An imported Genotype D Coxsackievirus B4 Strain Identified in Tianjin, China

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Hand, foot, and mouth disease (HFMD) is an infectious disease caused by various enterovirus (EV) serotypes and occurs in infants and children across the world. The mild symptoms of HFMD include fever and a maculopapular rash on the hands, feet, mouth, and buttocks. However, in some patients, this infection causes severe neurological syndromes and even death. EVs belong to the Enterovirus genus (family Picornaviridae, order Picornavirales), of which there are 15 species: Enterovirus A (EV-A), EV-B, EV-C, EV-D, EV-E, EV-F, EV-G, EV-H, EV-I, EV-J, EV-K, EV-L, Rhinovirus A, Rhinovirus B, and Rhinovirus C. Since the 2008 outbreaks, enterovirus 71 (EV-A71) and coxsackievirus A16 (CVA16) have been considered to be the two major HFMD pathogens in China[1]. Nevertheless, other prevalent EV serotypes have caused large-scale outbreaks (e.g., CVA4, CVA6, CVA10, and Echovirus 11). Therefore, increasing attention has recently shifted to other EV-A and EV-B pathogens to determine the spectrum of HFMD-causing pathogens besides the major causative ones.
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