Detection of enteroviruses during a 2018 hand, foot and mouth disease outbreak in Malaysia

• Published in: Tropical biomedicine Vol. 38; no. 1; p. 150
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Malaysia 01.03.2021
• ISSN: 2521-9855
• DOI: 10.47665/tb.38.1.026

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.