摘要
Hand,foot,and mouth disease(HFMD)is one of the most common class C infectious diseases,posing a seri-ous threat to public health worldwide.Enterovirus A71(EV-A71)and coxsackievirus A16(CV-A16)have been regarded as the major pathogenic agents of HFMD;however,since an outbreak caused by coxsackievirus A6(CV-A6)in France in 2008,CV-A6 has gradually become the predominant pathogen in many regions.CV-A6 infects not only children but also adults,and causes atypical clinical symptoms such as a more generalized rash,eczema herpeticum,high fever,and onychomadesis,which are different from the symptoms associated with EV-A71 and CV-A16.Importantly,the rate of genetic recombination of CV-A6 is high,which can lead to changes in virulence and the rapid evolution of other characteristics,thus posing a serious threat to public health.To date,no specific vaccines or therapeutics have been approved for CV-A6 prevention or treatment,hence it is essential to fully understand the relationship between recombination and evolution of this virus.Here,we systematically review the genetic recombination events of CV-A6 that have occurred worldwide and explore how these events have promoted virus evolution,thus providing important information regarding future HFMD surveillance and prevention.
