Search Our Scientific Publications & Authors

J Med Virol 2020 Jun 16. Epub 2020 Jun 16.

Department of Neurology, Affiliated Shenzhen Baoan Hospital, Southern Medical University.

Therapeutic strategies for severe hand, foot, and mouth disease (HFMD) are currently either inconsequent or deficient in evidence. We retrospectively surveyed HFMD outbreaks in Xiangyang from June 2008 to December 2013. HFMD is staged form I to V according to clinical severity and the case with central nervous system involvement is defined as a severe one. Read More

Clinics (Sao Paulo) 2020 15;75:e1619. Epub 2020 May 15.

Department of Pediatrics, The First Affiliated Hospital of Kangda College of Nanjing Medical University /, First People's Hospital of Lianyungang, Lianyungang, China.

Objective: We aimed to evaluate the association between platelet (PLT) count and the risk and progression of hand, foot, and mouth disease (HFMD).

Methods: In total, 122 HFMD patients and 40 healthy controls were enrolled in the study. The differences between variables among the different subgroups were compared. Read More

J Biomed Sci 2020 Apr 16;27(1):53. Epub 2020 Apr 16.

Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan, 333, Taiwan.

Enterovirus A71 (EV-A71) is one of the causative pathogens of hand, foot, and mouth disease (HFMD), which may cause severe neurological and cardiopulmonary complications in children. In this review, we discuss the pathogenesis, clinical manifestations, management strategy, and clinical outcomes of cardiopulmonary failure (CPF) in patients with EV-A71 infection.The pathogenesis of CPF involves both catecholamine-related cardiotoxicity following brainstem encephalitis and vasodilatory shock due to cytokine storm. Read More

BMC Infect Dis 2020 Apr 7;20(1):271. Epub 2020 Apr 7.

Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, People's Republic of China.

Background: Hand, foot, and mouth disease (HFMD) is a common infectious disease occurring in children under 5 years of age worldwide, and Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CVA-16) are identified as the predominant pathogens. In recent years, Coxsackievirus A6 (CVA-6) and Coxsackievirus A10 (CVA-10) have played more and more important role in a series of HFMD outbreaks. This study aimed to understand the epidemic characteristics associated with HFMD outbreak in Guangzhou, 2018. Read More

Sci Rep 2020 Mar 2;10(1):3810. Epub 2020 Mar 2.

Singapore Immunology Network, Agency for Science, Technology and Research, Singapore, Singapore.

Hand, foot and mouth disease (HFMD), caused by enterovirus A71 (EV-A71), presents mild to severe disease, and sometimes fatal neurological and respiratory manifestations. However, reasons for the severe pathogenesis remain undefined. To investigate this, infection and viral kinetics of EV-A71 isolates from clinical disease (mild, moderate and severe) from Sarawak, Malaysia, were characterised in human rhabdomyosarcoma (RD), neuroblastoma (SH-SY5Y) and peripheral blood mononuclear cells (PBMCs). Read More

J Infect Dis 2020 Mar 2. Epub 2020 Mar 2.

Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.

Background: Encephalitis in Hand, Foot and Mouth Disease is a serious threat to children's health and life. Toll-like receptor 3 is an innate immune-recognition receptor which can recognize virus and initiate innate immune responses. Emodin have the effects of anti-inflammatory and regulating immune function, but the mechanism is not very clear. Read More

Arch Virol 2020 Apr 1;165(4):823-834. Epub 2020 Feb 1.

Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.

While conducting sentinel surveillance of hand, foot, and mouth disease (HFMD) in Vietnam, we found a sudden increase in the prevalence of coxsackievirus A10 (CV-A10) in 2016 and CV-A2 and CV-A4 in 2017, the emergence of which has been reported recently to be associated with various clinical manifestations in other countries. However, there have been only a limited number of molecular studies on those serotypes, with none being conducted in Vietnam. Therefore, we sequenced the entire VP1 genes of CV-A10, CV-A4, and CV-A2 strains associated with HFMD in Vietnam between 2012 and 2017. Read More

CMAJ 2020 01;192(3):E69

Departments of Pediatrics (Hoffmann, Latrous, Lam), and of Dermatology and Skin Science (Lam), University of British Columbia, Vancouver, BC

Sci Rep 2020 01 13;10(1):159. Epub 2020 Jan 13.

Department of Viral Infection and International Health, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, 9208640, Japan.

Enterovirus-A71 (EV-A71) is a common cause of hand-foot-and-mouth disease (HFMD) and, rarely, causes severe neurological disease. This study aimed to elucidate the epidemiological and genetic characteristics and virulence of EV-A71 strains isolated from children diagnosed with HFMD. Rectal and throat swabs were collected from 488 children with HFMD in Hanoi, Vietnam, in 2015-2016. Read More

Lancet Infect Dis 2020 02 16;20(2):230-239. Epub 2019 Dec 16.

Section of Infectious Diseases, School of Medicine, University of Colorado, Aurora, CO, USA; Children's Hospital Colorado, Aurora, CO, USA.

Background: In May, 2018, Children's Hospital Colorado noted an outbreak of enterovirus A71 (EV-A71) neurological disease. We aimed to characterise the clinical features of EV-A71 neurological disease during this outbreak.

Methods: In this retrospective observational cohort study, children (younger than 18 years) who presented to Children's Hospital Colorado (Aurora, CO, USA) between March 1 and November 30, 2018, with neurological disease (defined by non-mutually exclusive criteria, including meningitis, encephalitis, acute flaccid myelitis, and seizures) and enterovirus detected from any biological specimen were eligible for study inclusion. Read More

J Biomed Sci 2019 Oct 18;26(1):75. Epub 2019 Oct 18.

Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Enterovirus A71 (EV-A71) is one of the common causative pathogens for hand foot and mouth disease (HFMD) affecting young children. HFMD outbreak can result in a substantial pediatric hospitalization and burden the healthcare services, especially in less-developed countries. Since the initial epidemic of predominantly EV-A71 in California in 1969, the high prevalence of HFMD in the Asia-pacific region and elsewhere around the world represents a significant morbidity in this age group. 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

BMJ Case Rep 2019 Aug 20;12(8). Epub 2019 Aug 20.

Canniesburn Plastic Surgery Unit, NHS Greater Glasgow and Clyde, Glasgow, UK.

A literature search confirmed no previous cases of necrotising fasciitis (NF) complicating hand,foot and mouth disease (HFMD). This report explores the case of a previously well 55-week-old Caucasian boy who attended accident and emergency with an acutely swollen right hand and atypical viral rash affecting the hands and face. He was admitted under plastic surgery and treated with intravenous antibiotics and fluid resuscitation for sepsis secondary to cellulitis. Read More

Artif Cells Nanomed Biotechnol 2019 Dec;47(1):3485-3491

Department of Microbiology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University , Guangzhou , People's Republic of China.

Enterovirus 71 (EV71) which commonly caused the hand-foot-mouth disease (HFMD) has become one of public health challenges worldwide. However, no effective vaccines or drugs for this disease has been developed. Thus, there is an urgent need to find a new strategy for treating the EV71 infection. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2019 Aug;21(8):796-800

Department of Pediatrics, Ganzhou Medical and Healthcare Center for Women and Children, Ganzhou, Jiangxi 341000, China.

Objective: To study the clinical effect of carvedilol in the treatment of children with severe hand-foot-mouth disease (HFMD) caused by enterovirus 71 (EV71) infection.

Methods: A retrospective analysis was performed for the clinical data of 86 children with severe HFMD caused by EV71 infection who were admitted to the hospital from April 2016 to August 2017. According to whether carvedilol was used, the children were divided into conventional treatment group with 51 children and carvedilol treatment group with 35 children. 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

J Biomed Sci 2019 Aug 8;26(1):57. Epub 2019 Aug 8.

Departments of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan.

During recent 20 years, enterovirus A71 (EV-A71) has emerged as a major concern among pediatric infectious diseases, particularly in the Asia-Pacific region. The clinical manifestations of EV-A71 include uncomplicated hand, foot, and mouth disease, herpanina or febrile illness and central nervous system (CNS) involvement such as aseptic meningitis, myoclonic jerk, polio-like syndrome, encephalitis, encephalomyelitis and cardiopulmonary failure due to severe rhombencephalitis. In follow-up studies of patients with EV-A 71 CNS infection, some still have hypoventilation and need tracheostomy with ventilator support, some have dysphagia and need nasogastric tube or gastrostomy feeding, some have limb weakness/astrophy, cerebellar dysfunction, neurodevelopmental delay, lower cognition, or attention deficiency hyperactivity disorder. Read More

F1000Res 2018 30;7:1156. Epub 2018 Jul 30.

Microbiology Section, Institute of Public Health (IPH), Mohakhali, Dhaka, 1212, Bangladesh.

Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to lack in laboratory-diagnostic facilities. Following the World Health Organization's case-definition, we conducted a rapid-appraisal of HFMD among all of the 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and extremity rash. Read More

Pol J Microbiol 2019 ;68(2):165-171

Bezmialem Vakif University, Department of Medical Microbiology , Istanbul , Turkey ; Bezmialem Vakif University, Beykoz Institute of Life Sciences and Biotechnology (BILSAB) , Istanbul , Turkey.

Hand, foot, and mouth disease (HFMD) is caused by various serotypes of genus. Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) were known to be the only responsible agents for these epidemics; however, this opinion was challenged after the detection that coxsackievirus A6 (CV-A6) was the responsible species for the outbreak in Finland in 2008. HFMD is frequently seen in Turkey, and no detailed study on its clinical and microbiological epidemiology has previously been reported. 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

BMC Infect Dis 2019 Mar 27;19(1):285. Epub 2019 Mar 27.

Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.

Background: Hand, foot and mouth disease (HFMD) is a transmissible infectious disease caused by human enteroviruses (EV). Here, we described features of children with severe HFMD caused by EV-A71 or coxsackievirus A16 (CV-A16) in Shanghai, China.

Methods: Severe EV-A71 or CV-A16 caused HFMD children admitted to the Xinhua Hospital from January 2014 and December 2016, were recruited retrospectively to the study. Read More

J Microbiol Immunol Infect 2019 Mar 14. Epub 2019 Mar 14.

Virus Laboratory, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 318 Renminzhong Road Yuexiu District, Guangzhou, 510120, China. Electronic address:

Background: Enterovirus 71 (EV71) is one of the major causative pathogens of hand, foot, and mouth disease (HFMD). Immune cells play a critical role in determining the outcomes of virus infection. We aimed to characterize the lymphocyte subsets and transcriptional levels of T lymphocytes-associated transcription factors in peripheral blood cells of children with EV71 infection. Read More

Indian J Dermatol Venereol Leprol 2020 Jan-Feb;86(1):105

Regional Virus Research Diagnostic Laboratory, ICMR-Regional Medical Research Centre, N.E.Region, Dibrugarh, Assam, India.

Sci Adv 2019 03 6;5(3):eaau4255. Epub 2019 Mar 6.

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Recent worldwide outbreaks of enterovirus 71 (EV71) have caused major epidemics of hand, foot, and mouth disease with severe neurological complications, including acute flaccid paralysis. EV71 is transmitted by the enteral route, but little is known about the mechanisms it uses to cross the human gastrointestinal tract. Using primary human intestinal epithelial monolayers, we show that EV71 infects the epithelium from the apical surface, where it preferentially infects goblet cells. Read More

Sci Rep 2019 03 7;9(1):3856. Epub 2019 Mar 7.

Department of Epidemiology, The Key Laboratory of Public Health Safety of Minister of Education, School of Public Health, Fudan University, Shanghai, 200032, China.

Hand, foot and mouth disease (HFMD) is responsible for a heavy economic and social burden in the Asia-Pacific region. Previous studies have shown that coxsackievirus A6 (CVA6) and coxsackievirus A10 (CVA10) have become the predominant agents of HFMD in mainland China in recent years, replacing enterovirus 71 (EV71) and coxsackievirus A16 (CVA16), although it is unclear if this is consistent throughout China. In this study, samples from 253 HFMD cases were collected in Shenzhen, China, from May 2013 through April 2014 to identify the etiological agent of HFMD. Read More

Antiviral Res 2019 04 25;164:139-146. Epub 2019 Feb 25.

Vaccine Research Center, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China; Joint Center for Infection and Immunity, Guangzhou Institute of Pediatrics, Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. Electronic address:

Coxsackievirus A10 (CVA10) has emerged as one of the major pathogens of hand, foot, and mouth disease in recent years. However, there are no approved vaccines or effective drugs against CVA10. Several experimental CVA10 vaccines have been shown to elicit neutralizing antibodies that could confer protection against viral infection. Read More

BMJ Open 2019 02 24;9(2):e027224. Epub 2019 Feb 24.

Department of Infectious Diseases, Guangzhou Women and Children's Medical Center, Guangzhou, China.

Introduction: Hand-foot-and-mouth disease (HFMD) is a paediatric infectious disease that is particularly prevalent in China. Severe HFMDs characterised by neurological involvement are fatal and survivors who have apparently fully recovered might still be afflicted later in life with neurocognitive impairments. Only when a well-designed, prospective cohort study is in place can we develop clinical tools for early warning of neurological involvement and can we obtain epidemiological evidence regarding the lingering effects of the sequelea. Read More

BMC Pediatr 2019 02 13;19(1):59. Epub 2019 Feb 13.

Intensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education; Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

Background: Hand, foot, and mouth disease (HFMD) is an acute viral infection occurring mostly in infants and children. Enterovirus 71 (EV71) infection mostly occurs in children < 5 years of age. Severe cases, however, are usually encountered in children under the age of 3 years, and exceedingly rare in teenagers > 14 years and adults. Read More

J Neurovirol 2019 06 7;25(3):354-362. Epub 2019 Feb 7.

Guangzou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.

Enterovirus 71 (EV-A71) is a major causative agent for hand, foot, and mouth disease (HFMD), especially severe HFMD characterized by neurologic involvement. The objective of this study is to investigate the relationship between the distribution of neurologic infection and the outcomes of severe HFMD. A total of 139 suspected severe HFMD cases (92 were confirmed as EV-A71 infection) underwent clinical and laboratory diagnosis as well as magnetic resonance imaging (MRI) scans of the nervous system. Read More

Disaster Med Public Health Prep 2019 08 1;13(4):740-744. Epub 2019 Feb 1.

Institute of Pediatrics, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Objective: Hand, foot, and mouth disease (HFMD) is a common infectious disease caused by a group of viruses. The causative viruses have changed over time, and there is a need for a more effective protective vaccine. In this study, we investigated the profiles of human enteroviruses that caused HFMD outbreaks in Nanjing in 2015, with the goal of guiding the future prevention and treatment of HFMD. Read More

Vaccine 2019 02 22;37(8):1109-1117. Epub 2019 Jan 22.

Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata 1-6-6, Yamagata 990-0031, Japan.

Although coxsackievirus A6 (CV-A6) is generally recognized as a causative agent of herpangina in children, CV-A6 infections globally emerged as a new and major cause of epidemic hand-foot-and-mouth-diseases (HFMDs) around 2008. To clarify the longitudinal epidemiology of CV-A6, we carried out sequence and phylogenetic analyses for the VP1 and partially for the VP4-3D regions as well as antigenic analysis using 115 CV-A6 isolates and 105 human sera in Yamagata, Japan between 2001 and 2017. Phylogenetic analysis revealed that CV-A6 isolates were clearly divided into two clusters; strains in circulation between 2001 and 2008 and those between 2010 and 2017. Read More

Int J Infect Dis 2019 Mar 11;80:84-91. Epub 2019 Jan 11.

Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok-noi, Bangkok 10700, Thailand; Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand. Electronic address:

Background: Enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16) are the major causative agents of hand, foot and mouth disease (HFMD) worldwide, particularly in the Asia-Pacific region. Several strains have emerged, circulated, and faded out over time in recent decades. This study investigated the EV-A71 and CV-A16 circulating strains and replacement of genotypes/subgenotypes in Thailand during the years 2000-2017. Read More

J Pediatr 2019 Apr 14;207:259-259.e1. Epub 2018 Dec 14.

Department of Dermatology and Pediatrics Columbia University New York, New York.

Emerg Microbes Infect 2018 Dec 14;7(1):214. Epub 2018 Dec 14.

Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon, Pathom, 73170, Thailand.

Hand, foot, and mouth disease (HFMD) caused by enteroviruses remains a public health threat, particularly in the Asia-Pacific region during the past two decades. Moreover, the introduction of multiple subgenotypes and the emergence of recombinant viruses is of epidemiological importance. Based on either the full genome or VP1 sequences, 32 enteroviruses (30 from HFMD patients, 1 from an encephalitic patient, and 1 from an asymptomatic contact case) isolated in Thailand between 2006 and 2014 were identified as 25 enterovirus 71 (EV71) isolates (comprising 20 B5, 1 C2, 2 C4a, and 2 C4b subgenotypes) and 7 coxsackievirus A16 (CA16) isolates (comprising 6 B1a and 1 B1b subgenotypes). Read More

J Dermatol 2019 Jun 10;46(6):e191-e192. Epub 2018 Dec 10.

Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan.

J Trop Pediatr 2019 10;65(5):510-513

Professor, Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

Hand, foot and mouth disease (HFMD) is a common infectious disease among children, caused primarily by human enterovirus-A71 (EV-A71) and coxsackievirus-A16 (CV-A16). To date, only two case reports mention that renal involvement can be secondary to or coexisting with CV-A16-associated HFMD. In the present report, we describe a 10-year-old girl who was infected with EV-A71 and subsequently developed a definite acute kidney injury (AKI), mainly based on the characteristic rash, virus isolation, eyelid edema, hypertension, decreased urine output, mild proteinuria and impaired renal function. Read More

Acta Paediatr 2019 06 7;108(6):1133-1139. Epub 2018 Dec 7.

Department of Paediatrics, West China Second Hospital, Sichuan University, Chengdu, China.

Aim: This study explored the gut microbiota of children with hand, foot and mouth disease (HFMD).

Methods: We enrolled 15 cases with HFMD admitted to the West China Second Hospital, Sichuan University, China, from July to September 2016 at a median age of three years. The controls were 15 healthy children of a similar age who underwent routine health examinations at the hospital during the same period. Read More

J Epidemiol 2019 Sep 10;29(9):354-362. Epub 2018 Nov 10.

Department of Public Health, Osaka City University Graduate School of Medicine.

Background: Severe pediatric cases of hand, foot, and mouth disease (HFMD), herpangina (HA), and associated complications caused by enterovirus 71 (EV71) infection have brought substantial public health impact in Asia. This study aimed to elucidate the epidemiology of these pediatric cases in Japan.

Methods: A nationwide survey was conducted using stratified random sampling of hospital pediatric departments. Read More

Virol J 2018 10 16;15(1):158. Epub 2018 Oct 16.

Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand.

Background: Hand, foot and mouth disease (HFMD) is endemic among population of young children in Thailand. The disease is mostly caused by enterovirus 71 (EV71) and coxsackievirus A16 (CA16).

Methods: This study conducted serosurveillance for neutralizing (NT) antibodies to EV71 subgenotypes B5 and C4a, and to CA16 subgenotypes B1a and B1b, in 579 subjects of various ages using a microneutralization assay in human rhabdomyosarcoma (RD) cells. Read More

Iran J Public Health 2018 Sep;47(9):1234-1243

Dept. of Public Health, Xuhui Central Hospital, Shanghai, China.

Background: Hand-foot-mouth disease (HFMD) is a widespread communicable disease and has caused large epidemics in many countries. This meta-analysis aimed to analyze and evaluate the epidemiological features of HFMD outbreaks in Chinese preschools.

Methods: Literature review was based on PubMed, Chinese National Knowledge Infrastructure (CNKI) and Wanfang databases from 2008 to 2015. Read More

World J Pediatr 2018 Oct 3;14(5):437-447. Epub 2018 Oct 3.

Department of Pediatrics, Yan'an Hospital of Kunming City, Kunming, China.

Background: Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed.

Methods: National Health Commission of China assembled an expert committee for a revision of the guidelines. Read More

Emerg Microbes Infect 2018 Sep 26;7(1):162. Epub 2018 Sep 26.

Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.

Coxsackievirus A16 (CVA16) is an etiologic agent of hand, foot, and mouth disease (HFMD) that affects young children, and although typically self-limited, severe complications, and fatal cases have been reported. Due to the lack of specific medication and vaccines against CVA16, there is currently a need to develop effective antivirals to better control CVA16 infections in epidemic areas. In this study, we identified the tannins chebulagic acid (CHLA) and punicalagin (PUG) as small molecules that can efficiently disrupt the CVA16 infection of human rhabdomyosarcoma cells. Read More

Epidemiol Infect 2018 Sep 13:1-6. Epub 2018 Sep 13.

Saw Swee Hock School of Public Health, National University of Singapore and National University Health System,Singapore,Singapore.

Febrile seizure (FS) in children is a common complication of infections with respiratory viruses and hand, foot and mouth disease (HFMD). We conducted a retrospective ecological time-series analysis to determine the temporal relationship between hospital attendances for FS and HFMD or respiratory virus infections. Epilepsy attendance was used as a control. Read More

PLoS One 2018 7;13(9):e0202316. Epub 2018 Sep 7.

Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Background: Our previous study demonstrated that pediatricians prescribe antibiotics without proper clinical justification to patients with enterovirus infection, although antibiotics are not effective in treating the infections caused by these viruses. To improve the quality of healthcare, we aim to evaluate the association of clinical and demographic characteristics of patients and further to identify the determining factors for prescribing antibiotics to children experiencing enterovirus infection.

Methods: We retrospectively reviewed the medical records of children who were hospitalized between January 2008 and December 2016 with a diagnosis of herpangina or hand-foot-mouth disease (HFMD). Read More

Int J Infect Dis 2018 Oct 28;75:115-117. Epub 2018 Aug 28.

Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Sex differences in childhood infections are commonly reported in case-only studies. In this population-based study of 278000 Taiwanese children followed from 3 months to 18 years of age during the period 2000-2012, age-trajectories of monthly numbers of all-cause healthcare visits and monthly rates of infection-specific healthcare visits were compared between boys and girls. For all-cause healthcare visits and for healthcare visits related to conjunctivitis, respiratory tract infections, enteritis, hand, foot, and mouth disease, and herpangina, there was good resemblance of age trajectories between boys and girls. Read More

Curr Med Sci 2018 Aug 20;38(4):640-647. Epub 2018 Aug 20.

Department of Pediatrics, the Affiliated Hospital of Qingdao University, Qirtgdao, 266000, China.

This study aimed to assess the relationship of OAS2 rs739901 5,-flanking C/A polymorphisms with the susceptibility to Enterovirus-71 (EV71) infection. We investigated 294 hand-foot-mouth disease (HFMD) Chinese children with EV71 infection (165 mild cases and 129 encephalitis cases). The improved multiplex ligation detection reaction (iMLDR) technique was used to test the genotypes. Read More

PLoS One 2018 10;13(8):e0201726. Epub 2018 Aug 10.

Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea.

Background: In 2009, a nationwide sentinel surveillance for hand-foot-mouth disease (HFMD) and herpangina (HA) with neurologic complications was initiated in South Korea. We used this surveillance system to investigate the clinical characteristics of patients with either HFMD or HA with neurologic complications, with the aim of determining risk factors for severe neurologic complications.

Methods: A retrospective review of medical records was conducted on all cases of HFMD and HA with neurologic complications that were reported in the national system between April 1, 2009 and December 31, 2014. Read More

Zhonghua Er Ke Za Zhi 2018 Aug;56(8):575-581

Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing 100020, China.

To understand the epidemiological and etiological characteristics of enterovirus (EV)-associated diseases among children in Beijing from 2010 to 2016. This was a repeated cross-sectional study. The throat swabs were collected from children with probable EV-associated diseases at the Children' s Hospital Affiliated to Capital Institute of Pediatrics from 2010 to 2016. Read More

Sci Rep 2018 Jul 16;8(1):10713. Epub 2018 Jul 16.

Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.

Enterovirus 71 (EV71) is an aetiological agent responsible for seasonal epidemics of hand-foot-and-mouth disease, which causes considerable mortality among young children. Mucosal vaccines can efficiently induce secretory IgA at mucosal surfaces and thereby prevent or limit infection at the site of virus entry. CpG oligodeoxynucleotides (ODNs), which resemble bacterial DNA, can induce the innate immune response through activation of Toll-like receptor 9. Read More