Coxsackievirus A6 strains causing an outbreak of hand-foot-and-mouth disease in Northeastern Brazil in 2018

Author(s):Show less -

Adriana Luchs ^[1] ; Lais Sampaio de Azevedo ^[2] ; Ellen Viana de Souza ^[3] ; Roberta Salzone Medeiros ^[4] ; Yasmin França Viana Pires de Souza ^[5] ; Dalane Loudal Florentino Teixeira ^[6] ; Thiago Franco de Oliveira Carneiro ^[7] ; Gabriela Maria Fernandes de Alencar ^[8] ; Fernanda Lúcia de Sousa Leite Morais ^[9] ; Diana de Fátima Alves Pinto ^[10] ; Thelma Suely Okay ; Lidia Yamamoto ^[12] ; Vanessa dos Santos Morais ^[13] ; Emerson Luiz Lima Araújo ^[14] ; Elcio Leal ^[15] ; Antonio Charlys da Costa ^[16]

Affiliation:Show less -

^[1] Instituto Adolfo Lutz. Centro de Virologia. Núcleo de Doenças Entéricas - Brasil

^[2] Instituto Adolfo Lutz. Centro de Virologia. Núcleo de Doenças Entéricas - Brasil

^[3] Instituto Adolfo Lutz. Centro de Virologia. Núcleo de Doenças Entéricas - Brasil

^[4] Instituto Adolfo Lutz. Centro de Virologia. Núcleo de Doenças Entéricas - Brasil

^[5] Instituto Adolfo Lutz. Centro de Virologia. Núcleo de Doenças Entéricas - Brasil

^[6] Estado da Saúde da Paraíba. Laboratório Central de Saúde Pública - Brasil

^[7] Estado da Saúde da Paraíba. Laboratório Central de Saúde Pública - Brasil

^[8] Estado da Saúde da Paraíba. Hospital Infantil Arlinda Marques - Brasil

^[9] Estado da Saúde da Paraíba. Hospital Infantil Arlinda Marques - Brasil

^[10] Estado da Saúde da Paraíba. Centro de Informações Estratégicas em Vigilância em Saúde - Brasil

^[12] Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo - Brasil

^[13] Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo - Brasil

^[14] Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Articulação Estratégica de Vigilância em Saúde - Brasil

^[15] Universidade Federal do Pará. Instituto de Ciências Biológicas - Brasil

^[16] Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo - Brasil

• Document type: Journal article
• Source: Revista do Instituto de Medicina Tropical de São Paulo; v. 64, 2022-02-21.

Abstract

ABSTRACT Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks. (AU)

• FAPESP's process: 20/11182-6 - Molecular epidemiology of G8 rotavirus strains isolated in Brazil associated with P[4], P[6] or P[8] genotypes
• Grantee: Roberta Salzone Medeiros
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 20/02469-0 - Full genotype constellation of five rare G12P[9] rotavirus strains detected in Brazil during 2011-2013
• Grantee: Yasmin França Viana Pires de Souza
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 19/21706-5 - Viral metagenomics of mosquitoes captured in the State of São Paulo
• Grantee: Vanessa dos Santos Morais
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 20/14786-0 - Surveillance and molecular epidemiology of human Bocaviruses associated with acute gastroenteritis
• Grantee: Adriana Luchs
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/00021-9 - Viral metagenomics to track, explain and predict the transmission and spatiotemporal spread of Dengue and Chikungunya viruses in Brazil
• Grantee: Antonio Charlys da Costa
• Support Opportunities: Scholarships in Brazil - Post-Doctoral