1.Detection of enteroviruses during a 2018 hand, foot and mouth disease outbreak in Malaysia
Lee, M.H.P. ; Chong, Y.M. ; Tay, C.G. ; Koh, M.T. ; Chem, Y.K. ; Noordin, N. ; Jahis, R. ; Sam, I.C. ; Chan, Y.F.
Tropical Biomedicine 2021;38(No.1):150-153
Hand, foot, and mouth disease (HFMD) is a common childhood disease caused by
enteroviruses. In 2018, a HFMD outbreak in Malaysia affected over 76,000 children. In this
study, we used RT-qPCR and CODEHOP PCR to detect the causative agents in 89 clinically
diagnosed HFMD patients in Kuala Lumpur and Selangor. Most (62.9%) of the children were
below 3 years old. PCR with either assay detected enteroviruses in 84.2% (75/89) and CODEHOP
PCR successfully typed 66.7% (50/75) of the enteroviruses. Sequencing of CODEHOP amplicons
showed co-circulation of multiple enteroviruses with coxsackievirus A6 (CV-A6) and A16 as
the predominant serotypes, but not the neurovirulent enterovirus A71. CV-A6 infection was
more common in children less than 12 months old (p=0.01) and was more likely to cause
vesicles in the gluteal area (p=0.01) compared to other enteroviruses. Establishing a robust
identification method during HFMD outbreaks is important for patient management and
public health responses.