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BMC Pediatr 2019 Feb 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 Feb 7. 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 Feb 1:1-5. 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 Feb 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 Jan 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 2018 Dec 14. 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 2018 Dec 10. Epub 2018 Dec 10.

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

J Trop Pediatr 2018 Nov 19. Epub 2018 Nov 19.

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 2018 Nov 14. Epub 2018 Nov 14.

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 2018 Nov 10. 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

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

J Clin Virol 2018 Aug 3;105:41-48. Epub 2018 Jun 3.

Department of pathogen diagnosis and biosafety, Shanghai public health clinical center, Fudan University, Shanghai, 201508, PR China. Electronic address:

Background: Enteroviruses cause hand, foot and mouth disease (HFMD). The host B-cells recognize the viral proteins and provoke humoral responses. Deciphering the B-cell responses to the viral epitopes helps diagnosis and vaccine development. Read More

EBioMedicine 2018 May 10;31:299-306. Epub 2018 May 10.

Laboratory of Molecular RNA Virology and Antiviral Strategies, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University Health System, 5 Science Drive 2, National University of Singapore, 117597, Singapore; Collaborative and Translational Unit for HFMD, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore. Electronic address:

Enhancements in the diagnostic capabilities using host biomarkers are currently much needed where sensitivity and specificity issues plague the diagnosis of Hand, Foot and Mouth Disease (HFMD) in pediatrics clinical samples. We investigated miRNome profiles of HFMD saliva samples against healthy children and developed miRNA-based diagnosis models. Our 6-miRNA scoring model predicted HFMD with an overall accuracy of 85. Read More

Int Immunopharmacol 2018 Jul 24;60:26-33. Epub 2018 Apr 24.

Department of Pediatrics, First Affiliated Hospital of Xinxiang Medical University, Weihui, Xinxiang, Henan Province, PR China. Electronic address:

Interaction between Toll-like receptor (TLR) and Notch signaling contributes to inflammatory response in nephropathy and fungicidal infection, however, the role of this crosstalk remains not fully elucidated in enterovirus 71 (EV71)-induced hand, foot, and mouth disease (HFMD). The aim of this study was to investigate the crosstalk between TLR and Notch in inflammatory regulation in EV71 infection. Thirty-seven EV-71-indcued HFMD (16 mild and 21 severe cases) and eleven normal control (NC) were enrolled. Read More

Indian J Dermatol Venereol Leprol 2018 May-Jun;84(3):328-331

Department of Virus Research, Regional Reference Laboratory for Influenza Viruses and ICMR Virology Network Laboratory-Grade-I, Manipal Academy of Higher Education, Manipal, Karnataka, India.

BMJ Glob Health 2018 26;3(1):e000442. Epub 2018 Jan 26.

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

Background: Hand, foot and mouth disease (HFMD) affects millions of children across Asia annually, leading to an increase in implemented control policies such as surveillance, isolation and social distancing in affected jurisdictions. However, limited knowledge of disease burden and severity causes difficulty in policy optimisation as the associated economic cost cannot be easily estimated. We use a data synthesis approach to provide a comprehensive picture of HFMD disease burden, estimating infection risk, symptomatic rates, the risk of complications and death, and overall disability-adjusted life-year (DALY) losses, along with associated uncertainties. Read More

Sci Rep 2018 Mar 6;8(1):4087. Epub 2018 Mar 6.

Collaborative and Translation Unit for HFMD, Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.

Hand, foot and mouth disease (HFMD) is a prevalent contagious childhood disease typically associated with fever, oral lesions and limb exanthema. While HFMD is caused by a plethora of serotypes of viruses under the genus Enterovirus within the Picornaviridae family, Coxsackievirus A16 (CV-A16) and Enterovirus 71 (EV-A71) are considered the main etiological agents. In recent years however, other viruses have also been isolated in considerable numbers from infected individuals in many regions, joining the legion commonly associated with HFMD. Read More

Kaohsiung J Med Sci 2018 Mar 6;34(3):150-159. Epub 2017 Dec 6.

Department of Renal Care, College of Medicine, Kaohsiung Medical University, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan. Electronic address:

Artemisia capillaris (A. capillaris) is a common herbal drug used for thousands years in ancient China. A. Read More

Antiviral Res 2018 04 20;152:124-130. Epub 2018 Feb 20.

Unit of Vaccinology & Antiviral Strategies, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai 200031, 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 510623, China. Electronic address:

Coxsackievirus A10 (CVA10) has emerged worldwide as one of the main pathogens of hand, foot, and mouth disease (HFMD) in recent years. However, there is currently no commercial vaccine available to prevent CVA10 infection. Here we report the development of a recombinant virus-like particle (VLP) based candidate vaccine for CVA10. Read More

Epidemiol Infect 2018 02 1;146(3):324-332. Epub 2018 Feb 1.

Division of Behavioural Sciences,School of Public Health,The University of Hong Kong,Hong Kong,China.

Hand, foot, and mouth disease (HFMD), usually a self-limiting illness for young children, could cause a significant burden for parents because it can take up to 1-2 weeks for a sick child to recover. We conducted a two-wave longitudinal study over one summer peak season (May-July 2014) of HFMD to examine parents' HFMD-related risk perceptions and protective responses. In total, 618 parents with at least one child aged ⩽12 years, recruited using randomly-dialled household telephone calls completed the baseline survey interview, 452 of whom subsequently completed the follow-up survey. Read More

PLoS One 2018 25;13(1):e0191617. Epub 2018 Jan 25.

Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan.

EV71 is a positive-sense single-stranded RNA virus that belongs to the Picornaviridae family. EV71 infection may cause various symptoms ranging from hand-foot-and-mouth disease to neurological pathological conditions such as aseptic meningitis, ataxia, and acute transverse myelitis. There is currently no effective treatment or vaccine available. Read More

PLoS Pathog 2018 01 11;14(1):e1006778. Epub 2018 Jan 11.

Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

A close relative of poliovirus, enterovirus 71 (EV71) is regarded as an important neurotropic virus of serious public health concern. EV71 causes Hand, Foot and Mouth Disease and has been associated with neurological complications in young children. Our limited understanding of the mechanisms involved in its neuropathogenesis has hampered the development of effective therapeutic options. Read More

Medicine (Baltimore) 2017 Dec;96(49):e8934

Infection Department of the Children's Hospital, The Pediatrics Institution of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, The Children's Hospital of Chongqing Medical University, Chongqing, P.R. China.

Hand-foot-and-mouth disease (HFMD) is a common childhood infection that may lead to serious complications and even death. Globally, epidemics of HFMD are increasing each year, especially in China. This study aimed to identify risk factors for death in children with critical and severe HFMD in Chongqing, China. Read More

Indian Pediatr 2018 02 14;55(2):137-139. Epub 2017 Dec 14.

Departments of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China. Correspondence to: Dr Dan Wei, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Objective: To analyze the clinical features of children with hand foot and mouth disease (HFMD) who died.

Methods: 331 deaths due to HFMD between 2010 and 2014 were included in this retrospective study; 15 autopsies were performed.

Results: Most deaths were seen in children aged below 3 y, and with enterovirus 71 infection (91%). Read More

Front Microbiol 2017 28;8:2249. Epub 2017 Nov 28.

Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.

Enterovirus 71 (EV71) is a global infectious disease that affects millions of people. The virus is the main etiological agent for hand, foot, and mouth disease with outbreaks and epidemics being reported globally. Infection can cause severe neurological, cardiac, and respiratory problems in children under the age of 5. Read More

Postgrad Med 2018 Mar 14;130(2):258-263. Epub 2017 Dec 14.

a Department of Pediatrics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.

Objectives: The enterovirus EV71 is a major pathogen of hand, foot, and mouth disease (HFMD) in children. Aseptic meningitis is the most common neurologic complication of EV71-induced HFMD. Lumbar puncture is a crucial procedure in the diagnosis of aseptic meningitis. Read More

Sci Rep 2017 Nov 27;7(1):16341. Epub 2017 Nov 27.

Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

Children of severe hand, foot, and mouth disease (HFMD) often present with same clinical features as those of mild HFMD during the early stage, yet later deteriorate rapidly with a fulminant disease course. Our goal was to: (1) develop a machine learning system to automatically identify cases with high risk of severe HFMD at the time of admission; (2) compare the effectiveness of the new system with the existing risk scoring system. Data on 2,532 HFMD children admitted between March 2012 and July 2015, were collected retrospectively from a medical center in China. Read More

Sci Rep 2017 Nov 27;7(1):16422. Epub 2017 Nov 27.

CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.

Enterovirus 71 (EV71) is the predominant causative pathogen of hand-foot-and-mouth disease (HFMD). Contrary to other HFMD-causing enterovirus, EV71 can lead to severe neurological complications, even death. MicroRNAs (miRNAs) are small non-coding RNAs that constitute the largest family of gene regulators participating in numerous biological or pathological processes. Read More

J Interferon Cytokine Res 2017 12 27;37(12):522-530. Epub 2017 Nov 27.

2 Department of Infectious Diseases, The First Affiliated Hospital of Xinxiang Medical University , Weihui, China .

Interleukin (IL)-35 modulates the imbalance between regulatory T cells (Tregs) and T helper (Th) 17 cells, which played vital roles in the pathogenesis of autoimmune and infectious diseases. However, the role of Tregs/Th17 cell imbalance and the regulatory functions of IL-35 have remained largely unknown in enterovirus 71 (EV71)-induced hand, foot, and mouth disease (HFMD). In this study, a total of 47 HFMD patients (30 with mild HFMD and 17 with severe HFMD) and 13 healthy individuals were enrolled. Read More

Korean J Pediatr 2017 Oct 20;60(10):333-336. Epub 2017 Oct 20.

Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.

Coxsackievirus A16 (CA16), which primarily causes hand, foot, and mouth disease (HFMD), is associated with complications, such as encephalitis, acute flaccid paralysis, myocarditis, pericarditis, and shock. However, no case of pancreatitis associated with CA16 has been reported in children. We report a case of CA16-associated acute pancreatitis in a 3-year-old girl with HFMD. Read More

J Virol 2018 01 2;92(2). Epub 2018 Jan 2.

National Center for Protein Science Shanghai, State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China

Coxsackievirus A6 (CVA6) has recently emerged as one of the predominant causative agents of hand, foot, and mouth disease (HFMD). The structure of the CVA6 mature viral particle has not been solved thus far. Our previous work shows that recombinant virus-like particles (VLPs) of CVA6 represent a promising CVA6 vaccine candidate. Read More

J Infect Dis 2017 12;216(11):1337-1339

Department of Molecular Virology and Microbiology, and Pediatrics, Baylor College of Medicine, Houston, Texas.

Eur Rev Med Pharmacol Sci 2017 Sep;21(18):4214-4218

Department of Emergency, Xuzhou Children's Hospital affiliated to Xuzhou Medical University, Xuzhou, Jiangsu Province, China.

Objective: In this prospective cohort study, the efficacy and action mechanism of an intestinal probiotic formulation, Golden Bifid, in severe hand, foot, and mouth disease (HFMD) were determined in 63 consecutively admitted patients successfully treated in the Pediatrics Emergency Department of our hospital.

Patients And Methods: All patients had a persistent fever; 43 patients had rashes on hands, feet, crissum, and hips; and 45 patients had neurological signs and symptoms. Patients were treated with standard supportive therapy along with ventilator-assisted respiration combined with bedside hemofiltration for removal of circulatory toxins and to achieve acid-base equilibrium and electrolyte stability. Read More

Antiviral Res 2018 01 10;149:106-112. Epub 2017 Oct 10.

Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Beijing Municipal Laboratory of Infection and Immunity, Capital Institute of Pediatrics, Beijing 100020, China; Graduate School of Peking Union Medical College, Beijing 100730, China. Electronic address:

Enterovirus 71, as one of the dominant pathogens associated with severe hand, foot, and mouth disease, has been well reported to trigger severe neurological symptoms among young children over the last decade, particularly among children in the Asia-Pacific region. To date, no effective antiviral agent has been developed for the treatment of severe enterovirus 71 infection. PNU-282987, a selective alpha 7 nicotinic acetylcholine receptor (α7nAChR) agonist, has been reported to have a neuroprotective effect by participating in inflammatory regulation in previous studies. Read More

Nat Commun 2017 10 2;8(1):762. Epub 2017 Oct 2.

Division of Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, 33305, Taiwan.

Protective antibody levels are critical for protection from severe enterovirus 71 infection. However, little is known about the specificities and functional properties of the enterovirus 71-specific antibodies induced by natural infection in humans. Here we characterize 191 plasmablast-derived monoclonal antibodies from three enterovirus 71-infected children, each of whom shows a distinct serological response. Read More

BMC Infect Dis 2017 09 29;17(1):651. Epub 2017 Sep 29.

Department of Emergency, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 Road, Yuzhong district, Chongqing, 400014, China.

Background: Hand-foot-mouth disease (HFMD) is an acute infectious disease caused by enteroviruses, and HFMD complicated by cardiopulmonary failure has a high mortality. B type natriuretic peptide (BNP) is widely applied in monitoring cardiovascular disorders, and thus, we investigated whether this index was associated with the severity of HFMD and the outcome in severe HFMD.

Methods: Serum BNP, lactate, and glucose levels as well as white blood cell (WBC) count, PaO/FiO, and cardiac output (CO) were analyzed in the 83 enrolled HFMD patients according to different conditions (common, severe, and critical; with and without complication; and survivors and non-survivors). Read More

J Virol 2017 12 14;91(23). Epub 2017 Nov 14.

Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan

RNA viruses accumulate mutations to rapidly adapt to environmental changes. Enterovirus A71 (EV-A71) causes various clinical manifestations with occasional severe neurological complications. However, the mechanism by which EV-A71 evolves within the human body is unclear. Read More

PLoS Negl Trop Dis 2017 Sep 11;11(9):e0005899. Epub 2017 Sep 11.

Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Background And Aims: Enterovirus 71 (EV71) has caused great morbidity, mortality, and use of health service in children younger than five years in China. Vaccines against EV71 have been proved effective and safe by recent phase 3 trials and are now available in China. The purpose of this study was to evaluate the health impact and cost-effectiveness of a national EV71 vaccination program in China. Read More

Sci Rep 2017 Sep 4;7(1):10385. Epub 2017 Sep 4.

Key Laboratory of Special Pathogens and Biosafety, Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.

Enterovirus 71 (EV71) is a major pathogen of hand, foot, and mouth disease (HFMD). To date, no antiviral drug has been approved to treat EV71 infection. Due to the essential role that EV71 3 C protease (3C) plays in the viral life cycle, it is generally considered as a highly appealing target for antiviral drug development. Read More

Asian Pac J Trop Med 2017 May 18;10(5):473-477. Epub 2017 May 18.

Pediatric Intensive Care Unit, Maternal and Child Health Care Hospital of Hainan Province (Children's Hospital of Hainan Province), Haikou 570206, China. Electronic address:

Objective: To investigate the relationship between the levels of plasma adrenaline and norepinephrine and gene polymorphism of β1 adrenergic receptor G1165C in children with enterovirus 71 (EV71) infection in hand foot and mouth disease (HFMD).

Methods: The polymerase chain reaction (PCR) was used to detect the expression of gene polymorphism of β1 adrenergic receptor G1165C in vitro. The levels of plasma adrenaline and norepinephrine were measured by enzyme-linked immunosorbent assay (ELISA). Read More