An epidemiological surveillance of hand foot and mouth disease in paediatric patients and in community : A Singapore retrospective cohort study, 2013-2018
BACKGROUND: While hand, foot and mouth disease (HFMD) is primarily self-resolving-soaring incidence rate of symptomatic HFMD effectuates economic burden in the Asia-Pacific region. Singapore has seen a conspicuous rise in the number of HFMD cases from 2010s. Here, we aims to identify the serology and genotypes responsible for such outbreaks in hospitals and childcare facilities.
METHODS: We studied symptomatic paediatric HFMD cases from 2013 to 2018 in Singapore. Surveillance for subclinical enterovirus infections was also performed in childcares at the same time period.
RESULTS: Genotyping 101 symptomatic HFMD samples revealed CV-A6 as the major etiological agent for recent outbreaks. We detected infections with CV-A6 (41.0%), EV-A71 (7%), CV-A16 (3.0%), coxsackievirus A2, CV-A2 (1.0%) and coxsackievirus A10, CV-A10 (1.0%). Phylogenetic analysis of local CV-A6 strains revealed a high level of heterogeneity compared against others worldwide, dissimilar to other HFMD causative enteroviruses for which the dominant strains and genotypes are highly region specific. We detected sub-clinical enterovirus infections in childcare centres; 17.1% (n = 245) tested positive for enterovirus in saliva, without HFMD indicative symptoms at the point of sample collection.
CONCLUSIONS: CV-A6 remained as the dominant HFMD causative strain in Singapore. Silent subclinical enteroviral infections were detected and warrant further investigations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
PLoS neglected tropical diseases - 15(2021), 2 vom: 10. Feb., Seite e0008885 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Min, Nyo [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 21.06.2021 Date Revised 21.06.2021 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.1371/journal.pntd.0008885 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321269195 |
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| 100 | 1 | |a Min, Nyo |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An epidemiological surveillance of hand foot and mouth disease in paediatric patients and in community |b A Singapore retrospective cohort study, 2013-2018 |
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| 500 | |a Date Revised 21.06.2021 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: While hand, foot and mouth disease (HFMD) is primarily self-resolving-soaring incidence rate of symptomatic HFMD effectuates economic burden in the Asia-Pacific region. Singapore has seen a conspicuous rise in the number of HFMD cases from 2010s. Here, we aims to identify the serology and genotypes responsible for such outbreaks in hospitals and childcare facilities | ||
| 520 | |a METHODS: We studied symptomatic paediatric HFMD cases from 2013 to 2018 in Singapore. Surveillance for subclinical enterovirus infections was also performed in childcares at the same time period | ||
| 520 | |a RESULTS: Genotyping 101 symptomatic HFMD samples revealed CV-A6 as the major etiological agent for recent outbreaks. We detected infections with CV-A6 (41.0%), EV-A71 (7%), CV-A16 (3.0%), coxsackievirus A2, CV-A2 (1.0%) and coxsackievirus A10, CV-A10 (1.0%). Phylogenetic analysis of local CV-A6 strains revealed a high level of heterogeneity compared against others worldwide, dissimilar to other HFMD causative enteroviruses for which the dominant strains and genotypes are highly region specific. We detected sub-clinical enterovirus infections in childcare centres; 17.1% (n = 245) tested positive for enterovirus in saliva, without HFMD indicative symptoms at the point of sample collection | ||
| 520 | |a CONCLUSIONS: CV-A6 remained as the dominant HFMD causative strain in Singapore. Silent subclinical enteroviral infections were detected and warrant further investigations | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Ong, Yasmin Hui Binn |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Alvin X |e verfasserin |4 aut | |
| 700 | 1 | |a Ho, Si Xian |e verfasserin |4 aut | |
| 700 | 1 | |a Yen, Emmerie Wong Phaik |e verfasserin |4 aut | |
| 700 | 1 | |a Ban, Kenneth Hon Kim |e verfasserin |4 aut | |
| 700 | 1 | |a Maurer-Stroh, Sebastian |e verfasserin |4 aut | |
| 700 | 1 | |a Chong, Chia Yin |e verfasserin |4 aut | |
| 700 | 1 | |a Chu, Justin Jang Hann |e verfasserin |4 aut | |
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