Emergence of a novel recombinant of CV-A5 in HFMD epidemics in Xiangyang, China

BMC Med Genomics. 2021 Nov 24;14(1):279. doi: 10.1186/s12920-021-01107-6.

Abstract

Background: Hand, foot and mouth disease (HFMD) is caused by a variety of enterovirus serotypes and the etiological spectrum worldwide has changed since a large scale of outbreaks occurred in 1997.

Methods: A large number of clinical specimens of HFMD patients were collected in Xiangyang and genotyping was performed by qRT-PCR, conventional PCR amplification and sequencing. Among the 146 CV-A5 detected cases, the complete genome sequences of representative strains were determined for genotyping and for recombination analysis.

Results: It was found that CV-A5 was one of the six major serotypes that caused the epidemic from October 2016 to December 2017. Phylogenetic analyses based on the VP1 sequences showed that these CV-A5 belonged to the genotype D which dominantly circulated in China. Recombination occurred between the CV-A5 and CV-A2 strains with a breakpoint in the 2A region at the nucleotide 3791.

Conclusions: The result may explain the emergence of CV-A5 as one of the major pathogens of HFMD. A multivalent vaccine against HFMD is urgently needed to control the disease and to prevent emerging and spreading of new recombinants.

Keywords: Coxsakievirus A5; Hand, foot and mouse disease; Recombinantion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • China / epidemiology
  • Enterovirus* / genetics
  • Epidemics*
  • Hand, Foot and Mouth Disease* / epidemiology
  • Humans
  • Phylogeny