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      An outbreak of hand, foot, and mouth disease associated with subgenotype C4 of human enterovirus 71 in Shandong, China

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          Abstract

          An outbreak of hand, foot, and mouth disease (HFMD) included 1149 people in Linyi City, Shandong Province, China, in 2007: three children died. To characterize the pathogens responsible for this outbreak and to analyze their genetic features. A total of 233 clinical specimens were collected from 105 hospitalized patients, including 11 patients with severe HFMD. Virological investigations (direct RT-PCR, viral isolation and molecular identification) and phylogenetic analysis were performed. Human enterovirus 71 (HEV71) was the main pathogen that caused this outbreak, based on clinical manifestations, epidemiological data, and laboratory results. Phylogenetic analysis indicated that the Shandong HEV71 isolates belonged to 3 lineages in subgenotype C4. Subgenotype C4 could be further divided into two clusters (C4a and C4b), which corresponded to two time periods. Cluster C4a HEV71 has been the predominant virus circulating in mainland China in the past 5 years. The 2007 HFMD outbreak was mainly caused by HEV71 subgenotype C4 with 3 transmission chains. This virus has been continuously circulating in China since 1998. The Shandong strains co-evolved with isolates from other provinces in mainland China and neighboring countries.

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          Author and article information

          Journal
          Journal of Clinical Virology
          Journal of Clinical Virology
          Elsevier BV
          13866532
          April 2009
          April 2009
          : 44
          : 4
          : 262-267
          Article
          10.1016/j.jcv.2009.02.002
          19269888
          a8f3b23f-40ba-4898-9211-f5c5e1791d82
          © 2009

          https://www.elsevier.com/tdm/userlicense/1.0/

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