title: Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014-2015.
abstract: The clinical impact of enteroviruses associated with hand, foot and mouth disease (HFMD) is unknown outside Asia, and the prevalence of enterovirus A71 (EV-A71) in particular might be underestimated. To investigate the prevalence of enterovirus serotypes and the clinical presentations associated with HFMD in France, we conducted prospective ambulatory clinic-based surveillance of children during April 2014-March 2015. Throat or buccal swabs were collected from children with HFMD and tested for the enterovirus genome. Physical examinations were recorded on a standardized form. An enterovirus infection was detected in 523 (79.3%) of 659 children tested. Two epidemic waves occurred, dominated by coxsackievirus (CV) A6, which was detected in 53.9% of enterovirus-infected children. CV-A6 was more frequently related to atypical HFMD manifestations (eruptions extended to limbs and face). Early awareness and documentation of HFMD outbreaks can be achieved by syndromic surveillance of HFMD by ambulatory pediatricians and rapid enterovirus testing and genotyping.
authors: Audrey
authors: A
authors: Mirand
authors: François Vié
authors: FV
authors: le Sage
authors: Bruno
authors: B
authors: Pereira
authors: Robert
authors: R
authors: Cohen
authors: Corinne
authors: C
authors: Levy
authors: Christine
authors: C
authors: Archimbaud
authors: Hélène
authors: H
authors: Peigue-Lafeuille
authors: Jean-Luc
authors: JL
authors: Bailly
authors: Cécile
authors: C
authors: Henquell
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D029821:Enterovirus A, Human / Q000145:classification / Q000235:genetics; D005260:Female; D005602:France / Q000453:epidemiology; D006232:Hand, Foot and Mouth Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000266:history / Q000821:virology*; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D058889:Molecular Typing; D010802:Phylogeny; D011159:Population Surveillance; D011446:Prospective Studies; D012367:RNA, Viral; D065288:Serogroup; D063189:Symptom Assessment
chemical_list: D012367:RNA, Viral
keywords: France; ambulatory; enterovirus A; foot and mouth disease; hand; human coxsackievirus infections; pediatric; sentinel surveillance; surveillance viruses