Detection and Characterization of Enterovirus Associated with Herpangina and Hand, Foot, and Mouth Disease in Seoul, Korea

Background: Human enteroviruses (HEVs) are a major cause of herpangina, HFMD (hand, foot, and mouth disease), and other neurological diseases in Seoul, Korea. Methods: A total of 56 specimens from hospitalized patients collected from February to December 2009 (37 females and 19 males) in Seoul were tested for HEV from stool, throat swab, and vesicle swab samples taken from patients with herpangina or HFMD using cell culture and RT-PCR in 2009. By the ID gene, encoding the VP1 capsid protein, seven different HEV genotypes were detected with Coxsackievirus A2, A4, A5, A9, A16 (CA), Coxsackievirus B1 (CB), and Enterovirus 71 (EV71). The most prevalent genotype was CA16 (6, 10.7 %), followed by CA2 (4, 7.1 %), CAS (4, 7.1 %), EV71 (2, 3.6 %), CA4 (1, 1.8 %), CA9 (I, 1.8 %), and CBI (I, 1.8 %). The ID gene sequences of two EV71 strains were closely related with one another (98.5 %, nucleotide similarity) and belonged to the C4 genotype. Conclusions: It is important to continuously survey the genetic characteristics of EV71 and CA16 from patients, which will provide useful data that aids in our understanding of HFMD infections in Seoul, Korea and may contribute to future control. (Clin. Lab. 2011;57:959-967)