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Newly emerged enterovirus-A71 C4 sublineage may be more virulent than B5 in the 2015–2016 hand-foot-and-mouth disease outbreak in northern Vietnam

[2020.01.13, Mon 11:03] The virulence of EV-A71 strains was examined in human scavenger receptor class B2-transgenic mice, and EV-A71 C4 strains exhibited higher mortality than B5 strains. A phylogenetic analysis based on the complete VP1 gene showed that 104 strains belonged to subgenotype B5 and 8 belonged to subgenotype C4. Seven of the eight C4 strains were isolated in 2016. Recombination analysis of EV-A71 strains 16NHP436 and 16NHP442 isolated in northern Vietnam in 2016. To experimentally assess the virulence of the virus strains, 19 EV-A71 B5 strains and 8 C4 strains were inoculated into hSCARB2-tg mice. It might be possible to identify more suitable candidate vaccine strains among the newly emerged EV-A71 C4a strains, especially for developing live attenuated vaccines. Thus, further study is necessary to isolate more EV-A71 C4 strains and assess their virulence in hSCARB2-tg mice compared to B5 strains. The newly emerged C4a-lineage may be more virulent than the B5 strain that circulated in the 2015-2016 HFMD outbreak.
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