Enteroviruses in Patients Experiencing Multiple Episodes of Hand, Foot, and Mouth Disease in the Same Season in Kobe, Japan, 2011

Akiyoshi, Kyoko; Suga, Tomoko; Mori, Ai

doi:10.7883/yoken.65.459

Cited by 5 publications

(6 citation statements)

References 2 publications

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“…Additionally, 74 of 108 HFMD patients in Japan in 2011 were identified as CA6-positive [13]. A 2-to 8-week follow-up study on 16 of these CA6-associated HFMD cases revealed the presence of onychomadesis in 6 cases (37.5%) [49], underscoring the link between CA6 infection and onychomadesis.…”

Section: Ca6-associated Hfmd Outbreaks In Asiamentioning

confidence: 95%

“…Follow-up studies and virus detection from HFMD patients in Finland in 2008 revealed for the first time that CA6 was linked to onychomadesis [9]. Subsequently, CA6-associated HFMD with onychomadesis was reported in Spain (2008) [10], Taiwan (2010) [47], Japan (2011) [13,49] and mainland China (2013) [17]. The incidence of CA6-associated HFMD with onychomadesis was 15.1% in Spain (2011) [10], 37.2% in Taiwan (2010) [47] and 22.6% in Beijing (2013) [17].…”

Section: Onychomadesismentioning

confidence: 99%

See 1 more Smart Citation

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Bian

Wang

Yao

et al. 2015

Expert Review of Anti-infective Therapy

183

141

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Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are the predominant pathogens causing outbreaks of hand, foot and mouth disease (HFMD) worldwide. Other human enterovirus A (HEV-A) serotypes tend to cause only sporadic HFMD cases. However, since a HFMD caused by coxsackievirus A6 broke out in Finland in 2008, CA6 has been identified as the responsible pathogen for a series of HFMD outbreaks in Europe, North America and Asia. Because of the severity of the clinical manifestations and the underestimated public health burden, the epidemic of CA6-associated HFMD presents a new challenge to the control of HFMD. This article reviewed the epidemic characteristics, molecular epidemiology, clinical features and laboratory diagnosis of CA6 infection. The genetic evolution of CA6 strains associated with HFMD was also analyzed. It indicated that the development of a multivalent vaccine combining EV71, CA16 and CA6 is an urgent necessity to control HFMD.

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Section: Ca6-associated Hfmd Outbreaks In Asiamentioning

confidence: 95%

Section: Onychomadesismentioning

confidence: 99%

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Bian

Wang

Yao

et al. 2015

Expert Review of Anti-infective Therapy

183

141

View full text Add to dashboard Cite

show abstract

“…Infection with a serotype is immunizing, but individuals can get HFMD multiple times if infected with different serotypes [ 7 ]. HFMD is usually mild and self-limiting, but a small proportion of cases infected with EV-A71 experience neurological manifestations and sequelae (aseptic meningitis, encephalitis or acute flaccid paralysis [ 8 ]).…”

Section: Introductionmentioning

confidence: 99%

Epidemic dynamics, interactions and predictability of enteroviruses associated with hand, foot and mouth disease in Japan

Takahashi

Metcalf

Arima

et al. 2018

J. R. Soc. Interface.

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Outbreaks of hand, foot and mouth disease have been documented in Japan since 1963. This disease is primarily caused by the two closely related serotypes of Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16). Here, we analyse Japanese virologic and syndromic surveillance time-series data from 1982 to 2015. As in some other countries in the Asia Pacific region, EV-A71 in Japan has a 3 year cyclical component, whereas CV-A16 is predominantly annual. We observe empirical signatures of an inhibitory interaction between the serotypes; virologic lines of evidence suggest they may indeed interact immunologically. We fit the time series to mechanistic epidemiological models: as a first-order effect, we find the data consistent with single-serotype susceptible–infected–recovered dynamics. We then extend the modelling to incorporate an inhibitory interaction between serotypes. Our results suggest the existence of a transient cross-protection and possible asymmetry in its strength such that CV-A16 serves as a stronger forcing on EV-A71. Allowing for asymmetry yields accurate out-of-sample predictions and the directionality of this effect is consistent with the virologic literature. Confirmation of these hypothesized interactions would have important implications for understanding enterovirus epidemiology and informing vaccine development. Our results highlight the general implication that even subtle interactions could have qualitative impacts on epidemic dynamics and predictability.

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“…For example, China had 1.7 million HFMD cases in 2010 and Vietnam reported 113,121 children infected with 170 deaths in 2011 [ 3 , 4 ]. Japan, Korea, Singapore, and Cambodia also have suffered from the recent re-emergence of HFMD [ 5 , 6 , 7 ], and cases also have increased in other parts of the world including India, Cuba, Europe, and the United States [ 8 , 9 , 10 ]. As a result, vaccination has been considered a necessary component for HFMD prevention and control; however, vaccination against HFMD is challenging.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a Trivalent Hand, Foot, and Mouth Disease Vaccine against Enterovirus 71 and Coxsackieviruses A16 and A6 in Mice

Caine

Fuchs

Das

et al. 2015

Viruses

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Hand, foot, and mouth disease (HFMD) has recently emerged as a major public health concern across the Asian-Pacific region. Enterovirus 71 (EV71) and Coxsackievirus A16 (CVA16) are the primary causative agents of HFMD, but other members of the Enterovirus A species, including Coxsackievirus A6 (CVA6), can cause disease. The lack of small animal models for these viruses have hampered the development of a licensed HFMD vaccine or antivirals. We have previously reported on the development of a mouse model for EV71 and demonstrated the protective efficacy of an inactivated EV71 vaccine candidate. Here, mouse-adapted strains of CVA16 and CVA6 were produced by sequential passage of the viruses through mice deficient in interferon (IFN) α/β (A129) and α/β and γ (AG129) receptors. Adapted viruses were capable of infecting 3 week-old A129 (CVA6) and 12 week-old AG129 (CVA16) mice. Accordingly, these models were used in active and passive immunization studies to test the efficacy of a trivalent vaccine candidate containing inactivated EV71, CVA16, and CVA6. Full protection from lethal challenge against EV71 and CVA16 was observed in trivalent vaccinated groups. In contrast, monovalent vaccinated groups with non-homologous challenges failed to cross protect. Protection from CVA6 challenge was accomplished through a passive transfer study involving serum raised against the trivalent vaccine. These animal models will be useful for future studies on HFMD related pathogenesis and the efficacy of vaccine candidates.

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Enteroviruses in Patients Experiencing Multiple Episodes of Hand, Foot, and Mouth Disease in the Same Season in Kobe, Japan, 2011

Cited by 5 publications

References 2 publications

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Epidemic dynamics, interactions and predictability of enteroviruses associated with hand, foot and mouth disease in Japan

Efficacy of a Trivalent Hand, Foot, and Mouth Disease Vaccine against Enterovirus 71 and Coxsackieviruses A16 and A6 in Mice

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