ArticlePloS one2014
Co-circulation and genomic recombination of coxsackievirus A16 and enterovirus 71 during a large outbreak of hand, foot, and mouth disease in Central China.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
81 citing papers in PubMed, 1 synthesis or guideline pooled it, 129 citations in OpenAlex.
- A systematic review of evidence that enteroviruses may be zoonotic.Emerging microbes & infections · 2018Pooled it
- The compatibility of inactivated-Enterovirus 71 vaccination with Coxsackievirus A16 and Poliovirus immunizations in humans and animals.Human vaccines & immunotherapeutics · 2015Trial
- Surveillance of enterovirus infection and genotypes/subgenotypes of enteroviruses in Dak Lak, Vietnam in 2022-2024.IJID regions · 2026Article
- Molecular evolution and spatial transmission of severe fever with thrombocytopenia syndrome virus.Nature communications · 2026Article
- Effects of the non-pharmaceutical interventions during the COVID-19 epidemic on hand, foot and mouth disease in Qingdao, China.BMC infectious diseases · 2025Article
- Risk Factors for Hand, Foot and Mouth Disease Reinfection in Qingdao, China, from 2014 to 2022.Iranian journal of public health · 2025Article
- Epidemiology and genetic characteristics of coxsackievirus A16 associated with hand-foot-mouth disease in Hangzhou city, Zhejiang province from 2021 to 2024.Frontiers in microbiology · 2025Article
- Visual detection of Coxsackievirus A6 using a reverse transcription polymerase spiral reaction method.Frontiers in cellular and infection microbiology · 2025Article
- Changing Epidemiology of Hand, Foot, and Mouth Disease Causative Agents and Contributing Factors.The American journal of tropical medicine and hygiene · 2024Review
- Global landscape of coxsackieviruses in human health.Virus research · 2024Review
- Rapid detection of four major HFMD-associated enteroviruses by multiplex HiFi-LAMP assays.Analytical and bioanalytical chemistry · 2024Article
- Age-time-specific transmission of hand-foot-and-mouth disease enterovirus serotypes in Vietnam: A catalytic model with maternal immunity.Epidemics · 2024Article
- Seasonal Testing, Results, and Effect of the Pandemic on Coxsackievirus Serum Studies.Microorganisms · 2024Article
- Integrated analysis reveals important differences in the gut and oropharyngeal microbiota between children with mild and severe hand, foot, and mouth disease.Emerging microbes & infections · 2023Article
- In Memory of the Virologist Jianguo Wu, 1957-2022.Viruses · 2023Article
- Seroprevalence of human enterovirus A71 in Guangzhou, China, 2019-2021.Biosafety and health · 2023Article
- Molecular mechanism of antibody neutralization of coxsackievirus A16.Nature communications · 2022Article
- Review
- Genomic surveillance of coxsackievirus A10 reveals genetic features and recent appearance of genogroup D in Shanghai, China, 2016-2020.Virologica Sinica · 2022Article
- Epidemiology of Echovirus 30 Infections Detected in a University Hospital in Catalonia, Spain, in 1995-2020.Microorganisms · 2022Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A total of 1844 patients with hand, foot, and mouth disease (HFMD), most of them were children of age 1-3-year-old, in Central China were hospitalized from 2011 to 2012. Among them, 422 were infected with coxsackievirus A16 (CVA16), 334 were infected with enterovirus 71 (EV71), 38 were co-infected with EV71 and CVA16, and 35 were infected with other enteroviruses. Molecular epidemiology analysis revealed that EV71 and CVA16 were detected year-round, but EV71 circulated mainly in July and CVA16 circulated predominantly in November, and incidence of HFMD was reduced in January and February and increased in March. Clinical data showed that hyperglycemia and neurologic complications were significantly higher in EV71-infected patients, while upper respiratory tract infection and C-reactive protein were significantly higher in CVA16-associated patients. 124 EV71 and 80 CVA16 strains were isolated, among them 56 and 68 EV71 strains were C4a and C4b, while 25 and 55 CVA16 strains were B1a and B1b, respectively. Similarity plots and bootscan analyses based on entire genomic sequences revealed that the three C4a sub-genotype EV71 strains were recombinant with C4b sub-genotype EV71 in 2B-2C region, and the three CVA16 strains were recombinant with EV71 in 2A-2B region. Thus, CVA16 and EV71 were the major causative agents in a large HFMD outbreak in Central China. HFMD incidence was high for children among household contact and was detected year-round, but outbreak was seasonal dependent. CVA16 B1b and EV71 C4b reemerged and caused a large epidemic in China after a quiet period of many years. Moreover, EV71 and CVA16 were co-circulated during the outbreak, which may have contributed to the genomic recombination between the pathogens. It should gain more attention as there may be an upward trend in co-circulation of the two pathogens globally and the new role recombination plays in the emergence of new enterovirus variants.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.