Etiology of hand foot and mouth disease and molecular epidemiology of enterovirus 71 in Hangzhou, 2011-2012

Objective To understand the etiological characteristics of hand foot and mouth disease (HFMD) and the molecular epidemiological characteristics of enterovirus 71 (EV71) in Hangzhou. Methods Stool specimens and related clinical data were collected from 210 suspected HFMD cases. Real-time RT-PCR was conducted to detect EV71 and coxsackie virus A16 (Cox A16). The positive specimens were used for VP1 gene sequencing. Results The real-time RT-PCR assay indicated that the positive rates of EV71, Cox A16 and other enterovirus in 210 specimens from suspected HFMD cases were 60.95% (128/210), 21.43% (45/210) and 9.05% (19/210) respectively. The sequence analysis showed that the VP1 gene of 10 EV71 strains shared homology of 95.7%-98.0% with JX509922, JX509924, JX509926, JX509927, JX509928 and JX509929 strains. The phylogenetic analysis revealed that 10 EV71 strains belonged to subtype C4a. Conclusion EV71 and Cox A16 were the major pathogens of HFMD in Hangzhou. It is necessary to improve the surveillance of EV71 and Cox A16, especially EV71, for the better prevention and control of HFMD.