Epidemiology of Hand, Foot, and Mouth Disease and Genetic Characterization of Coxsackievirus A16 in Shenyang, Liaoning Province, China, 2013-2023.

By comparing the distributions of sub-genogroups B1a and B1b across years, we can observe a clear trend of turnover.

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Since 2016, with the launch and application of the EV-A71 inactive vaccine, the prevalence of EV-A71 has shown a decreasing trend, and the pathogen spectrum of HFMD has undergone significant changes; CVA6 has gradually become the main pathogen of HFMD [ 15 , 16 ].

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