Changing epidemiology of human enteroviruses (HEV) in a hand,foot and mouth disease outbreak in Vellore,south India |
| |
| Authors: | Grace Mary George Hubert Darius-J Daniel Lydia Mathew Dincy Peter Leni George Susanne Pulimood Asha Mary Abraham Shoba Mammen |
| |
| Affiliation: | 1. Department of Clinical Virology, Christian Medical College, Vellore, India;2. Department of Dermatology, Christian Medical College, Vellore, India;1. Department of Microbiology, Jawaharlal Nehru Medical College & Hospital, Ajmer (Rajasthan), India;2. Department of Medical Microbiology, Postgraduate Institution of Medical Education & Research (PGIMER), Chandigarh, India;3. Department of Microbiology, Govt. Medical College & Hospital, Chandigarh, India;4. Department of Microbiology, Shri Ramachandra Institute of Higher Education & Research Institute, Chennai, India;1. Department of Microbiology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry - 605014, India;2. Department of Nephrology, Sri Naryani Hospital and Research Centre, Vellore - 632255, India;3. Department of Nephrology, JIPMER, Pondicherry - 605006, India;4. Department of Microbiology, The Madras Medical Mission, 4-A, Dr, Mogappair, Chennai - 600037, Tamil Nadu, India;5. Department of Nephrology, The Madras Medical Mission, 4-A, Dr, Mogappair, Chennai - 600037, Tamil Nadu, India;1. Department of Microbiology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India;2. Department of Microbiology, MVAS Medical College, Basti, UP, India;1. Eskisehir Osmangazi University, Department of Microbiology, Faculty of Medicine, Eskisehir, Turkey;2. Suleyman Demirel University, Faculty of Pharmacy, Pharmaceutical Microbiology, Isparta, Turkey;1. Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia;2. Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, Offa PMB, 4412, Kwara State, Nigeria;3. Department of Zoology, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria;4. Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150, Kelantan, Malaysia;5. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia;6. Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia;7. Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia |
| |
| Abstract: | PurposeHand Foot and mouth disease (HFMD) is a major childhood exanthematous disease causing outbreaks that have become a major public health threat in recent years. In Vellore district of Tamil Nadu, south India, occasional outbreaks are common among the paediatric age group, most commonly in those under 5years of age (U5s). CoxsackieA6, A4, A5, A9, A10, B2 and B5 are the common serotypes causing outbreaks. This study aimed to identify the molecular serotype of the causative agent, co-circulating in this region.MethodsAdapting the WHO case definition, cases during an HFMD outbreak between October and December 2017, were identified by a clinical criterion of fever, mouth ulcers and rash in the extremities. Vesicle fluid from these lesions were collected in viral transport medium and transported cold to the Clinical Virology laboratory of a tertiary care hospital in Vellore. Identification of the causative agent was undertaken by two real time PCRs (EV1 and EV2) followed by sequencing the VP1–2C region and constructing a phylogenetic tree.ResultsAmong the 31 HFMD patients included in this study, 23 (74.2%) were U5s, 3 (9.7%) were between 6 and 15 years and the remaining 5 (16.1%) were adolescents (>15 ?yrs). The outbreak ran a mild clinical course, with 22(71%) patients having fever as a prodromal symptom. Papulovesicular lesions characteristic of HFMD were present on all 31 (100%) patients’ palms and soles, buttocks of 19 (61.3%), oral mucosa of 12 (38.7%), and all over the body in 4 (12.9%) patients. Coxsackie A6(75%) and Coxsackie A16(25%) were the pathogens associated with this outbreak.ConclusionsChanging epidemiology of HFMD was seen in this outbreak since; other serotypes apart from the classical Coxsackievirus serotypes causing HFMD outbreak were also found co-circulating. EV1 PCR was a better screening assay than EV2 PCR in this region. Continued surveillance and molecular serotyping are necessary for HFMD outbreaks in any region. |
| |
| Keywords: | Hand foot mouth disease Coxsackie A6 Coxsackie A16 Changing epidemiology |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
