Evidence map›Paper›PMID 40006974›Full record

ArticleViruses2025

The Emergence of Coxsackievirus A16 Subgenotype B1c: A Key Driver of the Hand, Foot, and Mouth Disease Epidemic in Guangdong, China.

Huiling Zeng, Biao Zeng, Lina Yi, Lin Qu, Jiadian Cao, Fen Yang, Haiyi Yang, Chunyan Xie, Yuxi Yan, Wenwen Deng and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Viruses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Huiling ZengSchool of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China.
Biao ZengGuangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.ORCID 0009-0002-8507-9944
Lina YiGuangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Lin QuGuangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.ORCID 0000-0001-5957-2132
Jiadian CaoGuangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.ORCID 0009-0004-5433-0993
Fen YangGuangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Haiyi YangGuangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Chunyan XieGuangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Yuxi YanGuangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Wenwen DengGuangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Shuling LiSchool of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China.
Yingtao ZhangGuangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Baisheng LiGuangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Jing LuSchool of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China.
Hanri ZengGuangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.

Funding

the Guangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response 2023B1212010010the Natural Science Foundation of Guangdong Province 2023A1515011927
6 · The paper itself

Abstract

backgroundIn 2024, mainland China witnessed a significant upsurge in Hand, Foot, and Mouth Disease (HFMD) cases. Coxsackievirus A16 (CVA16) is one of the primary causative agents of HFMD. Long-term monitoring of theCVA16 infection rate and genotype changes is crucial for the prevention and control of HFMD.

methodsA total of 40,673 clinical specimens were collected from suspected HFMD cases in Guangdong province from 2018 to 2024, including rectal swabs (n = 27,954), throat swabs (n = 6791), stool (n = 5923), cerebrospinal fluid (n = 3), and herpes fluid (n = 2). A total of 24,410 samples were detected as EV-positive and further typed by RT-PCR. A total of 872 CVA16-positive samples were isolated and further sequenced to obtain the full-length VP1 sequence. Phylogenetic analysis was performed based on viral protein 1 gene (VP1).

resultsIn the first 25 weeks of 2024, reported cases of HFMD were 1.36 times higher than the mean rates of 2023. In 2024, CVA16 predominated at 75.42%, contrasting with the past etiological pattern in which the CVA6 was predominant with the detection rate ranging from 32.85 to 77.61% from 2019 to 2023. Phylogenetic analysis based on the VP1 gene revealed that the B1a and B1b subtypes co-circulated in Guangdong from 2018 to 2022. The B1c outbreak clade, detected in Guangdong in 2023, constituted 68.24% of the 148 strains of CVA16 collected in 2024, suggesting a subtype shift in the CVA16 virus. There were three specific amino acid variations (P3S, I235V, and T240A) in the VP1 sequence of B1c.

conclusionsThe new emergence of the CVA16 B1c outbreak clade in Guangdong during 2023-2024 highlights the necessity for the enhanced surveillance of the virus evolution epidemiological dynamic in this region. Furthermore, it is imperative to closely monitor the etiological pattern changes in Hand, Foot, and Mouth Disease (HFMD) in other regions as well. Such vigilance will be instrumental in guiding future vaccination strategies for HFMD.

Indexed as

EnterovirusHand, Foot and Mouth DiseaseChildChild, PreschoolChinaEpidemicsFemaleGenotypeHumansInfantMalePhylogenyB1c cladecoxsackievirus A16evolution of genotypeHFMD

Identifiers

PMID40006974
PMCPMC11860377

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