Author:
- ABSTRACT.
- INTRODUCTION
- Hand, foot, and mouth disease clinical features and stages.
- Clinical, pathological, and magnetic resonance imaging (MRI) features of HFMD among adults and children.
- Possible mechanism of pathogenesis of HFMD-associated complications.
- Shifting of molecular epidemiology of HFMD-causing pathogens and contributing factors.
- Role of recombination in changing epidemiology of HFMD pathogens.
- Possibility of a replacement of the dominating CV-A6 serotype by other EV serotypes.
- CONCLUSION
- REFERENCES
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Changing Epidemiology of Hand, Foot, and Mouth Disease Causative Agents and Contributing Factors
Nida Kalam
Nida Kalam
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Vinod Balasubramaniam
vinod.balasubramaniam@monash.edu
Vinod Balasubramaniam
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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ABSTRACT.
Hand, foot, and mouth disease (HFMD) is a common viral infection primarily affecting children. It causes vesicles on the skin and inside the mouth. Although most cases get better on their own, severe cases can lead to complications such as brain stem encephalitis, meningoencephalitis, acute flaccid paralysis, and pulmonary edema. Hand, foot, and mouth disease is caused by various enteroviruses, with enterovirus A71 (EV-A71) and coxsackievirus A16 being the most common. However, recent studies have shown a shift in the molecular epidemiology of HFMD-causing pathogens, with coxsackievirus A6 and coxsackievirus A10 causing more infections. In addition, extensive recombination events have been identified among enterovirus strains, which may have a role in faster evolution and extinction of dominant enterovirus serotypes. Other strains of enterovirus can also cause severe complications, and there has been an increase in mortality associated with brain stem encephalitis in children under 3 years of age and teenagers. Currently, there are no effective antiviral therapies available to treat enterovirus infections. Vaccines against EV-A71 have been approved and are now used in mainland China. Studying the changing epidemiology of HFMD pathogens and the evolution patterns of its causative agents is crucial in developing effective prevention and control strategies. Increased interest in the molecular epidemiology of HFMD causative agents has led to a better understanding of the critical drivers of HFMD outbreaks, which can inform efforts to prevent and control the disease.
Author Notes
Financial support: This work was supported by
Authors’ contributions: V. Balasubramaniam conceptualized and designed the manuscript. N. Kalam wrote and prepared the manuscript and the figure. V. Balasubramaniam critically revised the manuscript. Both authors approved the final version. Both authors significantly contributed to the development and the writing of this article.
Current contact information: Nida Kalam and Vinod Balasubramaniam, Infection and Immunity Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia, E-mails: nida.kalam@monash.edu and vinod.balasubramaniam@monash.edu.
- ABSTRACT.
- INTRODUCTION
- Hand, foot, and mouth disease clinical features and stages.
- Clinical, pathological, and magnetic resonance imaging (MRI) features of HFMD among adults and children.
- Possible mechanism of pathogenesis of HFMD-associated complications.
- Shifting of molecular epidemiology of HFMD-causing pathogens and contributing factors.
- Role of recombination in changing epidemiology of HFMD pathogens.
- Possibility of a replacement of the dominating CV-A6 serotype by other EV serotypes.
- CONCLUSION
- REFERENCES
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