Coxsackievirus B: The important agent of hand, foot, and mouth disease

Area of Science:

• Virology
• Infectious Diseases
• Pediatrics

Background:

• Hand, foot, and mouth disease (HFMD) is a common pediatric illness primarily caused by enteroviruses (EVs), with EV-A serotypes frequently implicated.
• Previous research has focused on EV-A, but the role of other enterovirus types, such as EV-B, in severe HFMD cases requires further investigation.

Purpose of the Study:

• To retrospectively analyze stool samples from children with severe HFMD in Yunnan, China, to identify and characterize enterovirus infections, with a specific focus on EV-B.
• To determine the prevalence of different EV serotypes and investigate potential associations between EV-B infections and severe HFMD.

Main Methods:

• Retrospective analysis of 213 stool samples collected from children diagnosed with severe HFMD in Yunnan, China, during 2013, 2015, and 2016.
• Enterovirus detection and serotyping using molecular methods.
• Genotyping of specific coxsackievirus B isolates.

Main Results:

• Enteroviruses were detected in 70.0% of the samples, with 20 distinct serotypes identified.
• Enterovirus A (EV-A) and Enterovirus B (EV-B) were prevalent, accounting for 45.1% and 41.3% of infections, respectively.
• Coxsackievirus B (CV-B) species represented 28.6% of positive specimens, with CV-B4 and CV-B5 being significant, alongside the predominant EV-A71. Co-infections were observed in 19.3% of cases.

Conclusions:

• Enterovirus B (EV-B), particularly coxsackievirus B (CV-B) strains, may play a more significant role in severe pediatric HFMD than previously recognized.
• These findings contribute to understanding the complex etiology of HFMD and can inform future prevention and treatment strategies.
• Further research into EV-B epidemiology and pathogenicity is warranted for comprehensive HFMD control.