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Emerging Coxsackievirus A6 Causing Hand, Foot and Mouth Disease, Vietnam

2018; Centers for Disease Control and Prevention; Volume: 24; Issue: 4 Linguagem: Inglês

10.3201/eid2404.171298

1080-6059

Nguyen To Anh, Le Nguyen Truc Nhu, Hoang Minh Tu Van, Nguyen Thi Thu Hong, Tran Tan Thanh, Vu Thi Ty Hang, Nguyen Thi Han Ny, Lam Anh Nguyet, Tran Thi Lan Phuong, Le Nguyen Thanh Nhan, Nguyễn Thanh Hùng, Truong Huu Khanh, Hà Mạnh Tuấn, Ho Lu Viet, Nguyen Tran Nam, Do Chau Viet, Phan Tu Qui, Bridget Wills, Sarawathy Sabanathan, Nguyễn Văn Vĩnh Châu, Louise Thwaites, H. Rogier van Doorn, Guy Thwaites, Maia A. Rabaa, Le Van Tan,

Viral gastroenteritis research and epidemiology

Abstract Hand, foot and mouth disease (HFMD) is a major public health issue in Asia and has global pandemic potential. Coxsackievirus A6 (CV-A6) was detected in 514/2,230 (23%) of HFMD patients admitted to 3 major hospitals in southern Vietnam during 2011–2015. Of these patients, 93 (18%) had severe HFMD. Phylogenetic analysis of 98 genome sequences revealed they belonged to cluster A and had been circulating in Vietnam for 2 years before emergence. CV-A6 movement among localities within Vietnam occurred frequently, whereas viral movement across international borders appeared rare. Skyline plots identified fluctuations in the relative genetic diversity of CV-A6 corresponding to large CV-A6–associated HFMD outbreaks worldwide. These data show that CV-A6 is an emerging pathogen and emphasize the necessity of active surveillance and understanding the mechanisms that shape the pathogen evolution and emergence, which is essential for development and implementation of intervention strategies.