Sporadic Hand, Foot and Mouth Disease Cases Associated With Non-C4 Enterovirus 71 Strain in Xiamen, China From 2009-2018

Abstract EV71 has caused large HFMD epidemics among young children and EV71 infection was the leading cause of severe cases and deaths. In mainland China, almost all EV71 strains were segregated into C4 sub-genotype and prevalence of non-C4 EV71 strains was still unclear in mainland China. This study aimed to comprehensively report this in Xiamen. 5’UTR and VP1 Sequences of the strains were amplified by RT-nested-PCR and then sequenced. 32 non-C4 EV71 strains were identified in Xiamen during the study. This study would provide important information for related fields and provide new insights of EV71 strains in China.