title: Clinical and molecular characterization of hand-foot-and-mouth disease in Thailand, 2008-2009.
abstract: Hand-foot-and-mouth disease (HFMD) is caused by a group of enteroviruses, most commonly coxsackievirus A 16 (CA16) and enterovirus 71 (EV71). In general, the disease is mild and self-limited except in the case of EV71 infections, which may incur serious complications. This research focused on virus characterization of HFMD cases in Thailand from 2008-2009, related clinical findings and complications of specific enterovirus subtypes. Specimens (stool, vesicle fluid, throat swab/sputum) from 48 cases were collected during 2008-2009. Reverse transcriptase-polymerase chain reaction (PCR) followed by direct sequencing and phylogenetic analysis served to detect enterovirus and determine subtype. Enterovirus was found in 58.3% (28/48) of cases, specifically EV71 (n=23), CA16 (n=4), and CA10 (n=1). Two patients infected by EV71 had brainstem encephalitis (one death). Eight patients required hospital admission due to dehydration. Of these, 3 were PCR positive for EV71, 1 for CA16, and the reminder negative. This study demonstrated EV71 as the most prevalent present cause of HFMD in Thailand in 2008-2009. Potentially fatal complications of HFMD should be taken into consideration. Surveillance of epidemiology and monitoring of disease severity should be continued, and as a prevention measure, sanitation and hygiene should be improved.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Susheera
authors.initials: S
authors.lastname: Chatproedprai
authors.forename: Apiradee
authors.initials: A
authors.lastname: Theanboonlers
authors.forename: Sumeth
authors.initials: S
authors.lastname: Korkong
authors.forename: Chittima
authors.initials: C
authors.lastname: Thongmee
authors.forename: Siriwan
authors.initials: S
authors.lastname: Wananukul
authors.forename: Yong
authors.initials: Y
authors.lastname: Poovorawan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018792:Encephalitis, Viral / Q000401:mortality / Q000821:virology; D004770:Enterovirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D005243:Feces / Q000821:virology; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000473:pathology* / Q000821:virology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008969:Molecular Sequence Data; D010614:Pharynx / Q000821:virology; D012367:RNA, Viral / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D012867:Skin / Q000821:virology; D013183:Sputum / Q000821:virology; D013785:Thailand; D055815:Young Adult
chemical_list: D012367:RNA, Viral