Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease
Human enterovirus 71 and coxsackievirus A16 are important causes of hand-foot-and-mouth disease (HFMD). Like other enteroviruses, they can be isolated from a range of sterile and nonsterile sites, but which clinical sample, or combination of samples, is the most useful for laboratory diagnosis of...
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| Format: | Article |
| Language: | English |
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American Society for Microbiology
2007
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| Online Access: | http://ir.unimas.my/id/eprint/13610/ http://ir.unimas.my/id/eprint/13610/1/Evaluation%20of%20Different%20Clinical%20Sample%20Types%20in%20Diagnosis%20%28abstract%29.pdf |
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| author | Mong, How Ooi Tom, Solomon Yuwana, Podin Anand, Mohan Winnie, Akin Mohd Apandi, Yusof Syvia, del Sel Kamsiah, Mohd Kontol Boon, Fu Lai Daniela, Clear Chae, Hee Chieng Blake, Emma David, Perera See, Chang Wong Jane, Cardosa |
| author_facet | Mong, How Ooi Tom, Solomon Yuwana, Podin Anand, Mohan Winnie, Akin Mohd Apandi, Yusof Syvia, del Sel Kamsiah, Mohd Kontol Boon, Fu Lai Daniela, Clear Chae, Hee Chieng Blake, Emma David, Perera See, Chang Wong Jane, Cardosa |
| author_sort | Mong, How Ooi |
| building | UNIMAS Institutional Repository |
| collection | Online Access |
| description | Human enterovirus 71 and coxsackievirus A16 are important causes of hand-foot-and-mouth disease
(HFMD). Like other enteroviruses, they can be isolated from a range of sterile and nonsterile sites, but which
clinical sample, or combination of samples, is the most useful for laboratory diagnosis of HFMD is not clear.
We attempted virus culture for 2,916 samples from 628 of 725 children with HFMD studied over a 3 1/2-year
period, which included two large outbreaks. Overall, throat swabs were the single most useful specimen, being
positive for any enterovirus for 288 (49%) of 592 patients with a full set of samples. Vesicle swabs were positive
for 169 (48%) of 333 patients with vesicles, the yield being greater if two or more vesicles were swabbed. The
combination of throat plus vesicle swabs enabled the identification of virus for 224 (67%) of the 333 patients
with vesicles; for this patient group, just 27 (8%) extra patients were diagnosed when rectal and ulcer swabs
were added. Of 259 patients without vesicles, use of the combination of throat plus rectal swab identified virus
for 138 (53%). For 60 patients, virus was isolated from both vesicle and rectal swabs, but for 12 (20%) of these,
the isolates differed. Such discordance occurred for just 11 (10%) of 112 patients with virus isolated from
vesicle and throat swabs. During large HFMD outbreaks, we suggest collecting swabs from the throat plus one
other site: vesicles, if these are present (at least two should be swabbed), or the rectum if there are no vesicles.
Vesicle swabs give a high diagnostic yield, with the added advantage of being from a sterile site. |
| first_indexed | 2025-11-15T06:39:43Z |
| format | Article |
| id | unimas-13610 |
| institution | Universiti Malaysia Sarawak |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T06:39:43Z |
| publishDate | 2007 |
| publisher | American Society for Microbiology |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | unimas-136102016-09-26T18:15:54Z http://ir.unimas.my/id/eprint/13610/ Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease Mong, How Ooi Tom, Solomon Yuwana, Podin Anand, Mohan Winnie, Akin Mohd Apandi, Yusof Syvia, del Sel Kamsiah, Mohd Kontol Boon, Fu Lai Daniela, Clear Chae, Hee Chieng Blake, Emma David, Perera See, Chang Wong Jane, Cardosa RA0421 Public health. Hygiene. Preventive Medicine Human enterovirus 71 and coxsackievirus A16 are important causes of hand-foot-and-mouth disease (HFMD). Like other enteroviruses, they can be isolated from a range of sterile and nonsterile sites, but which clinical sample, or combination of samples, is the most useful for laboratory diagnosis of HFMD is not clear. We attempted virus culture for 2,916 samples from 628 of 725 children with HFMD studied over a 3 1/2-year period, which included two large outbreaks. Overall, throat swabs were the single most useful specimen, being positive for any enterovirus for 288 (49%) of 592 patients with a full set of samples. Vesicle swabs were positive for 169 (48%) of 333 patients with vesicles, the yield being greater if two or more vesicles were swabbed. The combination of throat plus vesicle swabs enabled the identification of virus for 224 (67%) of the 333 patients with vesicles; for this patient group, just 27 (8%) extra patients were diagnosed when rectal and ulcer swabs were added. Of 259 patients without vesicles, use of the combination of throat plus rectal swab identified virus for 138 (53%). For 60 patients, virus was isolated from both vesicle and rectal swabs, but for 12 (20%) of these, the isolates differed. Such discordance occurred for just 11 (10%) of 112 patients with virus isolated from vesicle and throat swabs. During large HFMD outbreaks, we suggest collecting swabs from the throat plus one other site: vesicles, if these are present (at least two should be swabbed), or the rectum if there are no vesicles. Vesicle swabs give a high diagnostic yield, with the added advantage of being from a sterile site. American Society for Microbiology 2007 Article PeerReviewed text en http://ir.unimas.my/id/eprint/13610/1/Evaluation%20of%20Different%20Clinical%20Sample%20Types%20in%20Diagnosis%20%28abstract%29.pdf Mong, How Ooi and Tom, Solomon and Yuwana, Podin and Anand, Mohan and Winnie, Akin and Mohd Apandi, Yusof and Syvia, del Sel and Kamsiah, Mohd Kontol and Boon, Fu Lai and Daniela, Clear and Chae, Hee Chieng and Blake, Emma and David, Perera and See, Chang Wong and Jane, Cardosa (2007) Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease. Journal of Clinical Microbiology, 45 (6). pp. 1858-1866. ISSN 0095-1137 http://jcm.asm.org/content/45/6/1858.full doi:10.1128/JCM.01394-06 |
| spellingShingle | RA0421 Public health. Hygiene. Preventive Medicine Mong, How Ooi Tom, Solomon Yuwana, Podin Anand, Mohan Winnie, Akin Mohd Apandi, Yusof Syvia, del Sel Kamsiah, Mohd Kontol Boon, Fu Lai Daniela, Clear Chae, Hee Chieng Blake, Emma David, Perera See, Chang Wong Jane, Cardosa Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease |
| title | Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease |
| title_full | Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease |
| title_fullStr | Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease |
| title_full_unstemmed | Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease |
| title_short | Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease |
| title_sort | evaluation of different clinical sample types in diagnosis of human enterovirus 71-associated hand-foot-and-mouth disease |
| topic | RA0421 Public health. Hygiene. Preventive Medicine |
| url | http://ir.unimas.my/id/eprint/13610/ http://ir.unimas.my/id/eprint/13610/ http://ir.unimas.my/id/eprint/13610/ http://ir.unimas.my/id/eprint/13610/1/Evaluation%20of%20Different%20Clinical%20Sample%20Types%20in%20Diagnosis%20%28abstract%29.pdf |