Isolation of subgenus B adenovirus during a fatal outbreak of enterovirus 71-associated hand, foot, and mouth disease in Sibu, Sarawak

Cardosa, Mary Jane; Krishnan, Shekhar; Tio, Phaik Hooi; Perera, David; Wong, See Chang

doi:10.1016/s0140-6736(98)11032-2

Cited by 127 publications

(113 citation statements)

References 15 publications

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“…In these aspects, this outbreak is similar to those that occurred in Malaysia and Taiwan in recent years (6,7,9,10).…”

Section: Discussionsupporting

confidence: 79%

“…Coinfection with a second virus has been suggested as yet another possible pathogenetic factor (6,9), and this theory is supported by the concomitant isolation of a subgenus B adenovirus with an enterovirus from three persons who died during a HFMD outbreak in Sarawak (6). Among the Singaporean patients with HEV71 infection, three had a second virus isolated concurrently.…”

Section: Discussionmentioning

confidence: 93%

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Epidemic Hand, Foot and Mouth Disease Caused by Human Enterovirus 71, Singapore

Chan

Goh

Chong

et al. 2003

Emerg. Infect. Dis.

188

156

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Singapore experienced a large epidemic of hand, foot and mouth disease (HFMD) in 2000. After reviewing HFMD notifications from doctors and child-care centers, we found that the incidence of HFMD rose in September and declined at the end of October. During this period, 3,790 cases were reported. We performed enteroviral cultures on 311 and 157 specimens from 175 HFMD patients and 107 non-HFMD patients, respectively; human enterovirus 71 (HEV71) was the most frequently isolated virus from both groups. Most of the HFMD patients were <4 years of age. Three HFMD and two non-HFMD patients died. Specimens from two HFMD and both non-HFMD patients were culture positive for HEV71; a third HFMD patient was possibly associated with the virus. Autopsies performed on all three HFMD and one of the non-HFMD case-patients showed encephalitis, interstitial pneumonitis, and myocarditis. A preparedness plan for severe HFMD outbreaks provided for the prompt, coordinated actions needed to control the epidemic.

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“…In these aspects, this outbreak is similar to those that occurred in Malaysia and Taiwan in recent years (6,7,9,10).…”

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 93%

Epidemic Hand, Foot and Mouth Disease Caused by Human Enterovirus 71, Singapore

Chan

Goh

Chong

et al. 2003

Emerg. Infect. Dis.

188

156

View full text Add to dashboard Cite

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“…1 In a more recent publication from Borneo, Malaysia, during a fatal outbreak of enterovirus 71, subgroup B adenovirus was isolated from 10 patients who died and from 5 patients in whom the disease was complicated by acute flaccid paralysis. 7 The authors suggest that adenovirus infection had a major role in the morbidity and mortality of the disease. Munoz et al 8 described disseminated adenovirus disease with multiorgan involvement in 11 of 440 patients (2.5%) with adenovirus infection.…”

Section: Discussionmentioning

confidence: 99%

A Syndrome of Transient Encephalopathy Associated With Adenovirus Infection

et al. 2001

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ABSTRACT. Background and Objective. Adenovirus is a common pathogen in the pediatric population. Respiratory, gastrointestinal, or renal systems are often involved in adenovirus infections. Several neurologic syndromes have been attributed to adenovirus, such as adenovirus aseptic meningitis, myelitis, subacute focal encephalitis, and Reye-like syndrome. The purpose of this study was to describe the clinical features and encephalography findings in 7 infants treated in our center for a syndrome of transient encephalopathy associated with adenovirus infection.Study Participants. Three females and 4 males ages 7 to 34 months seen in our department between July 1983 and February 1984 and September 1998 and May 1999 presented with fever of at least 7 days' duration and a gradual decline in the state of alertness. Score on the Glasgow Coma Scale ranged from 9 to 12. Findings on lumbar puncture were normal. In all 7 patients, the encephalogram showed moderate to severe background slowing compatible with encephalopathy. All patients were catarrheal and had mild hepatomegaly with slight elevation of liver enzymes. Some had bronchopneumonia, diarrhea, and conjunctivitis either isolated or in combination.Methods and Results. Adenovirus was isolated by immunfluorescence technique in all patients-from the sputum in 3 patients, nasopharynx in 5, conjunctiva in 4, and rectal swab in 5. In 5 patients, serotyping was performed by an antibody neutralization method. Adenovirus type 3 was ascertained from a nasal swab in 1 patient, sputum specimens in 3, throat swab in 3, and rectal cultures in 5. The clinical course was characterized by a progressive recovery of alertness. After several days, there was a complete reversal of neurologic findings.Conclusion. We suggest that this syndrome of transient encephalopathy is a distinct entity and should be considered as another of the several neurologic syndromes known to be associated with adenovirus infection. Pediatrics 2001;107(5). URL: http://www. pediatrics.org/cgi/content/full/107/5/e69; encephalitis, adenovirus, encephalopathy.

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“…Virus isolation was attempted for all swabs and for CSF and any serum which had adequate volume. Specimens were inoculated into rhabdomyosarcoma (RD) and 293 cells as described previously (1,19). Enteroviruses isolated were typed by nucleotide sequencing of the VP1 or the VP4 genes (2,13).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease

et al. 2007

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Human enterovirus 71 and coxsackievirus A16 are important causes of hand-foot-and-mouth disease (HFMD). Like other enteroviruses, they can be isolated from a range of sterile and nonsterile sites, but which clinical sample, or combination of samples, is the most useful for laboratory diagnosis of HFMD is not clear. We attempted virus culture for 2,916 samples from 628 of 725 children with HFMD studied over a 3 1/2-year period, which included two large outbreaks. Overall, throat swabs were the single most useful specimen, being positive for any enterovirus for 288 (49%) of 592 patients with a full set of samples. Vesicle swabs were positive for 169 (48%) of 333 patients with vesicles, the yield being greater if two or more vesicles were swabbed. The combination of throat plus vesicle swabs enabled the identification of virus for 224 (67%) of the 333 patients with vesicles; for this patient group, just 27 (8%) extra patients were diagnosed when rectal and ulcer swabs were added. Of 259 patients without vesicles, use of the combination of throat plus rectal swab identified virus for 138 (53%). For 60 patients, virus was isolated from both vesicle and rectal swabs, but for 12 (20%) of these, the isolates differed. Such discordance occurred for just 11 (10%) of 112 patients with virus isolated from vesicle and throat swabs. During large HFMD outbreaks, we suggest collecting swabs from the throat plus one other site: vesicles, if these are present (at least two should be swabbed), or the rectum if there are no vesicles. Vesicle swabs give a high diagnostic yield, with the added advantage of being from a sterile site.

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Isolation of subgenus B adenovirus during a fatal outbreak of enterovirus 71-associated hand, foot, and mouth disease in Sibu, Sarawak

Cited by 127 publications

References 15 publications

Epidemic Hand, Foot and Mouth Disease Caused by Human Enterovirus 71, Singapore

Epidemic Hand, Foot and Mouth Disease Caused by Human Enterovirus 71, Singapore

A Syndrome of Transient Encephalopathy Associated With Adenovirus Infection

Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease

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