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Open Access Research

Enteroviruses isolated from herpangina and hand-foot-and-mouth disease in Korean children

KwiSung Park1, BaeckHee Lee2, KyoungAh Baek1, DooSung Cheon3, SangGu Yeo3, JoonSoo Park4, JaeWan Soh5, HaeKyung Cheon6, KyungAh Yoon7* and YoungJin Choi8*

Author Affiliations

1 Chungcheongnam-Do Institute of Health and Environmental Research, Daejeon, South Korea

2 JeongGene Pediatrics, Sejong, South Korea

3 Division of Vaccine Research, Center for Infectious Diseases, National Institute of Health, Korea Center for Disease Control and Prevention, Osong, South Korea

4 Department of Pediatrics, College of Medicine, Soonchunhyang University, Cheonan, South Korea

5 Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University, Cheonan, South Korea

6 Department of Radiological Science, Baekseok Culture University, Cheonan, South Korea

7 Department of Clinical Pathology, Daejeon Health Sciences College, Daejeon, South Korea

8 Departments of Laboratory Medicine, College of Medicine, Soonchunhyang University, Cheonan, South Korea

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Virology Journal 2012, 9:205  doi:10.1186/1743-422X-9-205

Published: 17 September 2012

Abstract

Hand-foot-and-mouth disease (HFMD) and herpangina are commonly prevalent illness in young children. They are similarly characterized by lesions on the skin and oral mucosa. Both diseases are associated with various enterovirus serotypes. In this study, enteroviruses from patients with these diseases in Korea in 2009 were isolated and analyzed. Demographic data for patients with HFMD and herpangina were compared and all enterovirus isolates were amplified in the VP1 region by reverse transcription-polymerase chain reaction and sequenced. Among the enterovirus isolates, prevalent agents were coxsackievirus A16 in HFMD and coxsackievirus A5 in herpangina. More prevalent months for HFMD were June (69.2%) and May (11.5%), and June (40.0%) and July (24.0%) for herpangina. Age prevalence of HFMD patients with enterovirus infection was 1 year (23.1%), 4 years (19.2%), and over 5 years (19.2%). However, the dominant age group of herpangina patients with enterovirus infection was 1 year (48.0%) followed by 2 years (28.0%). Comparison of pairwise VP1 nucleotide sequence alignment of all isolates within the same serotypes revealed high intra-type variation of CVA2 isolates (84.6–99.3% nucleotide identity). HFMD and herpangina showed differences in demographic data and serotypes of isolated enteroviruses, but there was no notable difference in amino acid sequences by clinical syndromes in multiple comparison of the partial VP1 gene sequence.

Keywords:
Herpangina; Hand-foot-and-mouth disea1se; Enteroviruses