title: Echovirus 4 associated to hand, foot and mouth disease.
abstract: Hand, foot and mouth disease (HFMD) is a contagious enteroviral infection occurring primarily in children and characterized by vesicular palmoplantar eruptions and erosive stomatitis. Echovirus 4 (EV-4) has been commonly associated with aseptic meningitis. The association of HFMD with EV-4 has not been reported previously. Two samples of a 14-month child who presented mild fever, sores in the mouth, rash with blisters on the palm of hands and soles of feet were sent to Enteric Viruses Laboratory of Adolfo Lutz Institute. Clinical samples were inoculated in three different cell lines, and those which presented cytopathic effect (CPE), were submitted to Indirect Immunofluorescence Assay (IFA) and "one step" RT-PCR. Agarose gel electrophoresis from RT-PCR product, showed a product with 437 bp, which is characteristic of Enterovirus group. Echovirus 4 was identified by IFA. Although HFMD is a viral infection associated mainly with Enterovirus 71 (HEV-71) and Coxsackievirus A16 (CV-A16), our results demonstrate a diversity of serotype related to HFMD and stress the importance of epidemiological surveillance to this disease and its complications.
authors.affiliation: Enteric Viruses Laboratory, Adolfo Lutz Institute, São Paulo, SP, Brazil. denrusso@ial.sp.gov.br
authors.forename: Denise Hage
authors.initials: DH
authors.lastname: Russo
authors.forename: Adriana
authors.initials: A
authors.lastname: Luchs
authors.forename: Bráulio Caetano
authors.initials: BC
authors.lastname: Machado
authors.forename: Rita de Cássia
authors.initials: Rde C
authors.lastname: Carmona
authors.forename: Maria do Carmo Sampaio
authors.initials: Mdo C
authors.lastname: Timenetsky
mesh_terms: D004587:Electrophoresis, Agar Gel; D029822:Enterovirus B, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis / Q000821:virology*; D019084:Fluorescent Antibody Technique, Indirect; D006232:Hand, Foot and Mouth Disease / Q000175:diagnosis / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D012367:RNA, Viral