1
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Huang CY, Su SB, Chen KT. A review of enterovirus-associated hand-foot and mouth disease: preventive strategies and the need for a global enterovirus surveillance network. Pathog Glob Health 2024:1-11. [PMID: 39229797 DOI: 10.1080/20477724.2024.2400424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024] Open
Abstract
Enterovirus (EV)-associated hand, foot, and mouth disease (HFMD) is a significant public health issue worldwide, commonly occurring in children five years of age or younger. The leading causes of most HFMD cases are EVs, which are members of the Picornaviridae family. The typical clinical manifestations of EV-associated HFMD are febrile presentations with mucosal herpangina, oral ulcerations, and skin rashes on the hands and feet. The majority of HFMD cases resolve without consequence; however, a subset progresses to severe neurological and cardiopulmonary complications, which can be fatal. In the past two decades, EV-associated HFMD has received significant attention. In this review, we organize published papers and provide updates on epidemiology, pathogenesis, surveillance, and vaccine developments for EV-associated HFMD. The impact of EV-associated HFMD is increasing globally. Developing efficacious vaccines has become a priority for preventing EV infections without adequate treatment. Simultaneously, emerging EV infections (including EV-D68, EV-A71, Coxsackieviruses, and echoviruses) are increasing, highlighting the need to create a vigilant surveillance system for EV infections worldwide.
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Affiliation(s)
- Chien-Yuan Huang
- Division of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital (managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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2
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Zhang X, Zhao Y, Zhu X, Tian W, Zhang C. Rapid detection of four major HFMD-associated enteroviruses by multiplex HiFi-LAMP assays. Anal Bioanal Chem 2024; 416:1971-1982. [PMID: 38358534 DOI: 10.1007/s00216-024-05197-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/19/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024]
Abstract
Hand, foot, and mouth disease (HFMD) caused by various enteroviruses is a major public health concern globally. Human enterovirus 71(EVA71), coxsackievirus A16 (CVA16), coxsackievirus A6 (CVA6), and coxsackievirus A10 (CVA10) are four major enteroviruses responsible for HFMD. Rapid, accurate, and specific point-of-care (POC) detection of the four enteroviruses is crucial for the prevention and control of HFMD. Here, we developed two multiplex high-fidelity DNA polymerase loop-mediated isothermal amplification (mHiFi-LAMP) assays for simultaneous detection of EVA71, CVA16, CVA6, and CVA10. The assays have good specificity and exhibit high sensitivity, with limits of detection (LOD) of 11.2, 49.6, 11.4, and 20.5 copies per 25 μL reaction for EVA71, CVA16, CVA6, and CVA10, respectively. The mHiFi-LAMP assays showed an excellent clinical performance (sensitivity 100.0%, specificity 83.3%, n = 47) when compared with four singleplex RT-qPCR assays (sensitivity 93.1%, specificity 100%). In particular, the HiFi-LAMP assays exhibited better performance (sensitivity 100.0%, specificity 100%) for CVA16 and CVA6 than the RT-qPCR assays (sensitivity 75.0-92.3%, specificity 100%). Furthermore, the mHiFi-LAMP assays detected all clinical samples positive for the four enteroviruses within 30 min, obviously shorter than about 1-1.5 h by the RT-qPCR assays. The new mHiFi-LAMP assays can be used as a robust point-of-care testing (POCT) tool to facilitate surveillance of HFMD at rural and remote communities and resource-limited settings.
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Affiliation(s)
- Xiaoling Zhang
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, People's Republic of China
| | - Yongjuan Zhao
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, People's Republic of China
| | - Xiaoyi Zhu
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, People's Republic of China
| | - Weimin Tian
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, People's Republic of China.
| | - Chiyu Zhang
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, People's Republic of China.
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Shrestha S, Malla B, Sangsanont J, Sirikanchana K, Ngo HTT, Inson JGM, Enriquez MLD, Alam ZF, Setiyawan AS, Setiadi T, Takeda T, Kitajima M, Haramoto E. Detection of enteroviruses related to hand foot and mouth disease in wastewater of Asian communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169375. [PMID: 38110101 DOI: 10.1016/j.scitotenv.2023.169375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/25/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is contagious and predominantly affects children below the age of five. HFMD-associated serotypes of Enterovirus A (EVA) family include EVA71, Coxsackievirus A type 6 (CVA6), 10 (CVA10), and 16 (CVA16). Although prevalent in numerous Asian countries, studies on HFMD-causing agents in wastewater are scarce. This study aimed to conduct wastewater surveillance in various Asian communities to detect and quantify serotypes of EVA associated with HFMD. In total, 77 wastewater samples were collected from Indonesia, the Philippines, Thailand, and Vietnam from March 2022 to February 2023. The detection ratio for CVA6 RNA in samples from Vietnam was 40 % (8/20). The detection ratio for CVA6 and EVA71 RNA each was 25 % (5/20) for the Indonesian samples, indicating the need for clinical surveillance of CVA6, as clinical reports have been limited. For the Philippines, 12 % (2/17) of the samples were positive for CVA6 and EVA71 RNA each, with only one quantifiable sample each. Samples from Thailand had a lower detection ratio (1/20) for CVA6 RNA, and the concentration was unquantifiable. Conversely, CVA10 and CVA16 RNAs were not detected in any of the samples. The minimum and maximum concentrations of CVA6 RNA were 2.7 and 3.9 log10 copies/L and those for EVA71 RNA were 2.5 and 4.9 log10 copies/L, respectively. This study underscores the importance of wastewater surveillance in understanding the epidemiology of HFMD-associated EVA serotypes in Asian communities. Long-term wastewater surveillance is recommended to monitor changes in dominant serotypes, understand seasonality, and develop effective prevention and control strategies for HFMD.
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Affiliation(s)
- Sadhana Shrestha
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Bikash Malla
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Jatuwat Sangsanont
- Department of Environmental Science, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand; Water Science and Technology for Sustainable Environmental Research Group, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Kwanrawee Sirikanchana
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, 54 Kamphaeng Phet 6 Rd., Talat Bang Khen, Lak Si, Bangkok 10210, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), OPS, MHESI, Bangkok 10400, Thailand.
| | - Huong Thi Thuy Ngo
- Faculty of Biotechnology, Chemistry and Environmental Engineering, Phenikaa University, Yen Nghia, Ha Dong, Hanoi 12116, Viet Nam; Environmental Chemistry and Ecotoxicology Lab, Phenikaa University, Yen Nghia Ward - Ha Dong District, Hanoi 12116, Viet Nam.
| | - Jessamine Gail M Inson
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Ma Luisa D Enriquez
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Zeba F Alam
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Ahmad Soleh Setiyawan
- Department of Environmental Engineering, Institut Teknologi Bandung, Jl. Ganesha No. 10, Bandung 40132, Indonesia.
| | - Tjandra Setiadi
- Department of Chemical Engineering, Institut Teknologi Bandung, Jl. Ganesa 10, Bandung 40132, Indonesia.
| | - Tomoko Takeda
- Department of Earth and Planetary Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Masaaki Kitajima
- Division of Environmental Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan.
| | - Eiji Haramoto
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan.
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Mustafa FH, Ismail I, Ahmad Munawar AAZ, Abdul Basir B, Shueb RH, Irekeola AA, Wan Ismail WZ, Jamaludin J, Balakrishnan SR, Sahrim M, Yusof NY. A review on current diagnostic tools and potential optical absorption spectroscopy for HFMD detection. Anal Biochem 2023; 683:115368. [PMID: 37890549 DOI: 10.1016/j.ab.2023.115368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023]
Abstract
Hand, Foot, and Mouth Disease (HFMD) is an outbreak infectious disease that can easily spread among children under the age of five. The most common causative agents of HFMD are enterovirus 71 (EV71) and coxsackievirus A16 (CVA16), but infection caused by EV71 is more associated with fatalities due to severe neurological disorders. The present diagnosis methods rely on physical examinations by the doctors and further confirmation by laboratories detection methods such as viral culture and polymerase chain reaction. Clinical signs of HFMD infection and other childhood diseases such as chicken pox, and allergies are similar, yet the genetics and pathogenicity of the viruses are substantially different. Thus, there is an urgent need for an early screening of HFMD using an inexpensive and user-friendly device that can directly detect the causative agents of the disease. This paper reviews current HFMD diagnostic methods based on various target types, such as nucleic acid, protein, and whole virus. This was followed by a thorough discussion on the emerging sensing technologies for HFMD detection, including surface plasmon resonance, electrochemical sensor, and surface enhanced Raman spectroscopy. Lastly, optical absorption spectroscopic method was critically discussed and proposed as a promising technology for HFMD screening and detection.
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Affiliation(s)
- Fatin Hamimi Mustafa
- Department of Electronic & Computer Engineering, Faculty of Electrical Engineering, University Teknologi Malaysia, Johor Bharu, 81310, Johor, Malaysia; Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
| | - Irneza Ismail
- Department of Electrical & Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia.
| | - Ahmad Aiman Zuhaily Ahmad Munawar
- Department of Electrical & Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Basmah Abdul Basir
- Department of Electrical & Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Rafidah Hanim Shueb
- Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia; Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
| | - Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia; Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, PMB 4412, Offa Kwara State, Nigeria
| | - Wan Zakiah Wan Ismail
- Department of Electrical & Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Juliza Jamaludin
- Department of Electrical & Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Sharma Rao Balakrishnan
- Department of Electrical & Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Mus'ab Sahrim
- Department of Electrical & Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Nik Yusnoraini Yusof
- Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
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Yamamoto Y, Matsumura M. Adult Hand, Foot, and Mouth Disease. Am J Med 2023; 136:e231-e232. [PMID: 37690505 DOI: 10.1016/j.amjmed.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/07/2023] [Accepted: 08/13/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
| | - Masami Matsumura
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Zhang Q, Wen D, Liu Q, Opriessnig T, Yu X, Jiang Y. Universal primer multiplex PCR assay for detection and genotyping of porcine astroviruses. J Virol Methods 2023; 322:114822. [PMID: 37729969 DOI: 10.1016/j.jviromet.2023.114822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/03/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
Porcine astroviruses (PAstV) are members of the family Astroviridae, Mamastravirus genus and have been identified to have five genotypes (PAstV1-5). These viruses are highly prevalent in pigs and can cause enteric disease as well as neurological or respiratory symptoms depending on their genotypes. At present, the epidemiological impacts of some PAstV genotypes on pigs are largely unknown and hence continuously monitoring of these PAstVs may be needed. The purpose of this research was to develop an improved and efficient detection tool for PAstVs and to evaluate the developed method using clinical samples. Initially, a set of five chimeric primers (CP), each comprising genotype specific primer pairs with an identical universal adapter at the 5' end, and a universal primer (UP) that is identical to universal adapter sequence, were designed. With these tools in place, a novel multiplex PCR system with universal primer was established for the simultaneous detection of the five types of PAstV. This method can specifically detect PAstV genotypes, with a limit of detection (LOD) of 5 copies/μL for each genotype irrespective of single or mixed target template. Using this new assay, 273 pig fecal samples were investigated for further assay evaluation. Among all samples, the positive rate was 70.0% with PAstV4 in 56.8% of the samples, PAstV2 in 38.8%, PAstV1 in 16.8%, and PAstV5 in 11.0%. More than one PAstV in a sample were detected in 39.2% of the samples. The consistency rate between the novel multiplex PCR and singleplex PCRs was 96.4-100%. Given its rapidity, specificity and sensitivity, the novel multiplex PCR is a useful approach for demonstrating single or mixed genotype infections of PAstV.
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Affiliation(s)
- Qiuya Zhang
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Dan Wen
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Qin Liu
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Tanja Opriessnig
- Vaccines and Diagnostics Department, Moredun Research Institute, Penicuik, Midlothian, UK; Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Xiaoya Yu
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Yonghou Jiang
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China.
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Shrestha S, Malla B, Haramoto E. Monitoring hand foot and mouth disease using long-term wastewater surveillance in Japan: Quantitative PCR assay development and application. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 901:165926. [PMID: 37527711 DOI: 10.1016/j.scitotenv.2023.165926] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/03/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is a highly contagious disease that primarily affects children under five years of age. It is mainly caused by serotypes of Enterovirus A (EVA): EVA71, Coxsackievirus A types 6 (CVA6), 10 (CVA10), and 16 (CVA16). Despite being highly prevalent in Japan and other countries in the Asia-Pacific region, few studies have investigated HFMD pathogens in wastewater. The present study aimed to develop a highly sensitive and broadly reactive quantitative polymerase chain reaction (qPCR) assay of dominant serotype CVA6, to revise previously developed CVA6, CVA10, and CVA16 assays, and to test these assays in wastewater samples from Yamanashi Prefecture, Japan. The new-CVA6 qPCR assay was developed with maximal nucleotide percent identity among CVA6 isolates from Japan. The new-CVA6 and revised assays were highly sensitive and had the ability to quantify respective positive controls at levels as low as 1 copy/μL. Among the 53 grab influent samples collected between March 2022 and March 2023, EVA71, CVA10, and CVA16 RNA were not detected in any samples, whereas the new-CVA6 assay could detect CVA6 RNA in 38 % (20/53) of samples. CVA6 RNA was detected at a significantly higher concentration in the summer season (3.3 ± 0.8 log10 copies/L; 79 % (11/14)) than in autumn (2.7 ± 0.6 log10 copies/L; 69 % (9/13)). The seasonal trend of CVA6 RNA detection in wastewater aligned with the trend of HFMD case reports in the catchment of the wastewater treatment plant. This is the first study to report the detection and seasonal trends of the EVA serotypes associated with HFMD in wastewater samples in Japan. It provides evidence that wastewater-based epidemiology is applicable even for diseases that are prevalent only in specific population groups.
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Affiliation(s)
- Sadhana Shrestha
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Bikash Malla
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Eiji Haramoto
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan.
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Lin Z, Sun B, Yang X, Jiang Y, Wu S, Lv B, Pan Y, Zhang Q, Wang X, Xiang G, Lou Y, Xiao X. Infectious Disease Diagnosis and Pathogen Identification Platform Based on Multiplex Recombinase Polymerase Amplification-Assisted CRISPR-Cas12a System. ACS Infect Dis 2023; 9:2306-2315. [PMID: 37811564 DOI: 10.1021/acsinfecdis.3c00381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Controlling and mitigating infectious diseases caused by multiple pathogens or pathogens with several subtypes require multiplex nucleic acid detection platforms that can detect several target genes rapidly, specifically, sensitively, and simultaneously. Here, we develop a detection platform, termed Multiplex Assay of RPA and Collateral Effect of Cas12a-based System (MARPLES), based on multiplex nucleic acid amplification and Cas12a ssDNase activation to diagnose these diseases and identify their pathogens. We use the clinical specimens of hand, foot, and mouth disease (HFMD) and influenza A to evaluate the feasibility of MARPLES in diagnosing the disease and identifying the pathogen, respectively, and find that MARPLES can accurately diagnose the HFMD associated with enterovirus 71, coxsackievirus A16 (CVA16), CVA6, or CVA10 and identify the exact types of H1N1 and H3N2 in an hour, showing high sensitivity and specificity and 100% predictive agreement with qRT-PCR. Collectively, our findings demonstrate that MARPLES is a promising multiplex nucleic acid detection platform for disease diagnosis and pathogen identification.
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Affiliation(s)
- Ziqin Lin
- Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Baochang Sun
- Department of Laboratory, Wenzhou Center for Disease Control and Prevention, Wenzhou 325035, China
| | - Xi Yang
- Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Yayun Jiang
- Department of Clinical Laboratory, People's Hospital of Deyang City, Deyang 618000, China
| | - Sihong Wu
- Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Binbin Lv
- Department of Laboratory, Wenzhou Center for Disease Control and Prevention, Wenzhou 325035, China
| | - Yajing Pan
- Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Qingxun Zhang
- Beijing Milu Ecological Research Center, Beijing Academy of Science and Technology, Beijing 100076, China
| | - Xiaoqiong Wang
- Zhuji Institute of Biomedicine, Wenzhou Medical University, Zhuji, Shaoxing 311800, Zhejiang, China
| | - Guangxin Xiang
- Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Yongliang Lou
- Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Xingxing Xiao
- Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, China
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Le Bars H, Madany N, Lamoureux C, Beauruelle C, Vallet S, Payan C, Pilorgé L. Evaluation of the Performance Characteristics of a New POC Multiplex PCR Assay for the Diagnosis of Viral and Bacterial Neuromeningeal Infections. Diagnostics (Basel) 2023; 13:diagnostics13061110. [PMID: 36980418 PMCID: PMC10047878 DOI: 10.3390/diagnostics13061110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
Point-of-care syndromic PCR (POC SPCR) assays are useful tools for the rapid detection of the most common causative agents of community-acquired infections responsible for meningitis and encephalitis infections. We evaluated the performance characteristics of the new QIAstat-Dx® Meningitis/Encephalitis panel (QS) compared to the laboratory reference methods and the POC SPCR Biofire® FilmArray® Meningitis Encephalitis Panel (FA). Viral (Enterovirus, Parechovirus, HSV-1, HSV-2, HHV-6, VZV) and bacterial (E. coli K1, H. influenzae, L. monocytogenes, encapsulated N. meningitidis, M. pneumoniae, S. agalactiae, S. pneumoniae, S. pyogenes) pathogens were suspended at low concentrations and tested with the POC SPCR systems. The reproducibility, analytical specificity, carryover contamination, interferences and clinical samples were evaluated. All samples tested positive with both QS and FA except for those containing the lowest concentrations of Enterovirus-D68-B3, Echovirus-30 and S. agalactiae which were only detected by FA. In terms of analytical specificity, we observed 3 false positive results out of 48 QS tests versus 1 out of 37 FA tests. For the other studied criteria, both QS and FA performed as expected. Our results suggest that the performance characteristics of QS are close to those of FA. A prospective multicenter study would be useful to complete the performances evaluation of QS.
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Affiliation(s)
- Hervé Le Bars
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
| | - Neil Madany
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
| | - Claudie Lamoureux
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Clémence Beauruelle
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Sophie Vallet
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Christopher Payan
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Léa Pilorgé
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Correspondence: ; Tel.: +33-298-347-191; Fax: +33-298-347-193
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Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Hand, Foot, and Mouth Disease: A Narrative Review. RECENT ADVANCES IN INFLAMMATION & ALLERGY DRUG DISCOVERY 2022; 16:77-95. [PMID: 36284392 DOI: 10.2174/1570180820666221024095837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/08/2022] [Accepted: 09/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hand, foot, and mouth disease is a common viral disease in childhood. Because the disease has the potential to reach epidemic levels and mortality is high in some countries, early recognition of this disease is of paramount importance. OBJECTIVE This purpose of this article is to familiarize pediatricians with the clinical manifestations and management of hand, foot, and mouth disease. METHODS A search was conducted in February 2022 in PubMed Clinical Queries using the key term "hand, foot, and mouth disease". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in English were included in this review. RESULTS Hand, foot, and mouth disease is characterized by a painful oral enanthem and asymptomatic exanthem on the palms and soles. Children younger than 5 years are most commonly affected. Hand, foot, and mouth disease caused by enterovirus A71 is more severe and has a higher rate of complications than that attributed to other viruses such as coxsackievirus A16. Circulatory failure secondary to myocardial impairment and neurogenic pulmonary edema secondary to brainstem damage are the main causes of death. Fortunately, the disease is usually benign and resolves in 7 to10 days without sequelae. Given the self-limited nature of most cases, treatment is mainly symptomatic and supportive. Intravenous immunoglobulin should be considered for the treatment of severe/complicated hand, foot, and mouth disease and has been recommended by several national and international guideline committees. Currently, there are no specific antiviral agents approved for the treatment of the disease. Drugs such as ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline have emerged as potential candidates for the treatment of hand, foot, and mouth disease. Vaccination of susceptible individuals in high-risk areas and good personal hygiene are important preventative measures to combat the disease. CONCLUSION Familiarity of the disease including its atypical manifestations is crucial so that a correct diagnosis can be made, and appropriate treatment initiated. A timely diagnosis can help avoid contact with the affected individual and decrease the risk of an outbreak.
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Affiliation(s)
- Alexander K C Leung
- Department of Paediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam Lun Hon
- Department of Paediatrics, Hong Kong Institute of Integrative Medicine, and the Jockey Club School of Public Health and Primary Care, The Chinese University Hong Kong, Hong Kong
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Kim YJ, Kim TG. Pseudomembranous conjunctivitis with hand, foot and mouth disease in a pregnant woman : a case report. BMC Ophthalmol 2021; 21:113. [PMID: 33653308 PMCID: PMC7922717 DOI: 10.1186/s12886-021-01878-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is a common systemic infection that is caused by an enterovirus, normally Coxsackie A16. Generally, it affects children or immunocompromised adults. Only a few reports have described pseudomembranous conjunctivitis associated with HFMD. We aim to describe the clinical outcomes and ocular findings of a 37-year-old female with HFMD and concurrent severe pseudomembranous conjunctivitis, who was 28 weeks pregnant. Case presentation A female patient who was 28-weeks pregnant was referred for an ophthalmological review due to pain and injection in both eyes. The patient was hospitalized under obstetrics and gynecology and evaluated for Behcet’s disease with oral and perineal ulcers. In an ophthalmic examination, both eyes were observed to have a conjunctival injection. Behcet’s disease-associated conjunctivitis was diagnosed. Topical steroids and antibiotics were administered every 6 h. Two days after her presentation, a maculopapular eruption occurred on her palms. Enterovirus type 71 was detected in a serum virus antibody test, and the patient was diagnosed with HFMD. After 7 days, severe pseudomembranous conjunctivitis and corneal epithelial defects occurred in both eyes. Topical steroids were administered every 3 h, and the pseudomembrane was removed every 2 to 3 days. The pseudomembrane did not occur after 3 weeks, but corneal erosion persisted. After 3 months, the corneal erosion had completely resolved. Conclusions HFMD-associated conjunctivitis is a rare complication in adults, however it can appear as a severe pseudomembranous conjunctivitis. In this case, the removal of the pseudomembrane and topical steroids helped improve the symptoms.
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Affiliation(s)
- Yoo Jin Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, 05278, Seoul, Korea
| | - Tae Gi Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, 05278, Seoul, Korea.
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Fu X, Wan Z, Li Y, Hu Y, Jin X, Zhang C. National Epidemiology and Evolutionary History of Four Hand, Foot and Mouth Disease-Related Enteroviruses in China from 2008 to 2016. Virol Sin 2019; 35:21-33. [PMID: 31664644 PMCID: PMC7035399 DOI: 10.1007/s12250-019-00169-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/27/2019] [Indexed: 01/21/2023] Open
Abstract
Hand, foot and mouth disease (HFMD) is a major public health concern in China. The most predominant enteroviruses that cause HFMD have traditionally been attributed to enterovirus A71 (EVA71) and coxsackievirus A16 (CVA16). Since its first large outbreak in 2008, the dominant HFMD pathogens are constantly changing. In 2013 and 2015, CVA6 exceeded both EVA71 and CVA16 to become the leading cause of HFMD in some provinces. However, there still lacks a comprehensive overview on the molecular epidemiology and evolution of HFMD-related enteroviruses at the national level. In this study, we performed systematic epidemiological analyses of HFMD-related enteroviruses using the data of 64 published papers that met the inclusion criteria, and conducted phylogenetic analyses based on 12,080 partial VP1 sequences identified in China before 31st June 2018. We found that EVA71 prevalence has decreased sharply but other enteroviruses have increased rapidly from 2008 to 2016 and that one subtype of each enterovirus is represented during the epidemic. In addition, four genotypes EVA71_C4, CVA16_B1, CVA6_D and CVA10_C are the most predominant enterovirus strains and collectively they cause over 90% of all HFMD cases in China according to the phylogenetic trees using representative partial VP1 sequences. These four major enterovirus genotypes have different geographical distributions, and they may co-circulate with other genotypes and serotypes. These results suggest that more molecular epidemiological studies should be performed on several enteroviruses simultaneously, and such information should have implications for virological surveillance, disease management, vaccine development and policy-making on the prevention and control of HFMD.
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Affiliation(s)
- Xuemin Fu
- Pathogen Discovery and Big Data Center, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, 200031, China
| | - Zhenzhou Wan
- Medical Laboratory of Taizhou Fourth People's Hospital, Taizhou, 225300, China
| | - Yanpeng Li
- Pathogen Discovery and Big Data Center, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yihong Hu
- Pathogen Discovery and Big Data Center, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, 200031, China
| | - Xia Jin
- Viral Disease and Vaccine Translational Research Unit, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Chiyu Zhang
- Pathogen Discovery and Big Data Center, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, 200031, China.
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Gonzalez G, Carr MJ, Kobayashi M, Hanaoka N, Fujimoto T. Enterovirus-Associated Hand-Foot and Mouth Disease and Neurological Complications in Japan and the Rest of the World. Int J Mol Sci 2019; 20:ijms20205201. [PMID: 31635198 PMCID: PMC6834195 DOI: 10.3390/ijms20205201] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022] Open
Abstract
Enteroviruses (EVs) are responsible for extremely large-scale, periodic epidemics in pediatric cohorts, particularly in East and Southeast Asia. Clinical presentation includes a diverse disease spectrum, including hand-foot and mouth disease (HFMD), aseptic meningitis, encephalitis, acute flaccid paralysis, and acute flaccid myelitis. HFMD is predominantly attributable to EV-A types, including the major pathogen EV-A71, and coxsackieviruses, particularly CV-A6, CV-A16, and CV-A10. There have been multiple EV-A71 outbreaks associated with a profound burden of neurological disease and fatal outcomes in Asia since the early 1980s. Efficacious vaccines against EV-A71 have been developed in China but widespread pediatric vaccination programs have not been introduced in other countries. Encephalitis, as a consequence of complications arising from HFMD infection, leads to damage to the thalamus and medulla oblongata. Studies in Vietnam suggest that myoclonus is a significant indicator of central nervous system (CNS) complications in EV-A71-associated HFMD cases. Rapid response in HFMD cases in children is imperative to prevent the progression to a CNS infection; however, prophylactic and therapeutic agents have not been well established internationally, therefore surveillance and functional studies including development of antivirals and multivalent vaccines is critically important to reduce disease burden in pediatric populations.
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Affiliation(s)
- Gabriel Gonzalez
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo 001-0020, Japan.
- National Advanced Computing Collaboratory, National Center for High Technology, San Jose 1174-1200, Costa Rica.
| | - Michael J Carr
- National Virus Reference Laboratory, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland.
- Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo 001-0020, Japan.
| | | | - Nozomu Hanaoka
- Division 4, Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
| | - Tsuguto Fujimoto
- Division 4, Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
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Reich M, Cakir B, Cvetkoski S, Lang SJ, Stahl A, Ness T, Agostini H, Lange C. Acute unilateral maculopathy associated with adult onset of hand, foot and mouth disease: a case report. BMC Ophthalmol 2019; 19:104. [PMID: 31064339 PMCID: PMC6505311 DOI: 10.1186/s12886-019-1111-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/22/2019] [Indexed: 01/29/2023] Open
Abstract
Background To report the case of a 31-year-old patient with Hand, Foot and Mouth Disease (HFMD) and concurrent acute monocular maculopathy, and to describe multimodal imaging findings never before described including optical coherence tomography angiography (OCT-A). Case presentation Nine days after the onset of clinically highly probable but not laboratory-verified HFMD, a 31-year old male noticed a central scotoma, distorted lines and loss of visual acuity (Snellen visual acuity 20/400) in his right eye. Funduscopy revealed focal alterations in the retinal pigmented epithelium (RPE) and yellow retinal dots corresponding to focal dots of decreased fundus autofluorescence (FAF) surrounded by increased FAF. Spectral domain optical coherence tomography (SD-OCT) demonstrated irregularities in the ellipsoide zone, hyperreflective dots above the RPE and RPE thickening. Fundus fluorescein angiography (FAG) revealed central hypofluorescence in the macular area in the early phase, as well as increasing focal hyperfluorescence in the late phase corresponding with RPE defects observed in FAF. Indocyanine green angiography (ICGA) showed central hypofluorescence in the early and late phase, corresponding with areas of reduced flow in the choroidea and choriocapillaris as apparent in OCT-A. Visual acuity improved within 3 months without any systemic or local therapy. At his three-month follow-up, SD-OCT revealed subtle subretinal fluid that resolved spontaneously over time. No signs of choroidal neovascularization were observed. Twelve months following the onset of symptoms Snellen visual acuity was 400/400. Multimodal imaging revealed subtly changed, decreased FAF while the choroidal architecture recovered completely as demonstrated by OCT-A. Conclusions HFMD-associated maculopahty is an uncommon but important differential diagnosis of chorioretinitis with macular involvement. The prognosis can be good and the initially observed morphological pathologies such as impaired perfusion of the choroidal vessels can recover spontaneously over a period lasting 12 months. OCT-A can be employed as a non-invasive tool to detect the reduced perfusion of the choroidal vessels and for monitoring the disease course.
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Affiliation(s)
- Michael Reich
- Eye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - Bertan Cakir
- Eye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | | | - Stefan J Lang
- Eye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - Andreas Stahl
- Eye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.,Department of Ophthalmology, University Medical Center Greifswald, Greifswald, Germany
| | - Thomas Ness
- Eye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - Hansjürgen Agostini
- Eye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - Clemens Lange
- Eye Center, Faculty of Medicine, Albert-Ludwigs University Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
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