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Volume 32, Number 4—April 2026

Dispatch

Cardiomyopathy Caused by Coxsackievirus Strain A9 in Previously Healthy Child, Northeastern France, 2024

Anne-Laure Lebreil1, Maxime Bisseux1, Audrey Mirand, Marie Glenet, Yohan N’Guyen, Norhan Taha, Pierre Mauran, Cecile Henquell, and Laurent AndreolettiComments to Author 
Author affiliation: INSERM UMR-S 1320, University of Reims Champagne-Ardenne, Reims, France (A.-L. Lebreil, M. Glenet, Y. N’Guyen, L. Andreoletti); National Reference Center for Enteroviruses and Parechoviruses, CHU Clermont-Ferrand, Clermont-Ferrand, France (M. Bisseux, A. Mirand, C. Henquell); UMR CNRS 6023, Université Clermont Auvergne, Clermont-Ferrand (M. Bisseux, A. Mirand, C. Henquell); University Hospital Centre of Reims, Reims (Y. N’Guyen, L. Andreoletti); American Memorial Hospital, Reims University Hospital, Reims (N. Taha, P. Mauran).

Main Article

Figure 3

Similarity plot of complete CVA9 genome sequences from a pediatric patient with severe inflammatory cardiomyopathy caused by CVA9, northeastern France, 2024, and from GenBank. We generated the plot by using SimPlot version 3.5.1 (https://mybiosoftware.com/simplot-3-5-1-sequence-similarity-plotting.html). We calculated the pairwise nucleotide similarity between the sequence we obtained (GenBank accession no. PX441804) and all other available CVA9 genomes by using a 200-nt sliding window with a step size of 10-nt. We further analyzed regions showing marked decreases in similarity, suggestive of potential recombination events, by using BLAST (https://blast.ncbi.nlm.nih.gov), and the most closely related complete genome sequences for each region were included in the SimPlot analysis. Green indicates CVA9 isolates from France collected in 2024 and red those from 2025. A CVA9 isolate from China (2019) is shown in gray, and a 2022 Russian isolate is shown in orange. Echovirus reference sequences from France are also included: E3 (2024) in purple, E6 (2022) in dark blue, and E11 (2022) in light blue. CVA9, coxsackievirus A9; E, echovirus; VP, viral protein; UTR, untranslated region.

Figure 3. Similarity plot of complete CVA9 genome sequences from a pediatric patient with severe inflammatory cardiomyopathy caused by CVA9, northeastern France, 2024, and from GenBank. We generated the plot by using SimPlot version 3.5.1 (https://mybiosoftware.com/simplot-3-5-1-sequence-similarity-plotting.html). We calculated the pairwise nucleotide similarity between the sequence we obtained (GenBank accession no. PX441804) and all other available CVA9 genomes by using a 200-nt sliding window with a step size of 10-nt. We further analyzed regions showing marked decreases in similarity, suggestive of potential recombination events, by using BLAST (https://blast.ncbi.nlm.nih.gov), and the most closely related complete genome sequences for each region were included in the SimPlot analysis. Green indicates CVA9 isolates from France collected in 2024 and red those from 2025. A CVA9 isolate from China (2019) is shown in gray, and a 2022 Russian isolate is shown in orange. Echovirus reference sequences from France are also included: E3 (2024) in purple, E6 (2022) in dark blue, and E11 (2022) in light blue. CVA9, coxsackievirus A9; E, echovirus; VP, viral protein; UTR, untranslated region.

Main Article

1These authors contributed equally to this article.

Page created: March 12, 2026
Page updated: April 10, 2026
Page reviewed: April 10, 2026
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