Evidence map›Paper›PMID 42170249›Full record

ArticleChina CDC weekly2026

Genetic Analysis of Coxsackievirus A4 Among Healthy Children - Xizang Autonomous Region, China, 1996-2024.

Kaitao Xiao, Mei Hong, Mengyi Xiao, Fan Li, Kexin Shao, Chenglin Zhu, Lan Yang, Jie Lin, Qin Wang, Cidan Zhuoga and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in China CDC weekly, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Kaitao Xiao *School of Public Health and Health Management, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan City, Shandong Province, China.
Mei Hong *Department of Microbiological Testing, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa City, Xizang Autonomous Region, China.
Mengyi XiaoSchool of Public Health and Health Management, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan City, Shandong Province, China.
Fan LiNational Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.
Kexin ShaoSchool of Public Health and Health Management, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan City, Shandong Province, China.
Chenglin ZhuSchool of Public Health and Health Management, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan City, Shandong Province, China.
Lan YangNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Laboratory for Poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of Microbial Genomics, National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.
Jie LinNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Laboratory for Poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of Microbial Genomics, National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.
Qin WangDepartment of Microbiological Testing, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa City, Xizang Autonomous Region, China.
Cidan ZhuogaDepartment of Microbiological Testing, Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa City, Xizang Autonomous Region, China.
Shuangli ZhuNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Laboratory for Poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of Microbial Genomics, National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.
Dongmei YanNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Laboratory for Poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of Microbial Genomics, National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.
Yong ZhangNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Laboratory for Poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of Microbial Genomics, National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.
Xiaomei LiSchool of Public Health and Health Management, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan City, Shandong Province, China.
Jinbo XiaoNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Laboratory for Poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of Microbial Genomics, National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Coxsackievirus A4 (CVA4) causes several diseases, including hand, foot, and mouth disease (HFMD) and herpangina. This study analyzed CVA4 isolates collected between 1996 and 2024 from the Xizang Autonomous Region to elucidate the phylogenetic characteristics and epidemiological patterns of this virus in high-altitude regions. Methods: VP1 coding region sequences of CVA4 were obtained through virus isolation and Sanger sequencing. MEGA software was used to construct a maximum likelihood phylogenetic tree based on the VP1 region. The BEAST toolkit was used to generate a maximum clade credibility tree and perform phylogeographic analysis. Results: From 2018 onwards, the prevalence of CVA4 among healthy carriers increased significantly, accounting for 62.12% of all detections. Genotyping revealed that most isolates belonged to genotype C, while the remainder were classified as D2. As the dominant genotype, genotype C has spread outward from Xigaze and Lhasa since 2011, leading to multiple asymptomatic infections in Shannan (2020), Xigaze and Lhasa (2023), and Ngari Prefecture (2024). Conclusions: Transmission of CVA4 genotype C among healthy children in high-altitude areas suggests strong environmental adaptability, highlighting the need to strengthen enterovirus surveillance and control, including targeted monitoring of CVA4, in these regions.

Indexed as

Coxsackievirus A4 (CVA4)phylogenetic analysisphylogeographic analysis.Xizang Autonomous Region

Identifiers

PMID42170249
PMCPMC13187658

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