Key result
Among 50 patients clinically diagnosed with Hand, Foot and Mouth Disease, enterovirus RNA was detected in 78% of cases, with genotyping identifying CV-A16, CV-A6, and EV-A71 strains.
Why the study?
Cases of hand, foot and mouth disease were reported from a tertiary care health centre in Northern India, prompting a study to highlight the clinical and molecular virological aspects of these cases.
Observational (n=50)
No
This study identifies CV-A16, CV-A6, and EV-A71 as the enterovirus strains responsible for HFMD in Udhampur, Northern India.
Supports regional HFMD strain surveillance in Northern India; hypothesis-generating, should not yet change practice.
PURPOSE: Hand, Foot and Mouth disease (HFMD) is a contagious pediatric viral disease caused due to enteroviruses (EV) of the family Picornaviridae. Cases of HFMD were reported from a tertiary care health centre, Udhampur, (Jammu and Kashmir), Northern India. The present study highlights the clinical and molecular virological aspects of HFMD cases. MATERIAL AND METHODS: Cases reported during August 2016-September 2017, and clinically diagnosed as HFMD of all age groups were included. Clinical, Biochemical and molecular virology aspects were compared. Clinical samples (n = 50) such as vesicle swab, buccal and throat swabs were collected for enterovirus detection. EV-RNA was detected by 5'NCR based RT-PCR and genotyping by VP1 gene amplification and cycle sequencing. RESULTS: Of the cases of HFMD enrolled (n = 50), highest (84%) were of children aged <5 years, presented either or both anathemas and exanthemas with prodromal symptoms (fever, irritability). Clinical presentations involved mainly oral ulcers on lips and tongue (48%). Oral erosions were either single or multiple in numbers. Exanthemas were seen on hand and palm, widely spread up to buttocks, legs, arms and trunk. Of these, six patients were found anemic. Complete blood count (CBC) indicated lymphocytosis and C-reactive protein (n = 10) in children aged <5 years. EV-RNA was detected in 78% (39/50) of the clinical samples. VP1 gene based typing indicated the presence of CV-A16, CVA6 and EV-A71 types. CONCLUSIONS: The study highlights association of EVs in HFMD cases in the reported region. CV-A16, CV-A6 and EV-A71 types were reported for the first time from Udhampur (J&K), Northern India. No differences were observed in the clinical profile of EV strains detected. Circulation of the strains warrant and alarm outbreaks. More focused studies on HFMD and monitoring of viral strains is mandatory.
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Aggarwal et al. (2022) conducted an observational in Hand, Foot and Mouth Disease (HFMD) (n=50). Enterovirus was evaluated on Detection of EV-RNA. Among 50 patients clinically diagnosed with Hand, Foot and Mouth Disease, enterovirus RNA was detected in 78% of cases, with genotyping identifying CV-A16, CV-A6, and EV-A71 strains.
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