Evidence map›Paper›PMID 42399954›Full record

ArticleVirology journal2026

Serotypes distribution characteristic of enterovirus in sewage in Hangzhou, Zhejiang Province from January 2023 to December 2024.

Lingxuan Su, Qiong Ge, Yi Sun, Jian Gao, Changping Xu, Zhen Li, Liming Gong

Abstract read
In one paragraph

Article in Virology journal, 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
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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

7 authors.

Lingxuan SuZhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
Qiong GeZhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
Yi SunZhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
Jian GaoZhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
Changping XuZhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
Zhen LiZhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
Liming GongZhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China. lmgong@cdc.zj.cn.

Funding

General Project of the Zhejiang Provincial Disease Prevention and Control Science and Technology Program 2025JK193Zhejiang Provincial Science and Technology Program for Disease Control and Prevention 2026JKZ020
6 · The paper itself

Abstract

backgroundEnteroviruses (EV) represent a significant public health concern due to their widespread prevalent and ability to cause disease in humans. Due to the limitations of routine surveillance, which primarily only detect clinically symptomatic cases, environment surveillance of urban sewage has emerged as a valuable and complementary strategy for EV surveillance.

methodsA total of 48 sewage samples were collected monthly from two wastewater treatment plants (WWTPs) in Hangzhou, Zhejiang Province from January 2023 to December 2024. Virus isolation and direct next-generation sequencing (NGS) were performed to characterize the EV serotypes profiles in sewage. Reverse transcription polymerase chain reaction (RT-PCR) was used to amplify VP1 gene sequences for molecular epidemiological analysis of EV serotypes.

resultsTen distinct serotypes were isolated and identified from WWTP-QT and sixteen from WWTP-XS via virus isolation. EV-B was the dominant group in both treatment plants, with E3 and E11 representing the most frequently isolated serotypes. Phylogenetic analysis showed that the predominant genotypes in E3 was C6, whereas all E11 included phylogenetic analysis were classified into genotype D5. On the other hand, direct NGS uncovered as many as 108 distinct EV serotypes covering four human-infective species across both WWTPs. CVA4 and CVA6 were the dominant serotypes identified via NGS. Additionally, multiple uncommon serotypes as EV-A76, A89, A90, A92, A114, B74, B79, B98, B101, B106, B107, C96, C99, C113, C116, D70, D94, D111, D120 were detected in sewage.

conclusionEnvironment surveillance is an important tool for monitoring EV circulation in the population. Furthermore, direct NGS can serve as a supplementary tool to the routine virus isolation method, particularly in detecting EV serotype diversity and evolution, and identifying uncommon serotypes.

Indexed as

EnterovirusSerogroupSewageChinaGenotypeHigh-Throughput Nucleotide SequencingHumansPhylogenyWastewaterSewageWastewaterEnterovirusEnvironment surveillanceNext generation sequencingSerotypesSewage

Identifiers

PMID42399954
PMCPMC13602519

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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.