Newly emerged enterovirus-A71 C4 sublineage may be more virulent than B5 in the 2015-2016 hand-foot-and-mouth disease outbreak in northern Vietnam.,Scientific Reports

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Newly emerged enterovirus-A71 C4 sublineage may be more virulent than B5 in the 2015-2016 hand-foot-and-mouth disease outbreak in northern Vietnam.
Scientific Reports ( IF 3.8 ) Pub Date : 2020-01-13 , DOI: 10.1038/s41598-019-56703-5
Son T Chu ₁ , Kyousuke Kobayashi ₂ , Xiuqiong Bi ₁ , Azumi Ishizaki _{1,

3} , Tu T Tran ₄ , Thuy T B Phung ₅ , Chung T T Pham ₅ , Lam V Nguyen ₆ , Tuan A Ta ₇ , Dung T K Khu ₈ , Masanobu Agoh ₉ , An N Pham _{6,

10} , Satoshi Koike ₂ , Hiroshi Ichimura _{1,

3}

Affiliation

Department of Viral Infection and International Health, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan.
Neurovirology Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, 1568506, Japan.
Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan.
Outpatient Department, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam.
Research Biomolecular for Infectious Disease Department, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam.
Center for Pediatric Tropical Diseases, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam.
Medical Intensive Care Unit, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam.
Neonatal Intensive Care Unit, Vietnam National Hospital of Pediatrics, Hanoi, 10000, Vietnam.
Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, 8528523, Japan.
Department of Pediatrics, Hanoi Medical University, Hanoi, 10000, Vietnam.

Enterovirus-A71 (EV-A71) is a common cause of hand-foot-and-mouth disease (HFMD) and, rarely, causes severe neurological disease. This study aimed to elucidate the epidemiological and genetic characteristics and virulence of EV-A71 strains isolated from children diagnosed with HFMD. Rectal and throat swabs were collected from 488 children with HFMD in Hanoi, Vietnam, in 2015-2016. From 391 EV-positive patients, 15 EVs, including coxsackievirus A6 (CV-A6; 47.1%) and EV-A71 (32.5%, n = 127), were identified. Of the 127 EV-A71 strains, 117 (92.1%) were the B5 subgenotype and 10 (7.9%) were the C4 subgenotype. A whole-genome analysis of EV-A71 strains showed that seven of the eight C4a strains isolated in 2016 formed a new lineage, including two possible recombinants between EV-A71 C4 and CV-A8. The proportion of inpatients among C4-infected children was higher than among B5-infected children (80.0% vs. 27.4%; P = 0.002). The virulence of EV-A71 strains was examined in human scavenger receptor class B2 (hSCARB2)-transgenic mice, and EV-A71 C4 strains exhibited higher mortality than B5 strains (80.0% vs. 30.0%, P = 0.0001). Thus, a new EV-A71 C4a-lineage, including two possible recombinants between EV-A71 C4 and CV-A8, appeared in 2016 in Vietnam. The EV-A71 C4 subgenotype may be more virulent than the B5 subgenotype.

中文翻译：

在2015-2016年越南北部手足口病疫情中，新出现的肠道病毒A71 C4亚系的毒力可能比B5亚系更强。

肠道病毒 A71 (EV-A71) 是手足口病 (HFMD) 的常见原因，但很少会引起严重的神经系统疾病。本研究旨在阐明从诊断为手足口病的儿童中分离出的 EV-A71 菌株的流行病学和遗传特征以及毒力。 2015-2016 年，从越南河内收集了 488 名手足口病儿童的直肠和咽喉拭子。从 391 名 EV 阳性患者中，鉴定出 15 种 EV，包括柯萨奇病毒 A6（CV-A6；47.1%）和 EV-A71（32.5%，n = 127）。 127株EV-A71中，117株（92.1%）为B5亚型，10株（7.9%）为C4亚型。对EV-A71菌株的全基因组分析表明，2016年分离的8个C4a菌株中有7个形成了新的谱系，其中包括EV-A71 C4和CV-A8之间的两个可能的重组体。 C4感染儿童住院患者比例高于B5感染儿童（80.0% vs. 27.4%；P = 0.002）。在人清道夫受体 B2 类 (hSCARB2) 转基因小鼠中检查了 EV-A71 菌株的毒力，EV-A71 C4 菌株表现出比 B5 菌株更高的死亡率（80.0% vs. 30.0%，P = 0.0001）。因此，一个新的 EV-A71 C4a 谱系，包括 EV-A71 C4 和 CV-A8 之间的两种可能的重组体，于 2016 年在越南出现。 EV-A71 C4 亚基因型可能比 B5 亚基因型毒性更强。

更新日期：2020-01-13

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