Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 30, Number 2—February 2024
Dispatch

Emerging Enterovirus A71 Subgenogroup B5 Causing Severe Hand, Foot, and Mouth Disease, Vietnam, 2023

Nguyen Van Vinh Chau, Tang Chi Thuong, Nguyen Thanh Hung, Nguyen Thi Thu Hong, Du Tuan Quy, Tran Ba Thien, Cao Minh Hiep, Ngo Ngoc Quang Minh, Truong Huu Khanh, Do Duong Kim Han, Truong Hoang Chau Truc, Nguyen Thi Han Ny, Le Kim Thanh, Lam Anh Nguyet, Cao Thu Thuy, Le Nguyen Truc Nhu, Pham Van Quang, Phung Nguyen The Nguyen, Phan Tu Qui, H. Rogier van Doorn, C. Louise Thwaites, Tran Tan Thanh, Nguyen Thanh Dung, Guy Thwaites, Nguyen To Anh, Le Nguyen Thanh Nhan, Le Van TanComments to Author , and for the SEACOVARIANTS1
Author affiliations: Department of Health, Ho Chi Minh City, Vietnam (N.V.V. Chau, T.C. Thuong); Children’s Hospital 1, Ho Chi Minh City (N.T. Hung, D.T. Quy, C.M. Hiep, N.N.Q. Minh, T.H. Khanh, P.V. Quang, P.N.T. Nguyen, L.N.T. Nhan); Oxford University Clinical Research Unit, Ho Chi Minh City (N.T.T. Hong, T.B. Thien, D.D.K. Han, T.H.C. Truc, N.T.H. Ny, L.K. Thanh, L.A. Nguyet, C.T. Thuy, L.N.T. Nhu, H.R. van Doorn, C.L. Thwaites, T.T. Thanh, G. Thwaites, N.T. Anh, L.V. Tan); Pham Ngoc Thach University of Medicine, Ho Chi Minh City (P.V. Quang); University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City (P.N.T. Nguyen); Hospital for Tropical Diseases, Ho Chi Minh City (P.T. Qui, N.T. Dung); University of Oxford, Oxford, UK (H.R. van Doorn, C.L. Thwaites, G. Thwaites, L.V. Tan)

Main Article

Table 1

Demographics of patients with enterovirus infections and clinical grades of hand, foot, and mouth disease in study of emerging EV-A71 subgenogroup B5, Vietnam, 2023*

Characteristics Total, n = 101 EV-A71, n = 83 EV-A71 B5, n = 65 PCR negative, n = 17
Sex
M 61 (60.4) 48 (57.8) 39 (60.0) 12 (70.6)
F
 40 (39.6)
 35 (42.2)
 26 (40.0)
 5 (29.4)
Median age, mo (IQR)
 26 (19–34)
 27 (21–36)
 28 (21–36)
 20 (15–22)
Illness at admission, median d (IQR)†
 2 (1–2)
 2 (1–2)
 2 (1–3)
 2 (1–2)
Origin of patients
Ho Chi Minh City 46 (45.5) 35 (42.2) 28 (43.1) 10 (58.8)
Other provinces/cities
 55 (54.5)
 48 (57.8)
 37 (56.9)
 7 (41.2)
Clinical grade of disease‡
2A 28 (27.7) 17 (20.5) 15 (23.1) 10 (58.8)
2B1 15 (14.9) 12 (14.5) 11 (16.9) 3 (17.6)
2B2 16 (15.8) 15 (18.1) 12 (18.5) 1 (5.9)
3 41 (40.6) 39 (47.0) 27 (41.5) 2 (11.8)
4 1 (1.0) 0 (0.0) 0 (0.0) 1 (5.9)

*Values are no. (%) except as indicated. EV-A71, enterovirus A71; IQR, interquartile range. †Median number of days of illness before admission. ‡Clinical grades of hand, foot, and mouth disease have been previously defined (3).

Main Article

References
  1. World Health Organization Regional Office for the Western Pacific. A guide to clinical management and public health response for hand, foot and mouth disease (‎HFMD)‎. 2011 [cited 2023 Jun 1]. https://apps.who.int/iris/handle/10665/207490
  2. Messacar  K, Burakoff  A, Nix  WA, Rogers  S, Oberste  MS, Gerber  SI, et al. Notes from the field: enterovirus A71 neurologic disease in children—Colorado, 2018. MMWR Morb Mortal Wkly Rep. 2018;67:1017–8. DOIPubMedGoogle Scholar
  3. Nhan  LNT, Khanh  TH, Hong  NTT, Van  HMT, Nhu  LNT, Ny  NTH, et al. Clinical, etiological and epidemiological investigations of hand, foot and mouth disease in southern Vietnam during 2015 - 2018. PLoS Negl Trop Dis. 2020;14:e0008544. DOIPubMedGoogle Scholar
  4. Thanh  TT, Anh  NT, Tham  NT, Van  HMT, Sabanathan  S, Qui  PT, et al. Validation and utilization of an internally controlled multiplex Real-time RT-PCR assay for simultaneous detection of enteroviruses and enterovirus A71 associated with hand foot and mouth disease. Virol J. 2015;12:85. DOIPubMedGoogle Scholar
  5. Kroneman  A, Vennema  H, Deforche  K, v d Avoort  H, Peñaranda  S, Oberste  MS, et al. An automated genotyping tool for enteroviruses and noroviruses. J Clin Virol. 2011;51:121–5. DOIPubMedGoogle Scholar
  6. Dung  NT, Hung  LM, Hoa  HTT, Nga  LH, Hong  NTT, Thuong  TC, et al. Monkeypox virus infection in 2 female travelers returning to Vietnam from Dubai, United Arab Emirates, 2022. Emerg Infect Dis. 2023;29:778–81. DOIPubMedGoogle Scholar
  7. Martin  DP, Murrell  B, Golden  M, Khoosal  A, Muhire  B. RDP4: Detection and analysis of recombination patterns in virus genomes. Virus Evol. 2015;1:vev003. DOIPubMedGoogle Scholar
  8. Minh  BQ, Schmidt  HA, Chernomor  O, Schrempf  D, Woodhams  MD, von Haeseler  A, et al. IQ-TREE 2: new models and efficient methods for phylogenetic inference in the genomic era. Mol Biol Evol. 2020;37:1530–4. DOIPubMedGoogle Scholar
  9. Kobayashi  K, Nishimura  H, Mizuta  K, Nishizawa  T, Chu  ST, Ichimura  H, et al. Virulence of enterovirus A71 fluctuates depending on the phylogenetic clade formed in the epidemic year and epidemic region. J Virol. 2021;95:e0151521. DOIPubMedGoogle Scholar
  10. Takahashi  S, Metcalf  CJE, Arima  Y, Fujimoto  T, Shimizu  H, Rogier van Doorn  H, et al. Epidemic dynamics, interactions and predictability of enteroviruses associated with hand, foot and mouth disease in Japan. J R Soc Interface. 2018;15:20180507. DOIPubMedGoogle Scholar
  11. Eden  JS, Sikazwe  C, Xie  R, Deng  YM, Sullivan  SG, Michie  A, et al.; Australian RSV study group. Off-season RSV epidemics in Australia after easing of COVID-19 restrictions. Nat Commun. 2022;13:2884. DOIPubMedGoogle Scholar
  12. Tee  KK, Lam  TT, Chan  YF, Bible  JM, Kamarulzaman  A, Tong  CYM, et al. Evolutionary genetics of human enterovirus 71: origin, population dynamics, natural selection, and seasonal periodicity of the VP1 gene. J Virol. 2010;84:3339–50. DOIPubMedGoogle Scholar
  13. Yuan  J, Shen  L, Wu  J, Zou  X, Gu  J, Chen  J, et al. Enterovirus A71 proteins: structure and function. Front Microbiol. 2018;9:286. DOIPubMedGoogle Scholar
  14. Nguyen  TT, Chiu  CH, Lin  CY, Chiu  NC, Chen  PY, Le  TTV, et al. Efficacy, safety, and immunogenicity of an inactivated, adjuvanted enterovirus 71 vaccine in infants and children: a multiregion, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet. 2022;399:1708–17. DOIPubMedGoogle Scholar
  15. Hong  J, Liu  F, Qi  H, Tu  W, Ward  MP, Ren  M, et al. Changing epidemiology of hand, foot, and mouth disease in China, 2013-2019: a population-based study. Lancet Reg Health West Pac. 2022;20:100370. DOIPubMedGoogle Scholar

Main Article

1Members are listed at the end of this article.

Page created: December 08, 2023
Page updated: January 24, 2024
Page reviewed: January 24, 2024
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external