Molecular Detection of Enteroviruses from an Outbreak of Hand, Foot and Mouth Disease in Malaysia in 1997

AbuBakar, Sazaly; Chee, Hui Yee; Shafee, Norazizah; Chua, Kaw Bing; Lam, Sai Kit

doi:10.1080/00365549950163734

Cited by 50 publications

(9 citation statements)

References 42 publications

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“…Since 1998, EV71 has been found in many cases and has recently become the predominant serotype in China, accounting for more than 100 deaths in 2009 [18]. It also caused 45 deaths in Hungary (1978) [19], and 29 deaths in Malaysia (1997) [20]. Other HEV-A species (CVA10, CVA14, CVA4, CVA6, and CVA2) were detected with only a single strain each.…”

Section: Discussionmentioning

confidence: 99%

Molecular Identification and Analysis of Human Enteroviruses Isolated from Healthy Children in Shenzhen, China from 2010 to 2011

Chen

et al. 2013

PLoS ONE

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ObjectiveTo determine the prevalence and distribution of human enteroviruses (HEVs) among healthy children in Shenzhen, China.MethodClinical specimens were obtained from 320 healthy children under 5 years old in Shenzhen, China from 2010 to 2011. The specimens were evaluated using real-time PCR and cell cultures. The positive specimens were further tested using reverse transcription-seminested PCR (RT-snPCR). Molecular typing and phylogenetic analysis were based on the sequence determined.ResultsAmong the 320 samples, 34 were tested positive for HEVs (10.6%) and 22 different serotypes were identified using RT-snPCR. PV1 and PV2 were also detected. The predominant serotype observed was EV71 (17.6%), followed by CV-B4 (14.7%). HEV-B was detected most frequently, with an overall prevalence of 47.1%. HEV-A and HEV-C were found in 32.3% and 20.6% of the samples, respectively. No HEV-D was identified. Molecular phylogeny indicated that all EV71 strains were of C4 genotype.ConclusionAlthough a variety of HEVs was detected in healthy children, HEV-B was relatively more prevalent than other HEV species. Considering HEV-A is more prevalent than HEV-B among patients with hand-foot-mouth disease, additional long-term surveillance of HEV is warranted in both asymptomatic and symptomatic populations.

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Section: Discussionmentioning

confidence: 99%

Molecular Identification and Analysis of Human Enteroviruses Isolated from Healthy Children in Shenzhen, China from 2010 to 2011

Chen

et al. 2013

PLoS ONE

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“…Repeated outbreaks of HFMD have occurred in many parts of the world such as Malaysia [49]–[50], Taiwan [1], [51]–[54], Singapore [55], Mainland China [56], Brunei [57], Western Australia [58], the Unites States [59] and Germany [60]. The first reported large and severe HFMD epidemic occurred in Taiwan region in 1998 including about 130 000 cases of HFMD, among whom 405 patients were severe cases and 78 died [1], [51]–[52].…”

Section: Discussionmentioning

confidence: 99%

The Characteristics of Blood Glucose and WBC Counts in Peripheral Blood of Cases of Hand Foot and Mouth Disease in China: A Systematic Review

Zhu

Qian

2012

PLoS ONE

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BackgroundOutbreaks of Hand Foot and Mouth Disease (HFMD) have occurred in many parts of the world especially in China. We aimed to summarize the characteristics of the levels of blood glucose and white blood cell (WBC) counts in cases of HFMD in Mainland China and Taiwan, using meta-analysis based on systematic review of published articles.MethodsWe systematically reviewed published studies, from the MEDLINE and WANFANG Data, about the levels of blood glucose and WBC counts in cases of HFMD until 15th June 2011, and quantitatively summarized the characteristics of them using meta-analysis.ResultsIn total, 37 studies were included in this review. In Mainland China and Taiwan, generally, the average level of blood glucose, the prevalence of hyperglycemia, WBC counts and the prevalence of leukocytosis increased with the severity of the illness. There was no significant difference in the prevalence of leukocytosis between ANS (autonomic nervous system dysregulation)/PE (pulmonary edema) group and CNS (central nervous system) group, and in the average level of blood glucose between healthy controls and mild cases of HFMD. WBC counts in cases infected by EV71 were less than those in cases infected by CA16.Conclusionsour analyses indicated that blood glucose and WBC counts increased with the severity of HFMD disease, which would help doctors to manage patients efficiently.

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“…In the late 1990s, EV71 emerged in East Asia. In 1997, 2628 cases in Malaysia were reported, with 34 deaths [4]. One year later, an estimated 1.5 million cases occurred in Taiwan; 405 cases developed severe neuropathic complications with 78 deaths [5].…”

Section: Introductionmentioning

confidence: 99%

An atypical winter outbreak of hand, foot, and mouth disease associated with human enterovirus 71, 2010

et al. 2014

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BackgroundTo analyze the epidemiological characteristics and pathogenic molecular characteristics of an hand, foot, and mouth disease (HFMD) outbreak caused by enterovirus 71 in Linyi City, Shandong Province, China during November 30 to December 28, 2010.MethodsOne hundred and seventy three stool specimens and 40 throat samples were collected from 173 hospitalized cases. Epidemiologic and clinical investigations, laboratory testing, and genetic analyses were performed to identify the causal pathogen of the outbreak.ResultsAmong the 173 cases reported in December 2010, the male–female ratio was 1.88: 1; 23 cases (13.3%) were severe. The majority of patients were children aged < 5 years (95.4%). Some patients developed respiratory symptoms including runny nose (38.2%), cough (20.2%), and sore throat (14.5%). One hundred and thirty eight EV71 positive cases were identified based on real time reverse-transcription PCR detection and 107 isolates were sequenced with the VP1 region. Phylogenetic analysis of full-length VP1 sequences of 107 Linyi EV71 isolates showed that they belonged to the C4a cluster of the C4 subgenotype and were divided into 3 lineages (Lineage I, II and III). The two amino acid substitutions (Gly and Gln for Glu) at position 145 within the VP1 region are more likely to appear in EV71 isolates from severe cases (52.2%) than those recovered from mild cases (8.3%).ConclusionThis outbreak of HMFD was caused by EV71 in an atypical winter. EV71 strains associated with this outbreak represented three separate chains of transmission. Substitution at amino acid position 145 of the VP1 region of EV71 might be an important virulence marker for severe cases. These findings suggest that continued surveillance for EV71 variants has the potential to greatly impact HFMD prevention and control.

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Molecular Detection of Enteroviruses from an Outbreak of Hand, Foot and Mouth Disease in Malaysia in 1997

Cited by 50 publications

References 42 publications

Molecular Identification and Analysis of Human Enteroviruses Isolated from Healthy Children in Shenzhen, China from 2010 to 2011

Molecular Identification and Analysis of Human Enteroviruses Isolated from Healthy Children in Shenzhen, China from 2010 to 2011

The Characteristics of Blood Glucose and WBC Counts in Peripheral Blood of Cases of Hand Foot and Mouth Disease in China: A Systematic Review

An atypical winter outbreak of hand, foot, and mouth disease associated with human enterovirus 71, 2010

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