Abstract：Objective To study the pathogenic spectrum of hand, foot, and mouth disease (HFMD) and genetic characteristics of coxasckievirus A6 in Chenzhou City, Hunan Province from 2013 to 2015, and to provide a scientific basis for HFMD control and prevention. Methods Anal swabs and stool specimens were collected from HFMD cases diagnosed in the sentinel hospitals in Chenzhou City in 2013-2015. RNA of human enterovirus A71 (HEV71), coxasckievirus A16 (CVA16), coxasckievirus A6 (CVA6), coxasckievirus A10 (CVA10) and other human enterovirus (HEV) was detected by fluorescent quantitative PCR assay. The other unidentified HEV positive specimens were amplified with RT-PCR and the pathogens was genotyped by gene sequencing. Results A total of 2,343 HFMD specimens were detected in Chenzhou City from 2013 to 2015. 1,325 specimens were positive for human enterovirus, with the detection rate of 56.55%. The pathogenic spectrum of HFMD included 16 types of intestinal viruses, with the top five genotypes of CVA6 (31.77%), CVA16 (16.45%), HEV71 (13.74%), CVA10 (11.47%) and CVB5 (0.30%). 25.13% of the specimens were identified as other HEV without typing. CVA6 and other HEV were the major pathogens for clustered HFMD cases, while HEV 71 and other HEV were the predominant pathogens for severe HFMD cases and deaths. There were statistically significant differences in the genotypes of pathogens among HFMD cases with different types (χ2=56.41, P<0.001) and in different years (χ2=64.90, P<0.001). CVA6 circulating strains in Chenzhou City were all distributed in the same cluster, and they were homologous to the circulating strains in Changsha City. Conclusions CVA6 had become the main pathogen of HFMD in Chenzhou City in 2013-2015. It is necessary to strengthen the detection of non-EV71 and non-CVA16 enteroviruses in HFMD monitoring.
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2018, Vol. 25 
