Abstract
In 2016, an upsurge of neurologic disease associated with infection with multirecombinant enterovirus A71 subgenogroup C1 lineage viruses was reported in France. These viruses emerged in the 2000s; 1 recombinant is widespread. This virus lineage has the potential to be associated with a long-term risk for severe disease among children.
Highlights
Stéphanie Tomba Ngangas, Alexander Lukashev, Gwendoline Jugie, Olga Ivanova, Jean-Michel Mansuy, Catherine Mengelle, Jacques Izopet, Anne-Sophie L’honneur, Flore Rozenberg, David Leyssene, Denise Hecquet, Stéphanie Marque-Juillet, David Boutolleau, Sonia Burrel, Hélène Peigue-Lafeuille, Christine Archimbaud, Kimberley Benschop, Cécile Henquell, Audrey Mirand, Jean-Luc Bailly
We used genomic region P1 to determine the evolutionary relatedness between C1v2015 and earlier C1 viruses and to date when the upsurge of C1v2015 infections began in Europe (Figure 2, panel B)
Seven Enterovirus A71 (EV-A71) subgenogroup C1 viruses from Africa and Europe were located at the base of the C1v2015 lineage (Figure 2, panel B), suggesting that the C1 strain involved in the emergence of C1v2015 was circulating in this region during the 2000s
Summary
§Specimens for which partial genomes were obtained. ¶Patients 15–19 were children in the same daycare facility who had no evidence of clinical disease. The nucleotide similarity patterns for module 2 (genomic region P1 comprising 4 capsid protein genes) suggest this region was inherited en bloc from an earlier subgenogroup C1 lineage. The C1v2015 genomic module 4 comprises the entire 3Dpol gene and has a 90%–95% nucleotide similarity with 4 distinct EV-A genomes: coxsackievirus A2 (CVA2) and CV-A5 from Russia, CV-A4 from China, and CV-A6 from Turkmenistan (Figure 2, panel A). We performed another phylogenetic analysis to assess the temporal origin of C1v2015 using this module. Whole-genome sequencing analysis showed that the isolate from patient 14 (14|COC286037|FRA|2016) shared distinct 3Dpol genes with other C1v2015 viruses (Appendix Figure 1). The C1v2015 5′ UTR was inherited from an EV-A
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