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Molecular epidemiology of enterovirus 71, coxsackievirus A16 and A6 associated with hand, foot and mouth disease in Spain.
Clin Microbiol Infect. 2014 Mar; 20(3):O150-6.CM

Abstract

Hand, foot and mouth disease (HFMD) is a childhood illness frequently caused by genotypes belonging to the enterovirus A species, including coxsackievirus (CV)-A16 and enterovirus (EV)-71. Between 2010 and 2012, several outbreaks and sporadic cases of HFMD occurred in different regions of Spain. The objective of the present study was to describe the enterovirus epidemiology associated with HFMD in the country. A total of 80 patients with HFMD or atypical rash were included. Detection and typing of the enteroviruses were performed directly in clinical samples using molecular methods. Enteroviruses were detected in 53 of the patients (66%). CV-A6 was the most frequent genotype, followed by CV-A16 and EV-71, but other minority types were also identified. Interestingly, during almost all of 2010, CV-A16 was the only causative agent of HFMD but by the end of the year and during 2011, CV-A6 became predominant, while CV-A16 was not detected. In 2012, however, both CV-A6 and CV-A16 circulated. EV-71 was associated with HFMD symptoms only in three cases during 2012. All Spanish CV-A6 sequences segregated into one major genetic cluster together with other European and Asian strains isolated between 2008 and 2011, most forming a particular clade. Spanish EV-71 strains belonged to subgenogroup C2, as did most of the European sequences circulated. In conclusion, the recent increase of HFMD cases in Spain and other European countries has been due to a larger incidence of circulating species A enteroviruses, mainly CV-A6 and CV-A16, and the emergence of new genetic variants of these viruses.

Authors+Show Affiliations

Enterovirus Unit, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24033818

Citation

Cabrerizo, M, et al. "Molecular Epidemiology of Enterovirus 71, Coxsackievirus A16 and A6 Associated With Hand, Foot and Mouth Disease in Spain." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 20, no. 3, 2014, pp. O150-6.
Cabrerizo M, Tarragó D, Muñoz-Almagro C, et al. Molecular epidemiology of enterovirus 71, coxsackievirus A16 and A6 associated with hand, foot and mouth disease in Spain. Clin Microbiol Infect. 2014;20(3):O150-6.
Cabrerizo, M., Tarragó, D., Muñoz-Almagro, C., Del Amo, E., Domínguez-Gil, M., Eiros, J. M., López-Miragaya, I., Pérez, C., Reina, J., Otero, A., González, I., Echevarría, J. E., & Trallero, G. (2014). Molecular epidemiology of enterovirus 71, coxsackievirus A16 and A6 associated with hand, foot and mouth disease in Spain. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 20(3), O150-6. https://doi.org/10.1111/1469-0691.12361
Cabrerizo M, et al. Molecular Epidemiology of Enterovirus 71, Coxsackievirus A16 and A6 Associated With Hand, Foot and Mouth Disease in Spain. Clin Microbiol Infect. 2014;20(3):O150-6. PubMed PMID: 24033818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular epidemiology of enterovirus 71, coxsackievirus A16 and A6 associated with hand, foot and mouth disease in Spain. AU - Cabrerizo,M, AU - Tarragó,D, AU - Muñoz-Almagro,C, AU - Del Amo,E, AU - Domínguez-Gil,M, AU - Eiros,J M, AU - López-Miragaya,I, AU - Pérez,C, AU - Reina,J, AU - Otero,A, AU - González,I, AU - Echevarría,J E, AU - Trallero,G, Y1 - 2013/09/14/ PY - 2013/05/17/received PY - 2013/07/16/revised PY - 2013/08/10/accepted PY - 2013/9/17/entrez PY - 2013/9/17/pubmed PY - 2015/1/31/medline KW - Coxsackievirus KW - HFMD KW - genotyping KW - molecular epidemiology KW - phylogenetic analyses SP - O150 EP - 6 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin. Microbiol. Infect. VL - 20 IS - 3 N2 - Hand, foot and mouth disease (HFMD) is a childhood illness frequently caused by genotypes belonging to the enterovirus A species, including coxsackievirus (CV)-A16 and enterovirus (EV)-71. Between 2010 and 2012, several outbreaks and sporadic cases of HFMD occurred in different regions of Spain. The objective of the present study was to describe the enterovirus epidemiology associated with HFMD in the country. A total of 80 patients with HFMD or atypical rash were included. Detection and typing of the enteroviruses were performed directly in clinical samples using molecular methods. Enteroviruses were detected in 53 of the patients (66%). CV-A6 was the most frequent genotype, followed by CV-A16 and EV-71, but other minority types were also identified. Interestingly, during almost all of 2010, CV-A16 was the only causative agent of HFMD but by the end of the year and during 2011, CV-A6 became predominant, while CV-A16 was not detected. In 2012, however, both CV-A6 and CV-A16 circulated. EV-71 was associated with HFMD symptoms only in three cases during 2012. All Spanish CV-A6 sequences segregated into one major genetic cluster together with other European and Asian strains isolated between 2008 and 2011, most forming a particular clade. Spanish EV-71 strains belonged to subgenogroup C2, as did most of the European sequences circulated. In conclusion, the recent increase of HFMD cases in Spain and other European countries has been due to a larger incidence of circulating species A enteroviruses, mainly CV-A6 and CV-A16, and the emergence of new genetic variants of these viruses. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/24033818/Molecular_epidemiology_of_enterovirus_71_coxsackievirus_A16_and_A6_associated_with_hand_foot_and_mouth_disease_in_Spain_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(14)60847-8 DB - PRIME DP - Unbound Medicine ER -