Abstract
BackgroundCoxsackievirus B3 (CV-B3) is usually associated with aseptic meningitis and myocarditis; however, the association between CV-B3 and hand, foot, and mouth disease (HFMD) has not been clearly demonstrated, and the phylogenetic dynamics and transmission history of CV-B3 have not been well summarized.MethodTwo HFMD outbreaks caused by CV-B3 were described in Hebei Province in 2012 and in Shandong Province in 2016 in China. To analyze the epidemiological features of two CV-B3 outbreaks, a retrospective analysis was conducted. All clinical specimens from CV-B3 outbreaks were collected and disposed according to the standard procedures supported by the WHO Global Poliovirus Specialized Laboratory. EV genotyping and phylogenetic analysis were performed to illustrate the genetic characteristics of CV-B3 in China and worldwide.ResultsTwo transmissible lineages (lineage 2 and 3) were observed in Northern China, which acted as an important “reservoir” for the transmission of CV-B3. Sporadic exporting and importing of cases were observed in almost all regions. In addition, the global sequences of CV-B3 showed a tendency of geographic-specific clustering, indicating that geographic-driven adaptation plays a major role in the diversification and evolution of CV-B3.ConclusionsOverall, our study indicated that CV-B3 is a causative agent of HFMD outbreak and revealed the phylogenetic dynamics of CV-B3 worldwide, as well as provided an insight on CV-B3 outbreaks for effective intervention and countermeasures.
Highlights
Coxsackievirus B3 (CV-B3) is usually associated with aseptic meningitis and myocarditis; the association between CV-B3 and hand, foot, and mouth disease (HFMD) has not been clearly demonstrated, and the phylogenetic dynamics and transmission history of CV-B3 have not been well summarized
The global sequences of CV-B3 showed a tendency of geographic-specific clustering, indicating that geographic-driven adaptation plays a major role in the diversification and evolution of CV-B3
Overall, our study indicated that CV-B3 is a causative agent of HFMD outbreak and revealed the phylogenetic dynamics of CV-B3 worldwide, as well as provided an insight on CV-B3 outbreaks for effective intervention and countermeasures
Summary
Coxsackievirus B3 (CV-B3) is usually associated with aseptic meningitis and myocarditis; the association between CV-B3 and hand, foot, and mouth disease (HFMD) has not been clearly demonstrated, and the phylogenetic dynamics and transmission history of CV-B3 have not been well summarized. Coxsackievirus B3 (CV-B3), which belongs to the genus Enterovirus and family Picornaviridae, is an important pathogen that causes several infectious diseases, ranging from a mild febrile syndrome or respiratory illness to aseptic meningitis, myocarditis, and encephalitis [1, 2]. Several studies have shown that CV-B3 is associated more with aseptic meningitis, myocarditis, and mild flu-like illness, while only a few studies definitely demonstrated the association between CV-B3 and hand, foot, and mouth disease (HFMD); these did not help us clearly understand the epidemiological characteristics to prevent this disease. This study aimed at overcoming the limitations of previous studies by providing a clear interpretation
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