Volume 28, Issue 10(209) 2018
Non-EV-A71 enteroviruses associated with hand, foot and mouth diseases among children aged under 5 years in Northern provinces, Vietnam, 2008-2018
Author: Hoa - Tran Thi Nguyen, Nguyen The Anh, Dao Thi Hai Anh, Ngu Duy Nghia, Nguyen
Thi Thu Trang, Vu Manh Hung, Ta Thi Thu Hong, Nguyen Thi Viet Ha, Nguyen Thi
Ha, Tran Nhu Duong and Nguyen Thi Hien Thanh
Hand, foot and mouth disease (HFMD) is mainly caused by enteroviruses with common serotypes of EV-A71, CVA16,
and recently-emerging serotype, CV-A6. EV-A71 has been reported to be responsible for severe neurological manifestation.
However, large outbreaks with severe cases caused by non-EV-A71 serotypes have been reported worldwide.
Nevertheless, compared with the huge number of molecular and epidemiological studies on EV-A71, there has been
limitation on non-EV-A71 serotypes, especially in Vietnam. Moreover, very few studies were conducted in a timeframe
long enough to gain insight into their circulation. Therefore, we conducted a review on non-EV-A71 serotypes causing
HFMD among children aged under 5 years in northern Vietnam with a long period of time, 2008-2018. Non-EV-A71
enteroviruses accounted for 65% of total of HFMD cases determined to be enterovirus-positive. As many as 41 non-
EV-A71 serotypes were detected thus the major ones were CV-A6, CV-A16, and CV-A10 with 27%, 21%, and 3%,
respectively, in relative frequencies. The other serotypes of CV-A2, CV-A4, CV-A12, E-18, E-30, and CV-A24 etc.
each accounted for less than 1%. The periodicities of CV-A16 and CV-A6 were observed but with wave shapes different
from each other and from that of EV-A71. Other serotypes, including CV-A10, CV-A4, and CV-A2 occasionally prevailed
but only for a short period of one or two quarters. Although non-EV-A71 serotypes mainly caused mild HFMD,
non-EV-A71 serotypes were responsible for 20% cases with severe neurological manifestation. In conclusion, this
long-term review highlights requirements of monitoring the activity of non-EV-A71 enteroviruses as important agents
causing HFMD for paediatric patients
Hand, foot and mouth disease (HFMD); non-EV-A71; CV-A16; CV-A6; CV-A10
2. Tran Thi Nguyen Hoa.pdf