Recombinant Human Coxsackievirus B3 from Children with Acute Myocarditis in China

Phylogenetic analysis of these strains was based on the alignment of complete VP1 or VP4 gene sequences. The existence of Bejing0811 and Fuyang19 indicate that recombination events occurred in noncapsid regions between CVB3, CVB5, and ECoV6 strains circulating in mainland China over the past several years, and a distinct, novel evolutionary lineage of CVB3 formed as a result of these recombination events. We noticed significant differences of disease burden among the different EV71-associated diseases (P < 0.001), of which the degree of severe HFMD was the highest while herpangina was the lowest (Table 3). Both Herpangina and HFMD are caused by a virus from the same family, Coxsackie A virus. Extensive surveillance and epidemiological studies will have to be conducted at both the national and international levels and will require standardized reagents and harmonized protocols to monitor the emergence of new serotypes, genetic drifts and antigenic variations. D823A, MiniBEST agarose gel DNA extraction kit version 3.0; TaKaRa, Japan) and sequenced by the ABI PrismTM 3730xl DNA analyzer using the BigDye Terminator version 3.1 cycle sequencing kit (Applied Biosystems). EV71 epidemics that occur cyclically every 2–4 years could be caused by a single genotype/subgenotype; however, the co-circulation of divergent isolates and unpredictable switching of genotypes and subgenotypes are frequently observed (Figure 1). Whether existing commercial HB vaccines could prevent the infection of viral mutant strains; what is the boost strategy for different people and what are the impact factors on HB vaccines’ effects. See “The Model” in S1 Text for mathematical details. As shown in Table 2, EV71 was detected more commonly in the severe cases than in the uncomplicated cases (39.2% (103/263) in the uncomplicated group and 85.2% (109/128) in the severe group (OR: 8.35, P=0.000). and Sanofi Pasteur for studies of influenza vaccine effectiveness, and BJC has consulted for Crucell NV on influenza prevention. EV71 national standards were included in each test as a control for the reproducibility of the results [23]. Do you have any experience on the management of clinic trail to share with us? Blomqvist, S.
Based on the results from the cohort studies together with our results from Thai subjects, we recommend vaccination during the first year of life, particularly when infants are 6 months to 12 months of age. A mixed generalized additive model (MGAM) was used for each of eight cities to derive parameter estimates of the exposure–response associations between meteorological factors and HFDM. The complications involving neurologic, respiratory or circulatory system diseases as a result of HFMD were defined in “A Guide to Clinical Management and Public Health Response for Hand Foot and Mouth Disease (HFMD)” ( It requires the information of every case be submitted to the National Notifiable Disease Reporting System (NNDRS) within 24-hour upon diagnosed. Pairwise nucleotide sequence identities based on each gene were also calculated (Table S4). Also, we feel that the true test of the vaccine’s efficacy would be a documentation of its protective efficiency during an outbreak, during which the infection challenge would likely be more intense. On 2 May 2008, HFMD was defined as a C-class notifiable disease in Mainland China.

Hand, foot, and mouth disease (HFMD) is a common contagious disease among children and occurs worldwide sporadically and in epidemics. However, CVA6 which had been largely ignored, replaced EVA71 and CVA16 as the predominant pathogen for the HFMD epidemic in Guangdong, China in 201322. (2006). Vaccine 2010; 28:3516 – 21;; PMID: 20304038 [CrossRef], [PubMed], [Web of Science ®],15 Liu CC, Guo MS, Lin FH, Hsiao KN, Chang KH, Chou AH, et al. HFMD typically occurs as outbreaks and is characterized by mucocutaneous papulovesicular lesions on the hands, feet, mouth, and buttocks. The frequency of A-C-C haplotype was significantly higher in EV71 infection patients than controls (P = 0.032). Their corresponding sophocarpinic acid (3 and 11a–b) with weaker activities and toxicities gave SI values ranging from 15.6 to 35.5.

Geographic differences in seasonal patterns were weakly associated with climate and demographic factors (variance explained 8-23% and 3–19%, respectively). It has been suggested that if mothers show higher levels of anti-EV71 and/or anti-CoxA16 antibodies, the antibody titers transferred vertically from mothers to their infants are also higher. Fengcai Zhu enrolled 10,245 healthy children aged 6-35 months from four centres (three in Jiangsu, one in Beijing) in China. Lancet Neurology 2010; 9: 1097–1105. Then, Kulldorff scan statistic based on a discrete Poisson model was used to detect spatial-temporal clusters. Hepatitis B vaccination is the most effective measure to control hepatitis epidemic. Author manuscript; available in PMC 2015 November 2.

The striking features of the disease were an initial encephalitic presentation followed by a rapidly fatal destructive alveolar pneumonia, alarming experienced clinicians. The determination of immunoglobulins against specific antigens of EBV is recommended in pediatric patients [15, 17]. Hand-foot-mouth disease (HFMD), one of the more distinctive rash syndromes, is most frequently caused by coxsackievirus A16, but can also be caused by enterovirus 71 (EV71) and other coxsackieviruses.

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