A Different Epidemiology of Enterovirus A and Enterovirus B Co-circulating in Korea, 2012–2019

2020 ◽  
Author(s):  
Hae Ji Kang ◽  
Youngsil Yoon ◽  
Young-Pyo Lee ◽  
Hye-Jin Kim ◽  
Deog-Yong Lee ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Virus Detection ◽  
Foot And Mouth Disease ◽  
Echovirus 30 ◽  
Health Measures ◽  
Coxsackievirus A6 ◽  
Polymerase Chain ◽  
Respiratory Specimens

Abstract Background Enteroviruses (EVs) occur frequently worldwide and are known to be associated with a broad spectrum of clinical manifestations from mild syndromes to neurological disease. To understand the epidemiology of EV in Korea, we characterized EV-infected cases during 2012–2019 based on national surveillance. Methods We collected specimens from patients with suspected EV infections and analyzed the data using real-time reverse-transcription polymerase chain reaction and VP1 gene sequencing. Results Among the 18 261 specimens collected, EVs were detected in 6258 (34.3%) cases. Although the most common EV types changed annually, EV-A71, echovirus 30, coxsackievirus B5, coxsackievirus A6, and coxsackievirus A10 were commonly identified. Among the human EVs, the case numbers associated with the 2 major epidemic species (EV-A and EV-B) peaked in the summer. While EV-A species affected 1-year-old children and were associated with herpangina and hand, foot, and mouth disease, EV-B species were mostly associated with neurologic manifestations. The highest incidence of EV-B species was observed in infants aged <12 months. Feces and respiratory specimens were the most predictive of EV infection. Specimens collected within 5 days of symptom onset allowed for timely virus detection. Conclusions EV-A and EV-B species co-circulating in Korea presented different epidemiologic trends in clinical presentation, affected subjects, and seasonality trends. This study could provide information for the characterization of EVs circulating in Korea to aid the development of EV antivirals and vaccines, as well as public health measures to control enteroviral diseases.

scholarly journals Characterization of oral virome and microbiome revealed distinctive microbiome disruptions in paediatric patients with hand, foot and mouth disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Si Xian Ho ◽  
Nyo Min ◽  
Emmerie Phaik Yen Wong ◽  
Chia Yin Chong ◽  
Justin Jang Hann Chu
Keyword(s):  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Human Microbiome ◽  
Foot And Mouth Disease ◽  
Critical Factor ◽  
Mouth Disease ◽  
Oral Microbiome ◽  
Coxsackievirus A6 ◽  
Foot And Mouth

AbstractWhile the underlying determinants are unclear, hand, foot and mouth disease (HFMD) presents a wide spectrum of clinical manifestations with varying severity in different individuals. Recently, many studies identified the human microbiome as a critical factor in the pathogenesis of various diseases. Therefore, we here investigated the ecological dynamics of the oral microbiome changes during the HFMD infection. After targeted enrichment of all known vertebrate viruses, the virome profiles of symptomatic and asymptomatic HFMD patients were examined and revealed to be significantly altered from those of healthy individuals, with nine discriminative viruses detected. Further characterization of the prokaryotic microbiome revealed an elevated level of Streptococcus sp. as the most important signature of the symptomatic HFMD cohort, positively correlating to the level of enterovirus A RNA. In addition, we found that while coxsackievirus A5 is detected in saliva RNA of all asymptomatic cases, coxsackievirus A6 dominates the majority of the symptomatic cohort.

scholarly journals Genetic recombination in fast-spreading coxsackievirus A6 variants: a potential role in evolution and pathogenicity

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Yang Song ◽  
Yong Zhang ◽  
Zhenzhi Han ◽  
Wen Xu ◽  
Jinbo Xiao ◽  
...  
Keyword(s):  
Large Scale ◽  
Genetic Recombination ◽  
Mainland China ◽  
Clinical Manifestations ◽  
Foot And Mouth Disease ◽  
Capsid Gene ◽  
Global Epidemic ◽  
Public Health Burden ◽  
Coxsackievirus A6 ◽  
Fast Spreading

Abstract Hand, foot, and mouth disease (HFMD) is a common global epidemic. From 2008 onwards, many HFMD outbreaks caused by coxsackievirus A6 (CV-A6) have been reported worldwide. Since 2013, with a dramatically increasing number of CV-A6-related HFMD cases, CV-A6 has become the predominant HFMD pathogen in mainland China. Phylogenetic analysis based on the VP1 capsid gene revealed that subtype D3 dominated the CV-A6 outbreaks. Here, we performed a large-scale (near) full-length genetic analysis of global and Chinese CV-A6 variants, including 158 newly sequenced samples collected extensively in mainland China between 2010 and 2018. During the global transmission of subtype D3 of CV-A6, the noncapsid gene continued recombining, giving rise to a series of viable recombinant hybrids designated evolutionary lineages, and each lineage displayed internal consistency in both genetic and epidemiological features. The emergence of lineage –A since 2005 has triggered CV-A6 outbreaks worldwide, with a rate of evolution estimated at 4.17 × 10−3 substitutions site-1 year−1 based on a large number of monophyletic open reading frame sequences, and created a series of lineages chronologically through varied noncapsid recombination events. In mainland China, lineage –A has generated another two novel widespread lineages (–J and –L) through recombination within the enterovirus A gene pool, with robust estimates of occurrence time. Lineage –A, –J, and –L infections presented dissimilar clinical manifestations, indicating that the conservation of the CV-A6 capsid gene resulted in high transmissibility, but the lineage-specific noncapsid gene might influence pathogenicity. Potentially important amino acid substitutions were further predicted among CV-A6 variants. The evolutionary phenomenon of noncapsid polymorphism within the same subtype observed in CV-A6 was uncommon in other leading HFMD pathogens; such frequent recombination happened in fast-spreading CV-A6, indicating that the recovery of deleterious genomes may still be ongoing within CV-A6 quasispecies. CV-A6-related HFMD outbreaks have caused a significant public health burden and pose a great threat to children’s health; therefore, further surveillance is greatly needed to understand the full genetic diversity of CV-A6 in mainland China.

scholarly journals Clinical Manifestations of Coxsackievirus A6 Infection Associated with a Major Outbreak of Hand, Foot, and Mouth Disease in Japan

2013 ◽  
Vol 66 (3) ◽  
pp. 260-261 ◽  
Author(s):  
Masaaki Kobayashi ◽  
Tomohiko Makino ◽  
Nozomu Hanaoka ◽  
Hiroyuki Shimizu ◽  
Miki Enomoto ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Coxsackievirus A6 ◽  
Foot And Mouth ◽  
Major Outbreak

Mucormycosis: Early Identification of a Deadly Fungus

2018 ◽  
Vol 35 (4) ◽  
pp. 257-266
Author(s):  
Ariel M. Brettholz ◽  
Sabrina Opiola Mccauley
Keyword(s):  
Risk Factors ◽  
Patient Outcomes ◽  
Pediatric Oncology ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Management Strategies ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Patients With Cancer ◽  
Polymerase Chain

Mucormycosis is a rare invasive fungal infection that affects immunocompromised patients and is fatal when not identified and treated early. Diagnosis is often delayed as the symptoms are nonspecific and frequently mimic other common diseases. Pediatric patients with cancer are at risk for the infection; however, there is limited research that applies directly to the pediatric population. An understanding of the risk factors and clinical presentation of mucormycosis is crucial for the pediatric oncology provider to initiate the workup and provide prompt treatment. The gold standard for diagnosing mucormycosis is biopsy; however, the use of polymerase chain reaction is a novel tool that is being investigated. The mainstays of treatment are antifungal medications, surgery, and reversal of predisposing risk factors, although, new therapies are also emerging. This article will review the pathophysiology, clinical manifestations, and diagnostics of mucormycosis and will discuss current treatment and management strategies for the pediatric oncology clinician to allow for timely diagnosis and intervention to optimize patient outcomes.

ENTEROVIRUS INFECTION: OVERVIEW OF THE CURRENT GLOBAL SITUATION IN THE CONTEXT OF INTENSIFIED MIGRATION FLOWS

2018 ◽  
pp. 55-60
Author(s):  
L.V. Butakova ◽  
O.E. Trotsenko ◽  
E.Yu. Sapega
Keyword(s):  
Molecular Genetic ◽  
Clinical Manifestations ◽  
Foot And Mouth Disease ◽  
Scientific Data ◽  
Enterovirus Infection ◽  
Coxsackievirus A6 ◽  
Golden Standard ◽  
Enterovirus D68 ◽  
Genetic Techniques ◽  
Migration Flows

The review presents data on epidemiological risks concerning worldwide spread of enterovirus infection due to intensified migration flows. Outbreak incidence of the most frequently registered forms of enterovirus infection – hand, foot and mouth disease (HFMD) –was analyzed. At the present time, Coxsackievirus A6 plays ever-greater significance in HFMD incidence. The article summarizes currently available scientific data on atypical Coxsackievirus A6-infection clinical manifestations. Details on the tense epidemiological situation concerning Enterovirus D68 that can be the cause of acute flaccid paralysis/myelitis are presented. According to latest recommendations, the molecular genetic techniques are the «golden standard» in diagnostics of enterovirus infection.

scholarly journals Isolation and molecular characterization of coxsackievirus A6 and coxsackievirus A16 from a case of recurrent Hand, Foot and Mouth Disease in Mumbai, Maharashtra, India, 2018

VirusDisease ◽  
2020 ◽  
Vol 31 (1) ◽  
pp. 56-60
Author(s):  
Vinay K. Saxena ◽  
Shailesh D. Pawar ◽  
Tarique H. I. H. Qureshi ◽  
Priyanka Surve ◽  
Pragya Yadav ◽  
...  
Keyword(s):  
Molecular Characterization ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Coxsackievirus A16 ◽  
Coxsackievirus A6 ◽  
Foot And Mouth

scholarly journals Tuberculosis in Birds: Insights into theMycobacterium aviumInfections

2011 ◽  
Vol 2011 ◽  
pp. 1-14 ◽  
Author(s):  
Kuldeep Dhama ◽  
Mahesh Mahendran ◽  
Ruchi Tiwari ◽  
Shambhu Dayal Singh ◽  
Deepak Kumar ◽  
...  
Keyword(s):  
Animal Health ◽  
Clinical Manifestations ◽  
Tuberculin Test ◽  
Rapid Identification ◽  
Molecular Techniques ◽  
Human Beings ◽  
Pet Birds ◽  
Polymerase Chain ◽  
World Organization

Tuberculosis, a List B disease of World Organization for Animal Health, caused byM. aviumorM. genavensepredominantly affects poultry and pet or captive birds. Clinical manifestations in birds include emaciation, depression and diarrhea along with marked atrophy of breast muscle. Unlike tuberculosis in animals and man, lesions in lungs are rare. Tubercular nodules can be seen in liver, spleen, intestine and bone marrow. Granulomatous lesion without calcification is a prominent feature. The disease is a rarity in organized poultry sector due to improved farm practices, but occurs in zoo aviaries. Molecular techniques like polymerase chain reaction combined with restriction fragment length polymorphism and gene probes aid in rapid identification and characterization of mycobacteria subspecies, and overcome disadvantages of conventional methods which are slow, labour intensive and may at times fail to produce precise results.M. avium subsp. aviumwith genotypeIS901+ andIS1245+ causes infections in animals and human beings too. The bacterium causes sensitivity in cattle to the tuberculin test. The paper discusses in brief theM. aviuminfection in birds, its importance in a zoonotic perspective, and outlines conventional and novel strategies for its diagnosis, prevention and eradication in domestic/pet birds and humans alike.

scholarly journals Neonatal hand, foot, and mouth disease due to Coxsackievirus A6 in Shanghai

2020 ◽  
Author(s):  
Shanshan Xu ◽  
Huajun Li ◽  
Peng Qiao ◽  
Guofeng Xu ◽  
Dongying Zhao ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
White Blood Cells ◽  
Clinical Manifestations ◽  
Foot And Mouth Disease ◽  
Nonparametric Test ◽  
Peripheral Blood Lymphocytes ◽  
Mouth Disease ◽  
Logistic Analysis ◽  
Coxsackievirus A6 ◽  
Foot And Mouth

Abstract Background: Evidence of hand, foot, and mouth disease (HFMD) in neonates is limited. The aim of this study was to evaluate the clinical symptoms, pathogens, possible transmission routes, and prognosis of neonatal HFMD in Shanghai. Methods: This was a case-control study based on the HFMD registry surveillance system. All neonates and infected family members were enrolled between 2016 and 2017 in Shanghai. Neonates with HFMD were followed for at least half a year. Detailed questionnaires, medical history, and physical examination were recorded. Routine blood examination, liver and renal function, immunophenotypes of peripheral blood lymphocytes (CD3, CD4, and CD8 T-cells; NK cells), immunoglobulin (Ig) M, IgG, and IgA, and cytokine interleukin (IL-1β, IL-2R, IL-6, IL-8, IL-10, and TNF-α) levels were measured. All rectal swab specimens were collected and genotyped for enterovirus, and phylogenetic analysis based on the VP1 sequences of coxsackievirus A6 (CV-A6) was performed to investigate molecular and evolutionary characteristics. T-test or nonparametric test was used to evaluate the differences. Logistic analysis was applied to calculate the risk of clinical manifestations in the group of HFMD neonates and their paired siblings. Results: There were 16 neonates among the 12608 diagnosed patients with HFMD, accounting for 0.13%. All neonatal infections were transmitted by other members of the family, mainly the elder siblings, and were caused by CV-A6. CV-A6 was the emerging and predominant causative agent of HFMD in Shanghai. None of the neonates with HFMD experienced fever, onychomadesis, or severe complications. However, two elder sibling patients showed lethargy, and one developed hypoperfusion. In the elder siblings with HFMD, the proportion of white blood cells was generally higher than in neonates with HFMD. The immunologic function of the neonates with HFMD was basically normal. The levels of inflammatory markers were higher in both neonates and elder siblings with HFMD compared to age-matched controls. The clinical symptoms receded about one week after onset. None of the neonates had sequelae. Conclusions: In our study, CV-A6 infection in neonates was benign, but had the character of family clustering. Due to the two-child policy in China, elder siblings may be the main route of HFMD transmission.

scholarly journals Molecular characterization of field isolates of Avian Infectious Laryngeotracheitis Virus from different farms in Iraq

2017 ◽  
Vol 40 (2) ◽  
pp. 31-35
Author(s):  
Aida Bara Allawe
Keyword(s):  
Polymerase Chain Reaction ◽  
Positive Result ◽  
Real Time ◽  
Virus Detection ◽  
Chain Reaction ◽  
Glycoprotein G ◽  
Polymerase Chain ◽  
Labeled Probe ◽  
First Time

     This study was conducted to detect virulent isolates of avian infectious laryngeotracheitis virus in Iraq by Real Time-Polymerase Chain Reaction with the amplification of glycoprotein G gene which is responsible for virulence of the virus. Seventy samples (larynx and trachea) were collected from different farms in Iraq to investigate presence of avian infectious laryngeotracheitis virus (detection of virulent isolates from other vaccine strains). Five samples out of seventy samples were virulent isolates (positive result) by using Real Time-Polymerase Chain Reaction utilizing flurescein amidite labeled probe specific for detection of isolates that have G gene (by amplification of G gene) for the first time in Iraq. These virulent isolates were negative by using Real Time-Polymerase Chain Reaction utilizing Quasar-labeled probe specific for the detection of attenuated isolates that lack G gene and targeted a region within glycoprotein J downstream from the sequence of glycoprotein G.

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