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Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland.
J Clin Virol. 2010 May; 48(1):49-54.JC

Abstract

BACKGROUND

A nationwide outbreak of hand, foot and mouth disease (HFMD) occurred in Finland in autumn 2008. The outbreak was untypical since a considerable number of clinically diagnosed patients were adults. Furthermore, many of the patients suffered from onychomadesis several weeks after the acute phase of HFMD.

OBJECTIVES

Detection, identification and phylogenetic analysis of human enteroviruses (HEV) that caused the outbreak.

STUDY DESIGN

A total of 420 clinical specimens were obtained from 317 HFMD cases all over the country. The presence of HEV in the specimens was analysed by virus isolation and/or direct real-time RT-PCR; selected HEV strains were further typed by molecular methods. The genetic similarities of HEV strains were assessed by phylogenetic analyses on partial VP1 sequences.

RESULTS

HEV were detected in 212 HFMD cases, including both children and adults, throughout Finland. Two HEV types, coxsackieviruses A6 (CV-A6) and A10 (CV-A10), were identified as the causative agents of the outbreak. One genetic variant of CV-A6 predominated, but, additionally, three other genetically distinct CV-A6 strains were found. All CV-A10 strains segregated into one genetic cluster distinct from previously reported CV-A10 sequences.

CONCLUSIONS

The Finnish 2008 HFMD outbreak was caused by two infrequently detected, co-circulating, coxsackie A viruses. Our data suggest endemic circulation of both CV-A types in Northern Europe and that the outbreak was due to the emergence of new genetic variants of these viruses.

Authors+Show Affiliations

National Institute for Health and Welfare (THL), Department of Infectious Disease Surveillance and Control, Gastrointestinal Infections Unit, PO Box 30, 00271 Helsinki, Finland. soile.blomqvist@thl.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20189452

Citation

Blomqvist, Soile, et al. "Co-circulation of Coxsackieviruses A6 and A10 in Hand, Foot and Mouth Disease Outbreak in Finland." Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, vol. 48, no. 1, 2010, pp. 49-54.
Blomqvist S, Klemola P, Kaijalainen S, et al. Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. J Clin Virol. 2010;48(1):49-54.
Blomqvist, S., Klemola, P., Kaijalainen, S., Paananen, A., Simonen, M. L., Vuorinen, T., & Roivainen, M. (2010). Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 48(1), 49-54. https://doi.org/10.1016/j.jcv.2010.02.002
Blomqvist S, et al. Co-circulation of Coxsackieviruses A6 and A10 in Hand, Foot and Mouth Disease Outbreak in Finland. J Clin Virol. 2010;48(1):49-54. PubMed PMID: 20189452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. AU - Blomqvist,Soile, AU - Klemola,Päivi, AU - Kaijalainen,Svetlana, AU - Paananen,Anja, AU - Simonen,Marja-Leena, AU - Vuorinen,Tytti, AU - Roivainen,Merja, Y1 - 2010/02/26/ PY - 2009/12/02/received PY - 2010/01/29/revised PY - 2010/02/03/accepted PY - 2010/3/2/entrez PY - 2010/3/2/pubmed PY - 2010/7/16/medline SP - 49 EP - 54 JF - Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology JO - J Clin Virol VL - 48 IS - 1 N2 - BACKGROUND: A nationwide outbreak of hand, foot and mouth disease (HFMD) occurred in Finland in autumn 2008. The outbreak was untypical since a considerable number of clinically diagnosed patients were adults. Furthermore, many of the patients suffered from onychomadesis several weeks after the acute phase of HFMD. OBJECTIVES: Detection, identification and phylogenetic analysis of human enteroviruses (HEV) that caused the outbreak. STUDY DESIGN: A total of 420 clinical specimens were obtained from 317 HFMD cases all over the country. The presence of HEV in the specimens was analysed by virus isolation and/or direct real-time RT-PCR; selected HEV strains were further typed by molecular methods. The genetic similarities of HEV strains were assessed by phylogenetic analyses on partial VP1 sequences. RESULTS: HEV were detected in 212 HFMD cases, including both children and adults, throughout Finland. Two HEV types, coxsackieviruses A6 (CV-A6) and A10 (CV-A10), were identified as the causative agents of the outbreak. One genetic variant of CV-A6 predominated, but, additionally, three other genetically distinct CV-A6 strains were found. All CV-A10 strains segregated into one genetic cluster distinct from previously reported CV-A10 sequences. CONCLUSIONS: The Finnish 2008 HFMD outbreak was caused by two infrequently detected, co-circulating, coxsackie A viruses. Our data suggest endemic circulation of both CV-A types in Northern Europe and that the outbreak was due to the emergence of new genetic variants of these viruses. SN - 1873-5967 UR - https://www.unboundmedicine.com/medline/citation/20189452/Co_circulation_of_coxsackieviruses_A6_and_A10_in_hand_foot_and_mouth_disease_outbreak_in_Finland_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1386-6532(10)00053-3 DB - PRIME DP - Unbound Medicine ER -