First detection of multiple cases related to CV-A16 strain of B1c clade in Beijing in 2022

Zhichao Liang1, Changying Lin1, Da Huo1

  • 1Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China.

PubMed

Insights

Coxsackievirus A16 (CV-A16) clade B1c infections, previously unreported in Beijing, emerged in 2022. These hand, foot, and mouth disease cases in Shunyi District were linked to an Indian strain, necessitating enhanced surveillance.

Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Coxsackievirus A16 (CV-A16) is a major cause of hand, foot, and mouth disease (HFMD) and herpangina (HA), potentially leading to severe neurological complications.
  • CV-A16 clades B1a and B1b circulated in Beijing from 2019-2021.
  • Clade B1c infections had not been previously reported in Beijing.

Purpose of the Study:

  • To investigate the emergence and characteristics of CV-A16 B1c clade infections in Beijing.
  • To analyze the genetic relatedness and identify unique mutations of the circulating CV-A16 B1c strains.

Main Methods:

  • Retrospective analysis of 400 HFMD and 493 HA cases from Beijing's surveillance system (2019-2022).
  • Real-time RT-PCR for enterovirus detection.
  • Full-length VP1 gene and whole-genome sequencing for CV-A16 positive cases.
  • Phylogenetic analysis and comparative sequence analysis.

Main Results:

  • CV-A16 was detected in 18.89% of enterovirus-positive cases.
  • Clades B1a, B1b, and B1c were identified in 14, 3, and 5 cases, respectively.
  • A cluster of five CV-A16 B1c cases occurred in Shunyi District in mid-2022, genetically linked to a 2018 Indian strain with over 98% sequence similarity.
  • Three unique amino acid variations (P3S, V25A, I235V) were identified in the B1c strains.

Conclusions:

  • The 2022 Shunyi District cases represent the first spatiotemporally correlated CV-A16 B1c clade infections in Beijing.
  • These findings highlight the need for increased surveillance of CV-A16 B1c in HFMD and HA cases in the region.
  • Genetic analysis revealed potential adaptations in the emerging B1c strains.

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