Abstract
Echovirus 11 (E-11) is one of the most frequently isolated enteroviruses causing meningitis and other diseases such as hand, foot, and mouth disease (HFMD) and acute flaccid paralysis (AFP). Fifty-nine newly determined E-11 VP1 sequences from the China AFP and HFMD surveillance network and 500 E-11 VP1 sequences obtained from the GenBank database, which were associated with 12 categories of diseases, were screened for phylogenetic analysis. Based on the standard method of genotype classification, E-11 strains circulated worldwide were reclassified into six genotypes as A, B, C, D, E, and F, in which genotype F is newly divided, and genotypes A and C are further divided into A1–5 and C1–4 by this research, whereas genotype D was still divided into D1–5 as in a previous study of Oberste et al. Sub-genotype A1 was the predominant sub-genotype in mainland China between 2008–2017, whereas sub-genotype D5 was the predominant sub-genotype circulated outside China from 1998–2014. However, genotype and sub-genotype spectra showed statistical significance among AFP and HFMD cases (χ2 = 60.86, P < 0.001), suggesting that different genotypes might have a tendency to cause different diseases. Strengthening the surveillance of E-11 might provide further information about pathogenic evolution or specific nucleotide mutation associated with different clinical diseases.
Highlights
Human enteroviruses are small, nonenveloped, positive single-stranded RNA viruses that belong to genus Enterovirus, family Picornaviridae
Echovirus, coxsackievirus group B, coxsackie A9 and several novel enteroviruses make up the EV-B species, which is the largest group of the Enterovirus genus, with 28 serotypes
The first molecular epidemiology study of Echovirus 11 (E-11) based on entire VP1 sequences showed that at least four monophyletic genotypes circulated among 16 countries worldwide from 1953–200120
Summary
Human enteroviruses are small, nonenveloped, positive single-stranded RNA viruses that belong to genus Enterovirus, family Picornaviridae. The genus Enterovirus, capable of infecting humans, was divided into 66 serotypes by a neutralization assay that was used as the previous gold standard for enterovirus serotype identification. This method had some disadvantages, and no new enterovirus serotypes were confirmed for more than 20 years after the 1970s1. A total of 559 entire VP1 sequences, including 500 (359 from abroad) sequences downloaded from GenBank and 59 sequences obtained from the China surveillance network in 11 provinces during the period from 1999 to 2017, were used as a dataset for molecular epidemiology. The results of this study will provide important basic information about the genetic evolution of E-11 circulated in China as well as a deep understanding of its genetic characteristics and clinical pathogenicity
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