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Furthermore, the year-round isolation and circulation of multiple independent genetic lineages of HEV71 (36 ) suggest that this virus circulates endemically within the human population of southern Vietnam.
These results indicate circulation of multiple descendants of MLST ST1 lineage in multiple provinces in southern Vietnam.
DHF is seen in 27% of the cases with low severity despite the circulation of multiple serotypes.
Our results indicate that H9N2 viruses have undergone extensive reassortments to generate multiple reassortants and genotypes, suggesting that the continued circulation of multiple genotypical H9N2 viruses throughout the world in diverse hosts has the potential to cause future influenza outbreaks in poultry and epidemics in humans.
All of these observations suggest that the similarities of PDV/USA2006 to the 1988 virus may be due to circulation of multiple lineages.
The circulation of multiple divergent hemagglutinin lineages challenges the design of effective cross-protective vaccines and highlights the need for additional surveillance.
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HCV transmission is closely associated with injection drug use (IDU), and co-circulation of multiple subtypes has been found among injection drug users (IDUs) in China.
Additionally, a major challenge in selecting appropriate swine IAV vaccine strains is the co-circulation of multiple lineages of viruses in the same region, requiring multivalent or broadly cross-reacting antigens.
Co-circulation of multiple serotypes is now being commonly reported [36] [37] and might be responsible for the increase in occurrence of DHF.
The increased diversity early in the epidemic was likely related to the co-circulation of multiple clades, and the reduced diversity during the peak period of the epidemic was related to the clonal expansion of one dominant clade.
One reason that may underlie this difference is the weaker antigenic drift in H1N1, associated with co-circulation of multiple H1N1 lineages and weaker H1N1 bottleneck effects between seasons compared to those of H3N2 [24], [24].
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