Detection of enteroviruses during a 2018 hand, foot and mouth disease outbreak in Malaysia

Trop Biomed. 2021 Mar 1;38(1):150-153. doi: 10.47665/tb.38.1.026.

Abstract

Hand, foot, and mouth disease (HFMD) is a common childhood disease caused by enteroviruses. In 2018, a HFMD outbreak in Malaysia affected over 76,000 children. In this study, we used RT-qPCR and CODEHOP PCR to detect the causative agents in 89 clinically diagnosed HFMD patients in Kuala Lumpur and Selangor. Most (62.9%) of the children were below 3 years old. PCR with either assay detected enteroviruses in 84.2% (75/89) and CODEHOP PCR successfully typed 66.7% (50/75) of the enteroviruses. Sequencing of CODEHOP amplicons showed co-circulation of multiple enteroviruses with coxsackievirus A6 (CV-A6) and A16 as the predominant serotypes, but not the neurovirulent enterovirus A71. CV-A6 infection was more common in children less than 12 months old (p=0.01) and was more likely to cause vesicles in the gluteal area (p=0.01) compared to other enteroviruses. Establishing a robust identification method during HFMD outbreaks is important for patient management and public health responses.

MeSH terms

  • Child
  • Child, Preschool
  • Disease Outbreaks
  • Enterovirus / classification
  • Enterovirus / isolation & purification*
  • Female
  • Hand, Foot and Mouth Disease / epidemiology*
  • Hand, Foot and Mouth Disease / virology
  • Humans
  • Infant
  • Malaysia / epidemiology
  • Male
  • Serogroup