Genetic characterization of human coxsackievirus A6 variants associated with atypical hand, foot and mouth disease: a potential role of recombination in emergence and pathogenicity.
Bottom Line: Until recently, CVA6 infections were considered as being of minor clinical significance, and only rarely aetiologically linked with hand, foot and mouth disease (HFMD) associated with other species A enteroviruses (particularly EV71 and CVA16).From 2008 onwards, however, CVA6 infections have been associated with several outbreaks worldwide of atypical HFMD (aHFMD) accompanied by a varicelliform rash.These observations provided evidence that NS gene regions may potentially contribute to clinical phenotypes and outcomes of CVA6 infection.
Affiliation: Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh EH25 9RG, UK.Show MeSH
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Mentions: To investigate when recombination groups of CVA6 first appeared, sequences from the VP1 region were analysed by Markov chain Monte Carlo (MCMC) analysis using sample dates to reconstruct a temporal phylogeny (Fig. 4). The substitution rate of CVA6 VP1 sequences was estimated at 4.2×10−3 substitutions site−1 year−1 (2.8–5.8×10−3 highest posterior density interval), comparable with that of EV71 and other species A serotypes in previous analyses (Lukashev et al., 2014; McWilliam Leitch et al., 2009). Substitution rates were relatively uniformly distributed amongst different lineages in the VP1 tree (Fig. S2).
Affiliation: Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh EH25 9RG, UK.