Hand, Foot and Mouth Disease Outbreak and Coxsackievirus A6, Northern Spain, 2011
Milagrosa Montes, Juncal Artieda, Luis D. Piñeiro, Marina Gastesi, Inmaculada Diez-Nieves, and Gustavo Cilla
Author affiliations: Author affiliations: Hospital Universitario Donostia-Instituto Biodonostia, San Sebastián, Spain (M. Montes, L.D. Piñeiro, G. Cilla); Biomedical Research Centre Network for Respiratory Diseases, San Sebastián (M. Montes, G. Cilla); Public Health Division of Gipuzkoa, Basque Government, San Sebastián (J. Artieda); Research Centre Network for Epidemiology and Public Health, San Sebastián (J. Artieda); Health Centre of Osakidetza Basque Health Service, Irun, Spain (M. Gastesi, I. Diez-Nieves)
Figure. . . . Phylogenetic analysis of the partial viral protein 1 gene sequence (positions 2929–3348, based on strain Shizuoka-18, GenBank accession no. AB678778) of coxsackievirus A6 isolated from distinct patients with hand, foot, and mouth disease detected in Irun, Spain, April–September 2011, compared with the Gdula prototype strain and other representative strains. Black dots indicate the strains in this study (GenBank accession nos. JX845228–JX845243 and KC431245–431253). The tree was constructed by using the neighbor-joining method with 1,000 bootstrap replications and shows bootstrap values >75%. Genetic distances are based on pairwise analysis by using the Kimura 2-parameter method in MEGA5.1 software (www.megasoftware.net). Bracket indicates strains showing nucleotide identity >94% and detected in outbreaks during 2008–2011. Scale bar indicates the number of substitutions per nucleotide position.
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.