phylogenetic dynamics and transmission history of CV-B3 have not been well summarized.
Method
Two HFMD outbreaks caused by CV-B3 were described in Hebei Province in 2012 and in Shandong Province in 2016 in China. To analyze the epidemiological features of two CV-B3 outbreaks, a retrospective analysis was conducted. All clinical specimens from CV-B3 outbreaks were collected and disposed according to the standard procedures supported by the WHO Global Poliovirus Specialized Laboratory. EV genotyping and phylogenetic analysis were performed to illustrate the genetic characteristics of CV-B3 in China and worldwide.
Results
Two transmissible lineages (lineage 2 and 3) were observed in Northern China, which acted as an important “reservoir” for the transmission of CV-B3. Sporadic exporting and importing of cases were observed in almost all regions. In addition, the global sequences of CV-B3 showed a tendency of geographic-specific clustering, indicating that geographic-driven adaptation plays a major role in the diversification and evolution of CV-B3.
Conclusions
Overall, our study indicated that CV-B3 is a causative agent of HFMD outbreak and revealed the phylogenetic dynamics of CV-B3 worldwide, as well as provided an insight on CV-B3 outbreaks for effective intervention and countermeasures.
Electronic supplementary material
The online version of this article (10.1186/s12879-019-4107-z) contains supplementary material, which is available to authorized users.
“…A few recent studies based on VP1 have classified CV-B3 strains into five genogroups, GI-GV (Chu et al, 2010;Huang et al, 2014). Of these GI, GII and GIII strains were found to be prevalent in America and Europe, GIV strains were reported from Taiwan and GV strains were found predominantly in East Asia (Chu et al, 2010;Huang et al, 2014). The importation/exportation of the CV-B3 genogroups across countries is presumed to be due to frequent population exchange (Tao et al, 2012).…”
Acute flaccid paralysis (AFP) associated with coxsackievirus type B3 (CV-B3) of the species Enterovirus B is an emerging concern worldwide. Although CV-B3-associated AFP in India has been demonstrated previously, the genomic characterization of these strains is unreported. Here, CV-B3 strains detected on the basis of the partial VP1 gene in 10 AFP cases and five asymptomatic contacts identified from different regions of south-western India during 2009-2010 through the Polio Surveillance Project were considered for complete genome sequencing and characterization. Phylogenetic analysis of complete VP1 gene sequences of global CV-B3 strains classified Indian CV-B3 strains into genogroup GVI, along with strains from Uzbekistan and Bangladesh, and into a new genogroup, GVII. Genomic divergence between genogroups of the study strains was 14.4 % with significantly lower divergence (1.8 %) within GVI (n512) than that within GVII (8.5 %) (n53). The strains from both AFP cases and asymptomatic contacts, identified mainly in coastal Karnataka and Kerala, belonged to the dominant genogroup GVI, while the GVII strains were recovered from AFP cases in north interior Karnataka. All study strains carried inter-genotypic recombination with the structural region similar to reference CV-B3 strains, and 59 non-coding regions and non-structural regions closer to other enterovirus B types. Domain II structures of 59 non-coding regions, described to modulate virus replication, were predicted to have varied structural folds in the two genogroups and were attributed to differing recombination patterns. The results indicate two distinct genomic compositions of CV-B3 strains circulating in India and suggest the need for concurrent analysis of viral and host factors to further understand the varied manifestations of their infections.
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