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Integr Med Res 2021 Sep 2;10(3):100726. Epub 2021 Apr 2.

Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

Background: Shufeng Jiedu capsule has been widely used in China for acute upper respiratory tract infections (AURTIs). The aim of this study was to evaluate its effectiveness and safety for AURTIs.

Methods: Randomized controlled trials comparing SFJD with conventional drug for patients with AURTIs were included. Read More

Front Med (Lausanne) 2021 26;8:656699. Epub 2021 Apr 26.

Department of Clinical Laboratory, Zunyi Medical University Third Affiliated Hospital, Zunyi, China.

Hand, foot and mouth disease (HFMD) and herpangina (HA), two of the most common childhood infectious diseases, are associated with enteroviruses (EVs) infection. The aim of this study was to identify the molecular epidemiology of enterovirus causing HFMD/HA in Zunyi, China, during 2019, and to describe the clinical features of the cases. We collected the information on demographic and clinical characteristics, laboratory data of laboratory-confirmed EVs associated HFMD/HA cases in Zunyi Medical University Third Affiliated Hospital between March 1 and July 31, 2019. Read More

Arch Public Health 2021 Apr 23;79(1):54. Epub 2021 Apr 23.

School of Public Health, Sun Yat-sen University, Guangzhou, China.

Background: Although several measures have been taken to control hand foot and mouth disease (HFMD) and herpangina (HA), these two diseases have been prevalent in China for 10 years with high incidence. We suspected that adults' inapparent infection might be the cause of the continued prevalence of HFMD/HA infection in mainland China.

Methods: To explore the role of adults (especially caregivers) in the transmission process of HFMD/HA among children, 330 HFMD/HA cases and 330 healthy children (controls) were selected for a case-control study. Read More

Int J Infect Dis 2021 Jun 17;107:62-68. Epub 2021 Apr 17.

Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China. Electronic address:

Objectives: The treatment of acute herpangina is inconsistent. We aim to evaluate the effectiveness and safety of interferon α-2b spray versus Ribavirin for this disease.

Methods: A randomized, controlled trial was conducted in eight hospitals in China between 2016 and 2018. Read More

Emerg Microbes Infect 2021 Dec;10(1):619-628

Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, People's Republic of China.

Enterovirus A71 (EV-A71) inactivated vaccines have been widely inoculated among children in Kunming City after it was approved. However, there was a large-scale outbreak of Enteroviruses (EVs) infection in Kunming, 2018. The epidemiological characteristics of HFMD and EVs were analysed during 2008-2018, which are before and three years after EV-A71 vaccine starting to use. Read More

Vaccines (Basel) 2021 Feb 27;9(3). Epub 2021 Feb 27.

Department of Biochemistry and Molecular Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA.

Enterovirus A71 (EV-A71) is a major causative agent of hand, foot, and mouth disease (HFMD) and herpangina. Moreover, EV-A71 infection can lead to neurological complications and death. Vaccination is the most efficient way to control virus infection. Read More

Front Microbiol 2020 13;11:610568. Epub 2021 Jan 13.

Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.

Infection with the re-emerging enterovirus 71 (EV-A71) is associated with a wide range of disease severity, including herpangina, encephalitis, and cardiopulmonary failure. At present, there is no FDA-approved therapeutics for EV-A71. Early diagnosis for the high-risk children is the key to successful patient care. Read More

PLoS One 2021 22;16(1):e0245529. Epub 2021 Jan 22.

Medical School and Jiangsu Provincial Key Laboratory of Medicine, Nanjing University, Nanjing, China.

Enterovirus A71 (EV-A71) has emerged as a clinically important neurotropic virus following poliovirus eradication. Recent studies have shown that human tonsillar epithelial cell lines (UT-SCC-60A and UT-SCC-60B) were susceptible to EV-A71, suggesting that human tonsillar crypt epithelium could be important in EV-A71 pathogenesis. However, the mechanism about how EV-A71 infects the upper oro-digestive tract remains largely unclear. Read More

Viruses 2021 Jan 4;13(1). Epub 2021 Jan 4.

Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria Monserrato (Cagliari), 09042 Monserrato, Italy.

Enterovirus A71 (EV-A71) infection has emerged as a significant public health concern atthe global level. Epidemic events of EV-A71 have been reported worldwide, and this succession of outbreaks has heightened concern that EV-A71 may become a public health threat. In recent years, widespread A71 enterovirus also occurred in European countries. Read More

Front Microbiol 2020 14;11:615965. Epub 2020 Dec 14.

Institute of Virology and AIDS Research, The First Hospital of Jilin University, Changchun, China.

Enteroviruses are a group of RNA viruses belonging to the family . They include human enterovirus groups A, B, C, and D as well as non-human enteroviruses. Enterovirus infections can lead to hand, foot, and mouth disease and herpangina, whose clinical manifestations are often mild, although some strains can result in severe neurological complications such as encephalitis, myocarditis, meningitis, and poliomyelitis. Read More

Acta Microbiol Immunol Hung 2020 Dec 5. Epub 2020 Dec 5.

1Department of Virology, National Public Health Center, Budapest, Hungary.

This report provides the findings of a retrospective surveillance study on the emergence and circulation of enteroviruses with their associated clinical symptoms over a nine-year period detected at the National Enterovirus Reference Laboratory in Hungary between 2010-2018.Enterovirus (EV) detection and genotyping were performed directly from clinical samples. From 4,080 clinical specimens 25 EV types were identified with a median age of patients of 5 years and 68% of all cases affected children aged 10 years or younger, although infections occurred in all age-groups. Read More

J Pediatric Infect Dis Soc 2021 Apr;10(4):398-407

Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.

Background: Enteroviruses (EVs) occur frequently worldwide and are known to be associated with a broad spectrum of clinical manifestations from mild syndromes to neurological disease. To understand the epidemiology of EV in Korea, we characterized EV-infected cases during 2012-2019 based on national surveillance.

Methods: We collected specimens from patients with suspected EV infections and analyzed the data using real-time reverse-transcription polymerase chain reaction and VP1 gene sequencing. Read More

PeerJ 2020 15;8:e9991. Epub 2020 Oct 15.

Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.

Background: Herpangina is a highly infectious disease, which is usually prevalent in preschool children.

Methods: This study analyzed the clinical and pathogenic characteristics of herpangina children to demonstrate the epidemiology of herpangina. Clinical manifestations, laboratory indicators and pharyngeal swabs were collected from children with herpangina who were monitored by Tongzhou Center for Disease Control and Prevention in Beijing, 2008. Read More

Viruses 2020 09 23;12(10). Epub 2020 Sep 23.

WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing 102206, China.

Coxsackievirus A8 (CV-A8) is one of the pathogens associated with hand, foot and mouth disease (HFMD) and herpangina (HA), occasionally leading to severe neurological disorders such as acute flaccid paralysis (AFP). Only one study aimed at CV-A8 has been published to date, and only 12 whole-genome sequences are publicly available. In this study, complete genome sequences from 11 CV-A8 strains isolated from HFMD patients in extensive regions from China between 2013 and 2018 were determined, and all sequences from GenBank were retrieved. Read More

J Clin Virol 2020 09 7;130:104582. Epub 2020 Aug 7.

Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China. Electronic address:

Objectives: Enterovirus A71 (EV-A71) is the main pathogen of severe hand, foot, and mouth disease (HFMD). Commercial enzyme-linked immunosorbent assays (ELISAs) are widely used in Chinese hospitals for the rapid diagnosis of acute EV-A71 infections. We present an evaluation of the diagnostic performance of a commercial anti-EV-A71 IgM-capture ELISA kit. Read More

Sci Total Environ 2020 Nov 23;741:140469. Epub 2020 Jun 23.

Department of Pediatrics, National Hospital Organization Beppu Medical Center, 1473 Oaza-Uchikamado, Beppu, Oita 874-0011, Japan. Electronic address:

Environmental factors have been suspected to have effects on the development of Kawasaki disease. However, the associations have been conflicting. The aim of this study was to investigate the effects of air pollution, weather conditions, and epidemic infections on the risks for Kawasaki disease in Japan. Read More

Front Pharmacol 2020 15;11:693. Epub 2020 May 15.

Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China.

Background: Considering the limitations of broad-spectrum antiviral drugs for the treatment of herpangina and the extensive exploration of Chinese herbal injections (CHIs), systematic evaluation of the efficacy of different CHIs in the treatment of herpangina is a key imperative. In this study, we performed a network meta-analysis to investigate the efficacy of CHIs, including Reduning injection (RDN), Shuanghuanglian injection (SHL), Tanreqing injection (TRQ), Xiyanping injection (XYP), and Yanhuning injection (YHN), in the treatment of herpangina.

Methods: A systematic literature review including studies published before December 17, 2018, was conducted in several databases. Read More

J Infect Public Health 2020 Jul 27;13(7):963-969. Epub 2020 May 27.

School of Public Health, Sun Yat-sen University, Guangzhou, China. Electronic address:

Background: Home quarantine as a non-pharmaceutical measure is a key strategy for preventing the spread of hand, foot, and mouth disease (HFMD) and herpangina (HA). However, the status of home quarantine remains unclear. This study aimed to provide a theoretical basis for the prevention and control of the HFMD and HA by investigating the situation and determining the factors influencing home quarantine in children with HFMD or HA. Read More

Int J Infect Dis 2020 Jul 19;96:538-540. Epub 2020 May 19.

Yancheng Center for Disease Control and Prevention, Yancheng, Jiangsu, China. Electronic address:

Objectives: To better understand the spectrums of pathogens causing herpangina and circulation of Coxsackievirus A4 in Yancheng, China.

Methods: Stool samples from herpangina and HFMD cases were collected. Real Time PCR Kits was used to identify Enterovirus 71, CV-A16 and CV-A6, and nested reverse transcription PCR (nRT-PCR) to detect the other enterovirus types. Read More

Arch Argent Pediatr 2020 04;118(2):e199-e203

Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina.

Typical hand-foot-mouth disease (HFMD) is an exanthematous viral disease with a classic symptomatology of fever, papulovesicular rash on the hands and feet with or without herpangina. It is usually caused by enterovirus 71 and Coxsackievirus A16, members of the genus Enterovirus. Recently, worldwide outbreaks of HFMD with atypical manifestations caused by Coxsackievirus A6 have been described. Read More

J Biomed Sci 2019 Nov 11;26(1):93. Epub 2019 Nov 11.

Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.

Background: Enterovirus 71 (EV71 or EV-A71) was first identified in California about half a century ago. In recent years, outbreaks of EV-A71 were prevalent worldwide, including Taiwan, Malaysia, Singapore, Japan, and China. Between 2008 and 2011, China alone reported 1894 deaths associated with EV-A71 infection. Read More

Vaccine 2020 01 31;38(1):1-9. Epub 2019 Oct 31.

National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan. Electronic address:

Enteroviruses (EV), the major pathogens of hand, foot, and mouth disease (HFMD) and herpangina, affect millions of children each year. Most human enteroviruses cause self-limited infections except polioviruses, enterovirus A71 (EV-A71), enterovirus D68 (EV-D68), and several echoviruses (Echo) and coxsackieviruses (CV). Especially, EV-A71 has repeatedly caused large-scale outbreaks in the Asia-Pacific region since 1997. Read More

PLoS One 2019 17;14(10):e0224110. Epub 2019 Oct 17.

Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.

Background: During recent 20 years, enterovirus 71 (EV71) has emerged as a major concern among children, particularly in the Asia-Pacific region. To understand current EV71 serostatus, to find risk factors associated with EV71 infection and to establish future EV71 vaccine policy, we performed a seroepidemiology study in Taiwan in 2017.

Methods: After informed consent was obtained, we enrolled preschool children, 6-15-year-old students, 16-50-year-old people. Read More

J Biomed Sci 2019 Sep 3;26(1):65. Epub 2019 Sep 3.

Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Enterovirus A71 (EV-A71) is an important emerging virus posing a threat to children under five years old. EV-A71 infection in infants or young children can cause hand-foot-and-mouth disease, herpangina, or severe neurological complications. However, there are still no effective antivirals for treatment of these infections. Read More

Medicine (Baltimore) 2019 Aug;98(33):e16493

Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Rationale: Unlike other enteroviruses which can cause herpangina or hand-foot-and-mouth disease, enterovirus D68 (EV-D68) has usually been linked to respiratory and neurological problems in young children. Skin manifestations had rarely been described in current literatures.

Patient Concerns: We report a 17-year-old girl with fever and painful skin rash over legs and soles for 9 days. Read More

World J Pediatr 2020 Apr 25;16(2):129-134. Epub 2019 Jul 25.

Infectious Disease Diagnosis and Treatment Center, Beijing Ditan Hospital Capital Medical University, Beijing, China.

Background: Herpangina is a common infectious disease in childhood caused by an enterovirus. This consensus is aiming to standardize and improve herpangina prevention and clinical diagnosis.

Methods: The Subspecialty Group of Infectious Diseases, the Society of Pediatric, Chinese Medical Association and Nation Medical Quality Control Center for Infectious Diseases gathered 20 experts to develop the consensus, who are specialized in diagnosis and treatment of herpangina. Read More

Arch Virol 2019 Oct 18;164(10):2565-2571. Epub 2019 Jul 18.

Department of Microbiology Laboratory, Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, People's Republic of China.

Enteroviruses (EVs) are the major cause of hand, foot, and mouth disease (HFMD) and herpangina in children. In this study, we conducted a molecular investigation of EVs in throat swab samples from children in Hangzhou, China with a diagnosis of HFMD or herpangina. EVs were detected using one-step real-time RT-PCR, and their serotypes were determined based on partial VP1 gene sequences. Read More

Pediatr Infect Dis J 2019 09;38(9):887-893

Taiwan Centers for Disease Control, Taipei, Taiwan.

Background: Nonpolio enterovirus (NPEV) infections are often present with herpangina (HA) and hand, foot and mouth disease (HFMD). Most countries sample NPEVs in HFMD cases, targeting enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16) that are associated with outbreaks and severe complications. HA is also monitored in Taiwan and several other countries, but its viral characteristics are underreported. Read More

Future Microbiol 2019 04 29;14:499-507. Epub 2019 Apr 29.

Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.

To describe the genetic diversity of enteroviruses (EV) causing hand, foot and mouth disease (HFMD) and herpangina, especially of coxsackievirus (CV)-A6, from patients attended at pediatric primary care centers during the 2017-2018 season. Phylogenetic analysis of partial VP1 region was performed for genetic characterization. The complete VP1 and 3Dpol proteins were sequenced for lineage determination and detection of recombination events. Read More

Int J Mol Sci 2019 Mar 13;20(6). Epub 2019 Mar 13.

Centre for Virus and Vaccine Research, Sunway University, Bandar Sunway, Subang Jaya, Selangor 47500, Malaysia.

Hand, foot, and mouth disease (HFMD) commonly produces herpangina, but fatal neurological complications have been observed in children. Enterovirus 71 (EV-A71) and Coxsackievirus 16 (CV-A16) are the predominant viruses causing HFMD worldwide. With rising concern about HFMD outbreaks, there is a need for an effective vaccine against EV-A71 and CV-A16. Read More