Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015

Mirand, Audrey; Sage, F. Vié Le; Pereira, Bruno; Cohen, Robert; Lévy, Corinne; Archimbaud, Christine; Peigue-Lafeuille, H.; Bailly, Jean‐Luc; Henquell, Cécile

doi:10.3201/eid2211.160590

Cited by 66 publications

(59 citation statements)

References 33 publications

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“…Thus, in recent years, CV‐A6 has gradually become the predominant EV serotype causing HFMD globally, showing a peak incidence in every other year, and overtaking EV‐A71. The incidence of CV‐A6 has gradually increased from less than 5% to more than 50% .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the proportion of people who were immunized is increasing, as stimulated by previous large outbreaks of EV-A71 HFMD, which also exhibited a relatively stable serotype and hence a reliably vaccine efficacy. 69 Thus, in recent years, CV-A6 has gradually become the predominant EV serotype causing HFMD globally, [70][71][72][73] showing a peak incidence in every other year, and overtaking EV-A71. The incidence of CV-A6 has gradually increased from less than 5% to more than 50%.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A review and meta‐analysis of the epidemiology and clinical presentation of coxsackievirus A6 causing hand‐foot‐mouth disease in China and global implications

Zhao

Sun

et al. 2019

Reviews in Medical Virology

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Summary Coxsackievirus A6 (CV‐A6) has been associated with increasingly occurred sporadic hand‐foot‐mouth disease (HFMD) cases and outbreak events in many countries. In order to understand epidemiological characteristics of CV‐A6, we collected the information describing HFMD caused by CV‐A6 to describe the detection rate, severe rate and onychomadesis rate, which is defined as one or more nails defluvium, caused by CV‐A6 from 2007 to 2017. The results showed that there was an outbreak of CV‐A6 every other year, and overall trend of the epidemic of CA6‐associated HFMD was increasing in China. The detection rate of CV‐A6 in other countries was 32.0% (95% CI: 25.0%~40.0%) before 2013 and 28.0% (95% CI: 20.0%~36.0%) after 2013, respectively. Although the severe rate of HFMD caused by CV‐A6 was low (0.10%, 95% CI: 0.01%~0.20%), CV‐A6 can cause a high incidence of onychomadesis (28.0%, 95%CI: 21.9%‐34.3%). Thus, it would be worthwhile to research and develop an effective multivalent vaccine for CV‐A6 to achieve a more powerful prevention of HMFD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A review and meta‐analysis of the epidemiology and clinical presentation of coxsackievirus A6 causing hand‐foot‐mouth disease in China and global implications

Zhao

Sun

et al. 2019

Reviews in Medical Virology

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“…However, CV-A6 was not frequently detected in our series (11/210), maybe due to the mildness of the disease that does not require to go to the hospital. A recent French study conducted an ambulatory clinicbased surveillance to report the underestimation of EV detected only in hospitals [27].…”

Section: Discussionmentioning

confidence: 99%

Surveillance of enteroviruses from paediatric patients attended at a tertiary hospital in Catalonia from 2014 to 2017

Andrés

Vila

Gimferrer

et al. 2019

Journal of Clinical Virology

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A B S T R A C TBackground: Enterovirus (EV) infections are usually asymptomatic or mild, but symptomatic infections can evolve to severe complications. Outbreaks of EV-A71 and EV-D68 have been recently reported worldwide, sometimes related to severe clinical outcomes. Objective: To describe EV genetic diversity and the clinical outcomes from paediatric patients attended at a tertiary university hospital in Barcelona (Catalonia, Spain) from 2014 to 2017. Study design: Specimens were collected from paediatric (< 17 years old) cases with suspicion of respiratory tract infection or EV infection. EV laboratory-confirmation was performed by specific real-time multiplex RT-PCR assay. Partial viral VP1 protein was sequenced for genetic characterisation by phylogenetic analyses. Results: A total of 376 (7%) from 5703 cases were EV laboratory-confirmed. Phylogenetic analyses of VP1 (210; 81%) sequences distinguished up to 27 different EV types distributed within EV-A (82; 40%), EV-B (90; 42%), EV-C (5; 2%), and EV-D (33; 15%), in addition to 50 (19%) rhinoviruses. The most predominant were EV-A71 (37; 45%) and EV-D68 (32; 99%). EV-A71 was highly related to neurological complications (25/39, 63%), of which 20/39 were rhombencephalitis, and most EV-D68 (28/32, 88%) were associated with lower respiratory tract infections (LRTI), and exceptionally one (3%) with acute flaccid paralysis. Conclusions: EV-A71 and EV-D68 were the most detected EV in respiratory specimens. EV-A71 was highly related to neurological disease and EV-D68 was often associated with LRTI. However, both potential relatedness to neurological diseases makes the monitoring of EV circulation obligatory.

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“…Her iki formda da (klasik, atipik) hastalık kendisini sınırlayıcı niteliktedir (1,8) . Lezyonlar skar bırakma-dan iyileşmektedir.…”

Section: Discussionunclassified

“…PCR tekniği ile serotip tayini olası olmadı-ğından enterovirüs için PCR pozitif örneklerde nük-leotid sekans yöntemi ile serotip belirlenir (1,8) . Olgumuzda tanı klinik bulgular ve solunum yolunda PCR ile enterovirüs gösterilerek konulmuş, ancak bül sıvısında inceleme ve serotip tayini yapılamamıştır.…”

Section: Discussionunclassified

A case with atypical hand-mouth-foot disease accompanying with onicomadesis and a small-scale outbreak

Kocabaş¹,

Karbuz²,

Doğulu³

et al. 2017

BUCH

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ÖZEl-ayak-ağız hastalığı enterovirüslerden sıklıkla Coxsackievirus A16 ve enterovirüs 71'in neden olduğu bir hastalık olup, toplumda salgınlara yol açabilmektedir. Son zamanlarda klasik el-ayak-ağız hastalığından farklı özellikleri içeren bir atipik form tanımlanmıştır. Bu atipik formda klasik hastalıktan farklı olarak cilt lezyonlarının daha fazla dorsal yüzleri etkilemesi, gövde ve boyunda daha fazla yoğunlaşması, ülse-re ve büllöz formda olması, kabuklanma ile soyulmanın tipik olması ve onikomadezis ile sık birliktelik görülmektedir. Burada, ekzema herpetikum kliniği ile başvuran ve izlemde kısa sürede küçük bir salgına yol açan ve onikomadezis ile iyileşen 17 aylık bir atipik el-ayak-ağız hastalığı olgusu sunulmuştur. Bu olgu sunumu ile ekzema herpetikum ön tanısı ile izlenen ve herpesvirüs için yapılan viral testleri negatif saptanan özellikle 2 yaş altındaki olgularda ayırıcı tanıda atipik enteroviral hastalığın düşünül-mesi vurgulanmak istenmiştir. Atipik hastalık bulgularının iyi bilinmesi gereksiz asiklovir kullanımının önüne geçebilir. Ayrıca koruyucu önlemlerin alınması ile nozokomiyal ve toplumsal salgınların önlenmesi sağlanabilecektir. Anahtar kelimeler: Atipik el-ayak-ağız hastalığı, enterovirüs, ekzema herpetikum, onikomadezis ABSTRACTHand-mouth-foot disease is generally caused by Coxsackievirus A16 and Enterovirus 71, which are subtypes of enteroviruses, and it can lead to outbreaks in the people. Recently, an atypical form of disease has been described which consists of different characteristics from classical form. It differs from the classical form of disease with widespread distribution of vesiculobullous skin lesions on the trunk and neck, high rate of ulcerate and bullous formation, crusted and scabbed lesions and onychomadesis. Herein, we reported a 17-month-old child with atypical hand-foot-mouth disease. He was firstly diagnosed with eczema herpeticum, lead to a small outbreak, and healed with onicomadesis. We pointed out atypical enteroviral diseases in infants especially presented with eczema herpeticum and negative tests for herpesviruses. Unnecessary use of acyclovir could be avoided if atypical manifestations of disease are well known. Also, hospital and community outbreaks can be prevented by taking protective measures.

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Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015

Abstract: Outbreaks can be detected by syndromic surveillance, rapid enterovirus testing, and genotyping.

Cited by 66 publications

References 33 publications

A review and meta‐analysis of the epidemiology and clinical presentation of coxsackievirus A6 causing hand‐foot‐mouth disease in China and global implications

A review and meta‐analysis of the epidemiology and clinical presentation of coxsackievirus A6 causing hand‐foot‐mouth disease in China and global implications

Surveillance of enteroviruses from paediatric patients attended at a tertiary hospital in Catalonia from 2014 to 2017

A case with atypical hand-mouth-foot disease accompanying with onicomadesis and a small-scale outbreak

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