Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6

Justino, Maria Cleonice Aguiar; Mesquita, Deisiane da S; Souza, Maur?cio F; Farias, Francisco P; Alves, Jainara Cristina dos S; Ferreira, James L; Lopes, Daniela P; Tavares, Fernando Neto

Artigo

Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6

BACKGROUND: Enterovirus (EV) A71 and coxsackievirus (CV) A16 were the most frequent serotypes involved in hand, foot, and mouth disease (HFMD) outbreaks throughout Asia. In the past 5 years, however, CV-A6 has emerged as a new important pathogen worldwide, and more severe and extensive dermatologic...

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Autor principal:	Justino, Maria Cleonice Aguiar
Outros Autores:	Mesquita, Deisiane da S, Souza, Maur?cio F, Farias, Francisco P, Alves, Jainara Cristina dos S, Ferreira, James L, Lopes, Daniela P, Tavares, Fernando Neto
Grau:	Artigo
Idioma:	eng
Publicado em:	Elsevier 2020
Assuntos:	Enterov?rus / patogenicidade Doen?a de M?o, P? e Boca / patologia Doen?a de M?o, P? e Boca / virologia Infec??es por Coxsackievirus / virologia Exantema / virologia
Acesso em linha:	http://patua.iec.gov.br//handle/iec/4084

id	ir-iec-4084
recordtype	dspace
spelling	ir-iec-40842020-04-29T00:39:00Z Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6 Justino, Maria Cleonice Aguiar Mesquita, Deisiane da S Souza, Maur?cio F Farias, Francisco P Alves, Jainara Cristina dos S Ferreira, James L Lopes, Daniela P Tavares, Fernando Neto Enterov?rus / patogenicidade Doen?a de M?o, P? e Boca / patologia Doen?a de M?o, P? e Boca / virologia Infec??es por Coxsackievirus / virologia Exantema / virologia BACKGROUND: Enterovirus (EV) A71 and coxsackievirus (CV) A16 were the most frequent serotypes involved in hand, foot, and mouth disease (HFMD) outbreaks throughout Asia. In the past 5 years, however, CV-A6 has emerged as a new important pathogen worldwide, and more severe and extensive dermatologic presentations has been reported. OBJECTIVES: Identify the clinical spectrum for atypical HFMD and enterovirus serotypes in Bel?m, Par?, Amazon region of northern Brazil. STUDY DESIGN: A prospective ambulatory clinic-based surveillance conducted from January to June 2019, involving patients under 15 years with symptoms of HFMD. Stool, serum, oropharyngeal, and skin swab samples were analyzed. Real-time RT-PCR was performed to detect the viral genome of enteroviruses. Positive specimens were submitted to semi-nested PCR. Physical examinations and demographic data were recorded on a standardized form. RESULTS: 48 patients with symptoms of HFMD were included in the study and collected all samples according to protocol. Enteroviruses were detected in 83 % of patients. An atypical form of HFMD with vesiculobullous exanthema was present in 70 % (28/40); desquamation of the palms and soles detected in 90 % (36/40) and onychomadesis in 30 % (12/40) of patients. The serotype was identified in 22 patients, CV- A6 occurred in 81.8 % of them. CONCLUSION: This is the first ambulatory surveillance and virologic investigation involving HFMD performed in outpatients from Amazon region, Brazil. The detection of CV-A6 was related to atypical forms HFMD. Desquamation of the palms and soles and nail changes occurred with frequency, such as a late sequel in the HFMD disease. 2020-04-28T22:16:04Z 2020-04-28T22:16:04Z 2020 Artigo JUSTINO, Maria Cleonice Aguiar et al. Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6. Journal of Clinical Virology, v. 126, n. xx, p.xx, May 2020. 1873-5967 http://patua.iec.gov.br//handle/iec/4084 10.1016/j.jcv.2020.104307 eng Acesso Embargado application/pdf Elsevier
institution	Instituto Evandro Chagas (IEC)
collection	PATUA
language	eng
topic	Enterov?rus / patogenicidade Doen?a de M?o, P? e Boca / patologia Doen?a de M?o, P? e Boca / virologia Infec??es por Coxsackievirus / virologia Exantema / virologia
spellingShingle	Enterov?rus / patogenicidade Doen?a de M?o, P? e Boca / patologia Doen?a de M?o, P? e Boca / virologia Infec??es por Coxsackievirus / virologia Exantema / virologia Justino, Maria Cleonice Aguiar Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6
topic_facet	Enterov?rus / patogenicidade Doen?a de M?o, P? e Boca / patologia Doen?a de M?o, P? e Boca / virologia Infec??es por Coxsackievirus / virologia Exantema / virologia
description	BACKGROUND: Enterovirus (EV) A71 and coxsackievirus (CV) A16 were the most frequent serotypes involved in hand, foot, and mouth disease (HFMD) outbreaks throughout Asia. In the past 5 years, however, CV-A6 has emerged as a new important pathogen worldwide, and more severe and extensive dermatologic presentations has been reported. OBJECTIVES: Identify the clinical spectrum for atypical HFMD and enterovirus serotypes in Bel?m, Par?, Amazon region of northern Brazil. STUDY DESIGN: A prospective ambulatory clinic-based surveillance conducted from January to June 2019, involving patients under 15 years with symptoms of HFMD. Stool, serum, oropharyngeal, and skin swab samples were analyzed. Real-time RT-PCR was performed to detect the viral genome of enteroviruses. Positive specimens were submitted to semi-nested PCR. Physical examinations and demographic data were recorded on a standardized form. RESULTS: 48 patients with symptoms of HFMD were included in the study and collected all samples according to protocol. Enteroviruses were detected in 83 % of patients. An atypical form of HFMD with vesiculobullous exanthema was present in 70 % (28/40); desquamation of the palms and soles detected in 90 % (36/40) and onychomadesis in 30 % (12/40) of patients. The serotype was identified in 22 patients, CV- A6 occurred in 81.8 % of them. CONCLUSION: This is the first ambulatory surveillance and virologic investigation involving HFMD performed in outpatients from Amazon region, Brazil. The detection of CV-A6 was related to atypical forms HFMD. Desquamation of the palms and soles and nail changes occurred with frequency, such as a late sequel in the HFMD disease.
format	Artigo
author	Justino, Maria Cleonice Aguiar
author2	Mesquita, Deisiane da S Souza, Maur?cio F Farias, Francisco P Alves, Jainara Cristina dos S Ferreira, James L Lopes, Daniela P Tavares, Fernando Neto
author2Str	Mesquita, Deisiane da S Souza, Maur?cio F Farias, Francisco P Alves, Jainara Cristina dos S Ferreira, James L Lopes, Daniela P Tavares, Fernando Neto
title	Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6
title_short	Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6
title_full	Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6
title_fullStr	Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6
title_full_unstemmed	Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6
title_sort	atypical hand-foot-mouth disease in bel?m, amazon region, northern brazil, with detection of coxsackievirus a6
publisher	Elsevier
publishDate	2020
url	http://patua.iec.gov.br//handle/iec/4084
_version_	1717584353535459328
score	11.755432

Atypical hand-foot-mouth disease in Bel?m, Amazon region, northern Brazil, with detection of coxsackievirus A6

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