Analysis and reflection on the global Enterovirus A popularity trend

Abstract Enteroviruses have been in massive, cyclical epidemics worldwide. Enterovirus A(EVA) is the most common enterovirus causing global infections. An in-depth understanding of the international epidemiological characteristics of EVA is critical to determining its clinical significance and total disease burden. Although much research has been conducted on EVA epidemiology, there is still a lack of a comprehensive overview of EVA epidemiological characteristics and trends worldwide. We analyzed the worldwide prevalence of EVA by year, geographic region, and serotype using EVA nucleic acid sequences provided by NCBI virus databases. The results found that 23041 retrieved nucleic acid sequences with precise collection dates and the geographical region as of December 2021, with Asia accounting for 87%, Europe for 11%, and Africa and the Americas for just 2%. EVA showed different epidemic patterns as time went by, with EV-A71 dominating the overall global epidemic from 2008 to 2012; after 2013, CVA6 replaced EV-A71 as the leading prevalent serotype, but EV-A71 still defeated the EVA isolated in cerebrospinal fluid. In conclusion, it was found that the prevalence of different serotypes of EVA varied considerably in other times and spaces, with EV-A71, CVA6, and CVA16 predominating in Asia, Europe and America. In contrast, the prevalence of EV-A71, CVA4, and CVA16 were higher in Africa. This study will likely provide important clues for prevention, control, and future research in virologic surveillance, disease management, and vaccine development.