Surveillance for Enteroviruses Associated with Hand, Foot, and Mouth Disease, and Other Mucocutaneous Symptoms in Spain, 2006–2020

  1. Launes, Cristian
  2. Valencia-Ramos, Juan
  3. Martínez-López, Nieves
  4. Romero, María Pilar
  5. Imaz-Pérez, Manuel
  6. Muñoz-Almagro, Carmen
  7. Calvo, Cristina
  8. Cabrerizo, María
  9. Reina, Jordi
  10. Otero, Almudena
  11. Ruiz-García, Montserrat
  12. Navascués, Ana
  13. Megias, Gregoria
  1. 1 Instituto de Salud Carlos III
    info

    Instituto de Salud Carlos III

    Madrid, España

    ROR https://ror.org/00ca2c886

  2. 2 Hospital Sant Joan de Deu
    info

    Hospital Sant Joan de Deu

    Barcelona, España

    ROR https://ror.org/001jx2139

  3. 3 Microbiological Department, Complejo Hospitalario de Navarra
  4. 4 Hospital Universitario de Basurto
    info

    Hospital Universitario de Basurto

    Bilbao, España

    ROR https://ror.org/00j4pze04

  5. 5 Hospital Universitario Son Espases
    info

    Hospital Universitario Son Espases

    Palma, España

    ROR https://ror.org/05jmd4043

  6. 6 Microbiological and Paediatric Departments, Hospital La Paz
  7. 7 Hospital General Universitario de Elche
    info

    Hospital General Universitario de Elche

    Elche, España

    ROR https://ror.org/01jmsem62

  8. 8 Complejo Asistencial Universitario de Burgos
    info

    Complejo Asistencial Universitario de Burgos

    Burgos, España

    ROR https://ror.org/01j5v0d02

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Revista:
Viruses

ISSN: 1999-4915

Año de publicación: 2021

Volumen: 13

Número: 5

Páginas: 781

Tipo: Artículo

DOI: 10.3390/V13050781 GOOGLE SCHOLAR

Otras publicaciones en: Viruses

Resumen

Hand, foot, and mouth disease (HFMD) is a mild illness caused by enteroviruses (EV), although in some Asian countries, large outbreaks have been reported in the last 25 years, with a considerable incidence of neurological complications. This study describes epidemiological and clinical characteristics of EV infections involved in HFMD and other mucocutaneous symptoms from 2006 to 2020 in Spain. EV-positive samples from 368 patients were included. EV species A were identified in 85.1% of those typed EV. Coxsackievirus (CV) A6 was the prevalent serotype (60.9%), followed by EV-A71 (9.9%) and CVA16 (7.7%). Infections affected children (1–6 years old) mainly, and show seasonality with peaks in spring–summer and autumn. Clinical data indicated few cases of atypical HFMD as well as those with neurological complications (associated with the 2016 EV-A71 outbreak). Phylogenetic analysis of CVA6 VP1 sequences showed different sub-clusters circulating from 2010 to present. In conclusion, HFMD or exanthemas case reporting has increased in Spain in recent years, probably associated with an increase in circulation of CVA6, although they did not seem to show greater severity. However, EV surveillance in mucocutaneous manifestations should be improved to identify the emergence of new types or variants causing outbreaks and more severe pathologies.

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