Genomic Epidemiology Of Coxsackievirus A16 In Mainland Of China, 2000–18,Virus Evolution

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Genomic Epidemiology Of Coxsackievirus A16 In Mainland Of China, 2000–18
Virus Evolution ( IF 5.3 ) Pub Date : 2020-12-12 , DOI: 10.1093/ve/veaa084
Zhenzhi Han ₁ , Yang Song ₁ , Jinbo Xiao ₁ , Lili Jiang ₂ , Wei Huang ₃ , Haiyan Wei ₄ , Jie Li ₅ , Hanri Zeng ₆ , Qiuli Yu ₇ , Jiameng Li ₈ , Deshan Yu ₉ , Yanjun Zhang ₁₀ , Chonghai Li ₁₁ , Zhifei Zhan ₁₂ , Yonglin Shi ₁₃ , Ying Xiong ₁₄ , Xianjun Wang ₁₅ , Tianjiao Ji ₁ , Qian Yang ₁ , Shuangli Zhu ₁ , Dongmei Yan ₁ , Wenbo Xu _{1,

16} , Yong Zhang _{1,

16}

Affiliation

WHO WPRO Regional Polio Reference Laboratory and National Laboratory for Poliomyelitis, NHC Key Laboratory of Biosafety, NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, People’s Republic of China
Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, People’s Republic of China
Chongqing Center for Disease Control and Prevention, Chongqing City, People’s Republic of China
Henan Center for Disease Control and Prevention, Zhengzhou, Henan Province, People’s Republic of China
Beijing Center for Disease Control and Prevention, Beijing City, People’s Republic of China
Guangdong Center for Disease Control and Prevention, Guangzhou, Guangdong Province, People’s Republic of China
Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei Province, People’s Republic of China
Tianjin Center for Disease Control and Prevention, Tianjin City, People’s Republic of China
Gansu Center for Disease Control and Prevention, Lanzhou, Gansu Province, People’s Republic of China
Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People’s Republic of China
Qinghai Center for Disease Control and Prevention, Xining, Qinghai Province, People’s Republic of China
Hunan Center for Disease Control and Prevention, Changsha, Hunan Province, People’s Republic of China
Anhui Center for Disease Control and Prevention, Hefei, Anhui Province, People’s Republic of China
Jiangxi Center for Disease Control and Prevention, Nanchang, Jiangxi Province, People’s Republic of China
Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, People’s Republic of China
Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei Province, People’s Republic of China

Abstract Hand, foot, and mouth disease (HFMD), which is a frequently reported and concerning disease worldwide, is a severe burden on societies globally, especially in the countries of East and Southeast Asia. Coxsackievirus A16 (CV-A16) is one of the most important causes of HFMD and a severe threat to human health, especially in children under 5 years of age. To investigate the epidemiological characteristics, spread dynamics, recombinant forms (RFs), and other features of CV-A16, we leveraged the continuous surveillance data of CV-A16-related HFMD cases collected over an 18-year period. With the advent of the EV-A71 vaccine since 2016, which targeted the EV-A71-related HFMD cases, EV-A71-related HFMD cases decreased dramatically, whereas the CV-A16-related HFMD cases showed an upward trend from 2017 to October 2019. The CV-A16 strains observed in this study were genetically related and widely distributed in the mainland of China. Our results show that three clusters (B1a–B1c) existed in the mainland of China and that the cluster of B1b dominates the diffusion of CV-A16 in China. We found that eastern China played a decisive role in seeding the diffusion of CV-A16 in China, with a more complex and variant transmission trend. Although EV-A71 vaccine was launched in China in 2016, it did not affect the genetic diversity of CV-A16, and its genetic diversity did not decline, which confirmed the epidemiological surveillance trend of CV-A16. Two discontinuous clusters (2000–13 and 2014–18) were observed in the full-length genome and arranged along the time gradient, which revealed the reason why the relative genetic diversity of CV-A16 increased and experienced more complex fluctuation model after 2014. In addition, the switch from RFs B (RF-B) and RF-C co-circulation to RF-D contributes to the prevalence of B1b cluster in China after 2008. The correlation between genotype and RFs partially explained the current prevalence of B1b. This study provides unprecedented full-length genomic sequences of CV-A16 in China, with a wider geographic distribution and a long-term time scale. The study presents valuable information about CV-A16, aimed at developing effective control strategies, as well as a call for a more robust surveillance system, especially in the Asia-Pacific region.

更新日期：2020-12-12

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