An epidemiological surveillance of hand foot and mouth disease in paediatric patients and in community: A Singapore retrospective cohort study, 2013-2018.

• Main Authors: Nyo Min (Author), Yasmin Hui Binn Ong (Author), Alvin X Han (Author), Si Xian Ho (Author), Emmerie Wong Phaik Yen (Author), Kenneth Hon Kim Ban (Author), Sebastian Maurer-Stroh (Author), Chia Yin Chong (Author), Justin Jang Hann Chu (Author)
• Format: Book
• Published: Public Library of Science (PLoS), 2021-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>CV-A6 remained as the dominant HFMD causative strain in Singapore. Silent subclinical enteroviral infections were detected and warrant further investigations.

Item Description

1935-2727
1935-2735
10.1371/journal.pntd.0008885