Virology
Genetic characteristics of CV-A12 VP1 region and clinical manifestations of CV-A12-associated severe hand, foot and mouth disease in Qingdao
Xiaoyan Shi, Yanhui Zhang, Zhilei Su, Dan Zhao, Qing Chai, Jinling Gong, Feng Zhang, Zhaoguo Wang
Published 2018-09-30
Cite as Chin J Microbiol Immunol, 2018, 38(9): 658-664. DOI: 10.3760/cma.j.issn.0254-5101.2018.09.003
Abstract
ObjectiveTo investigate the molecular characteristics of coxsackievirus A12 (CV-A12) and to understand the clinical manifestations of severe hand, foot and mouth disease (HFMD) caused by CV-A12 in Qingdao.
MethodsThroat swabs of HFMD, herpangina and influenza-like cases from 2011 to 2016 were detected for enteroviruses (EVs) in Qingdao. Human rhabdomyosarcoma (RD) and human laryngeal carcinoma (Hep-2) cells were used for virus proliferation and CV-A12 strains were identified through a semi-nest RT-PCR. The full-length of VP1 gene of CV-A12 strains was sequenced and phylogenetically analyzed using MEGA7.0 software package. Clinical data of severe HFMD cases positive for CV-A12 were collected and analyzed.
ResultsCV-A12-positive HFMD, herpangina and influenza-like cases accounted for 0.3%(18/6 798), 1.2%(2/169) and 0.1%(1/676) in Qingdao, respectively. Most of the HFMD caused by CV-A12 in children were mild before 2013 (84.6%, 11/13), while hospitalized severe cases with neurological symptoms (100%, 5/5) became more common after 2013. Phylogenetic analysis of the VP1 region revealed that CV-A12 strains worldwide could be divided into two genotypes, A and B. All of the CV-A12 strains successfully sequenced in Qingdao from 2011 to 2016 belonged to genotype B, and 88.9% (16/18) of them belonged to subgenotype B2. All hospitalized severe cases of CV-A12-caused HFMD after 2013 were associated with strains in branch B2b of subgenotype B2.
ConclusionCV-A12 was one of the pathogens causing HFMD, herpangina and influenza-like illness in children in Qingdao. Strains of genotype B2 were the predominant CV-A12 strains circulating in Qingdao in recent years. CV-A12-caused HFMD might complicated by nervous system damage.
Key words:
Coxsackievirus A12; Severe hand, foot and mouth disease; Phylogenetic analysis
Contributor Information
Xiaoyan Shi
Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Yanhui Zhang
Qingdao Women and Children Hospital, Qingdao 266034, China
Zhilei Su
Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Dan Zhao
Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Qing Chai
Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Jinling Gong
Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Feng Zhang
Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Zhaoguo Wang
Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao 266033, China
