TY - JOUR
T1 - Coxsackievirus A6-related hand foot and mouth disease
T2 - Skin manifestations in a cluster of adult patients
AU - Ben-Chetrit, Eli
AU - Wiener-Well, Yonit
AU - Shulman, Lester M.
AU - Cohen, Matan J.
AU - Elinav, Hila
AU - Sofer, Danit
AU - Feldman, Itamar
AU - Marva, Eytan
AU - Wolf, Dana G.
PY - 2014/3
Y1 - 2014/3
N2 - Background: Hand foot and mouth disease (HFMD) is a common childhood manifestation of enterovirus (EV) infection. It predominantly affects young children, and has been mainly associated with coxsackievirus (CV) A16 and EV 71. Objectives: We report an unusual cluster of adult patients with HFMD. Study design: Throat swabs and vesicular fluid samples obtained from patients admitted to the emergency room (ER) with HFMD were tested for EV by reverse transcription (RT)-real time PCR, and further subjected to sequencing and phylogenetic analysis. Results: CVA6 was identified as the causative agent of HFMD in five epidemiologically-unrelated adult patients (28-37 years old) admitted to the ER between December 2012 and February 2013. Phylogenetic analysis mapped the CVA6 strains into one cluster. All patients manifested with fever and a severe vasculitis-like rash, followed by spontaneous recovery. Conclusions: This cluster identifies CVA6 as an emerging cause of HFMD of unusual age distribution, seasonality, and clinical severity, underscoring the need for continued alertness and clinical-genotypic surveillance of EV HFMD.
AB - Background: Hand foot and mouth disease (HFMD) is a common childhood manifestation of enterovirus (EV) infection. It predominantly affects young children, and has been mainly associated with coxsackievirus (CV) A16 and EV 71. Objectives: We report an unusual cluster of adult patients with HFMD. Study design: Throat swabs and vesicular fluid samples obtained from patients admitted to the emergency room (ER) with HFMD were tested for EV by reverse transcription (RT)-real time PCR, and further subjected to sequencing and phylogenetic analysis. Results: CVA6 was identified as the causative agent of HFMD in five epidemiologically-unrelated adult patients (28-37 years old) admitted to the ER between December 2012 and February 2013. Phylogenetic analysis mapped the CVA6 strains into one cluster. All patients manifested with fever and a severe vasculitis-like rash, followed by spontaneous recovery. Conclusions: This cluster identifies CVA6 as an emerging cause of HFMD of unusual age distribution, seasonality, and clinical severity, underscoring the need for continued alertness and clinical-genotypic surveillance of EV HFMD.
KW - Adult
KW - Coxsackievirus A6
KW - Enterovirus
KW - Hand foot and mouth disease
UR - http://www.scopus.com/inward/record.url?scp=84893952865&partnerID=8YFLogxK
U2 - 10.1016/j.jcv.2013.12.012
DO - 10.1016/j.jcv.2013.12.012
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C2 - 24457116
AN - SCOPUS:84893952865
SN - 1386-6532
VL - 59
SP - 201
EP - 203
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
IS - 3
ER -