Enterovirus spectrum from the active surveillance of hand foot and mouth disease patients under the clinical trial of inactivated Enterovirus A71 vaccine in Jiangsu, China, 2012-2013

• Published in: Journal of medical virology 2015-12, Vol.87 (12), p.2009-2017
• Main Authors: Yao, Xin, Bian, Lian-Lian, Lu, Wei-Wei, Li, Jing-Xin, Mao, Qun-Ying, Wang, Yi-Ping, Gao, Fan, Wu, Xing, Ye, Qiang, Xu, Miao, Li, Xiu-Ling, Zhu, Feng-Cai, Liang, Zheng-Lun
• Format: Article
• Language: English
• Subjects: and mouth disease; Child, Preschool; China - epidemiology; Clinical trials; Coinfection - epidemiology; Coinfection - virology; coxsackievirus A16; Enterovirus; Enterovirus - classification; Enterovirus - genetics; Enterovirus - isolation & purification; enterovirus 71; enterovirus spectrum; Epidemiological Monitoring; Feces - virology; Female; foot; Genotype; hand; Hand, Foot and Mouth Disease - epidemiology; Hand, Foot and Mouth Disease - prevention & control; Hand, Foot and Mouth Disease - virology; hand, foot, and mouth disease; human enteroviruses; Humans; Incidence; Infant; Molecular Epidemiology; Pharynx - virology; RNA, Viral - genetics; Sequence Analysis, DNA; Serogroup; Vaccines; Vaccines, Inactivated - administration & dosage; Vaccines, Inactivated - immunology; Viral Vaccines - administration & dosage; Viral Vaccines - immunology; Virology
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.24275

Epidemiological data from active surveillance on human enterovirus, which could cause hand, foot, and mouth disease, were limited. An active surveillance system was used to investigate the enterovirus spectrum and the incidence of different enteroviruses in infants aged 6–35 months in Jiangsu Province from 2012 to 2013. Fifty‐nine infants were randomly selected from 522 non‐EV‐A71/CV‐A16 HFMD patients. We collected 173 throat swabs and 174 rectal swabs from these infants. RT‐PCR was used to amplify 5'‐UTR and VP1 regions of enteroviruses and the serotypes were determined by the sequence comparison using BLAST. Twenty‐one non‐EV‐A71/CA16 enterovirus serotypes were detected in those infants. E16, E18 were firstly reported in HFMD patients. The four top common non‐EV‐A71/CV‐A enteroviruses among infants were CV‐B3, CV‐A10, CV‐A6, and E9 with the HFMD incidence rates at 1.4%, 0.84%, 0.56%, and 0.47%, respectively. Over 20.8% patients were co‐infected with multiple enteroviruses. Neither the course of sickness nor clinical symptoms of the co‐infected patients was more severe than those infected with single enterovirus. Two patients were infected different enterovirus successively within 2 months. Several new enterovirus serotypes and multiple models of infection associated with HFMD were discovered through the active surveillance system. These data provide a better understanding of the viral etiology of HFMD. J. Med. Virol. 87:2009–2017, 2015. © 2015 Wiley Periodicals, Inc.