Frontiers in Microbiology ( IF 5.2 ) Pub Date : 2022-01-06 , DOI: 10.3389/fmicb.2021.811553 Fenglan He 1 , Jia Rui 2 , Zhiqiang Deng 1 , Yanxia Zhang 1 , Ke Qian 1 , Chunhui Zhu 3 , Shanshan Yu 2 , Junling Tu 1 , Wen Xia 1 , Qingxiong Zhu 4 , Shengen Chen 1 , Tianmu Chen 2 , Xianfeng Zhou 1
After the first national-scale outbreak of Hand, foot, and mouth disease (HFMD) in China, a national surveillance network was established. Here we described the epidemiology and pathogenic profile of HFMD and the impact of EV-A71 vaccination on pathogen spectrum of enteroviruses in the southeastern Chinese city of Nanchang during 2010–2019. A total of 7,951 HFMD cases from sentinel hospitals were included, of which 4,800 EV-positive cases (60.4%) were identified by real-time RT-PCR. During 2010–2012, enterovirus 71 (EV-A71) was the main causative agent of HFMD, causing 63.1% of cases, followed by 19.3% cases associated with coxsackievirus A16 (CV-A16). Since 2013, the proportion of other enteroviruses has increased dramatically, with the sub genotype D3 strain of Coxsackievirus A6 (CV-A6) replacing the dominance of EV-A71. These genetically diverse native strains of CV-A6 have co-transmitted and co-evolved in Nanchang. Unlike EV-A71 and CV-A16, most CV-A6 infections were concentrated in autumn and winter. The incidence of EV-A71 infection negatively correlated with EV-A71 vaccination (