Coxsackievirus A6 on the rise: epidemiology, pathogenicity, evolutionary dynamics, and antiviral strategy

Area of Science:

• Virology
• Public Health
• Epidemiology

Background:

• Coxsackievirus A6 (CVA6) has emerged as the leading cause of hand, foot, and mouth disease (HFMD) globally.
• CVA6 infections are associated with severe and atypical clinical presentations, including neurological complications, complicating diagnosis.
• The virus's continuous evolution through genetic variation and recombination poses challenges for developing effective countermeasures.

Purpose of the Study:

• To systematically review the global epidemiology, pathogenic mechanisms, and evolutionary dynamics of CVA6.
• To examine current diagnostic tools and antiviral strategies for CVA6.
• To inform public health preparedness and guide future research on emerging enterovirus serotypes.

Main Methods:

• Systematic literature review.
• Analysis of global epidemiological data on CVA6.
• Review of studies on CVA6 pathogenesis, evolution, diagnostics, and therapeutics.

Main Results:

• CVA6 has surpassed other enteroviruses in HFMD prevalence worldwide.
• Atypical presentations and neurological complications are frequently reported with CVA6.
• Genetic diversity and recombination in CVA6 contribute to ongoing public health challenges.

Conclusions:

• Enhanced molecular surveillance for CVA6 is crucial due to its evolving nature and diverse clinical manifestations.
• Understanding CVA6 evolution and pathogenesis is vital for developing effective vaccines and antivirals.
• Preparedness for CVA6 outbreaks requires integrated knowledge of its epidemiology, molecular biology, and clinical impact.