Genetic Characterization of Human Enteroviruses Associated with Hand, Foot and Mouth Diseases in Poland, 2013–2016


Share / Export Citation / Email / Print / Text size:

Polish Journal of Microbiology

Polish Society of Microbiologists

Subject: Microbiology


ISSN: 1733-1331
eISSN: 2544-4646





Volume / Issue / page

Related articles

VOLUME 66 , ISSUE 3 (September 2017) > List of articles

Genetic Characterization of Human Enteroviruses Associated with Hand, Foot and Mouth Diseases in Poland, 2013–2016

Magdalena Wieczorek * / Agnieszka Ciąćka / Arleta Krzysztoszek / Agnieszka Figas / Leszek Szenborn

Keywords : coxsackieviruses, genotyping of HFMD enteroviruses, hand, foot and mouth disease (HFMD), human enteroviruses (HEVs)

Citation Information : Polish Journal of Microbiology. Volume 66, Issue 3, Pages 405-409, DOI:

License : (CC BY-NC-ND 4.0)

Received Date : 03-October-2016 / Accepted: 12-January-2017 / Published Online: 27-September-2017



The objective of the present study was to describe the molecular characteristics of enteroviruses associated with hand, food, and mouth disease (HFMD) in Poland. Clinical material from HFMD cases, that occurred during 2013–2016 were examined. It has been showed that coxsackievirus A6 (CVA6), CVA10 and CVA16 were circulating in the country. Phylogenetic analysis showed that Polish CVA6 strains were divided into two distinct clusters suggesting two independent introductions. This is the first report of CVA6 infections associated with HFMD in Poland. These results emphasize the need for continuous monitoring of HFMD and facilitation of the diagnosis using molecular approaches.

Content not available PDF Share



Blomqvist S., P. Klemola, S. Kaijalainen, A. Paananen, M.L. Simonen, T. Vuorinen and M. Roivainen. 2010. Co-circulation ofcoxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. J. Clin. Virol. 48: 49–54.


Cabrerizo M., D. Tarrago, C. Munoz-Almagro, E. Del Amo,M. Dominguez-Gil, J.M. Eiros, I. Lopez-Miragava, C. Perez, J. Reina, A. Otero and others. 2014. Molecular epidemiology of enterovirus 71, coxsackievirus A16 and A6 associated with hand, foot and mouth disease in Spain. Clin. Microbiol. Infect. 20: O150–156.


Fujimoto T., S. Iizuka, M. Enomoto, K. Abe, K. Yamashita,N. Hanaoka, N. Okabe, H. Yoshida, Y. Yasui, M. Kobayashi and others. 2012. Hand, foot, and mouth disease caused by coxasckievirus A6, Japan, 2011. Emerg. Infect. Dis. 18: 337–339.


Lei X., S. Cui, Z. Zhao and J. Wang. 2015. Etiology, pathogenesis, antivirals and vaccines of hand, foot, and mouth disease. National Science Review 2: 268–284.


Leitch E.C., H. Harvala, I. Robertson, I. Ubillos, K. Templeton and P. Simmonds. 2009. Direct identification of human enterovirus serotypes in cerebrospinal fluid by amplification and sequencing of the VP1 region. J. Clin. Virol. 44: 119–124.


Lott J.P., K. Liu, M.L. Landry, W.A. Nix, M.S. Oberste, J. Bolognisand B. King. 2013. Atypical hand-foot-and-mouth disease associated with coxsackievirus A6 infection. J. Am. Acad. Dermatol. 69: 736–741.


Mirand A., C. Henquell, C. Archimbaud, S. Ughetto, D. Antona,J.L. Bailly and H. Peigue-Lafeuille. 2012. Outbreak of hand, foot and mouth disease/herpangina associated with coxsackievirus A6 and A10 infections in 2010, France: a large citywide, prospective observational study. Clin. Microbiol. Infect. 18: E110–118.


Nsaibia S., S. Wagner, P. Ronde, J.M. Warter, P. Poindron, M. Aouni and O.M. Dorchies. 2007. The difficult-to-cultivate coxsackieviruses A can productively multiply in primary culture of mouse skeletal muscle. Virus Res. 123: 30–39.


Osterback R., T. Vuorinen, M. Linna, P. Susi, T. Hyypia andM. Waris. 2009. Coxsackievirus A6 and hand, foot, and mouth disease, Finland. Emerg. Infect. Dis. 15: 1485–1488.


Puenpa J., T. Chieochansin, P. Linsuwanon, S. Korkong, S. Thongkomplew, P. Vichaiwattana, A. Theamboonlers and Y. Poovorawan. 2013. Hand, foot, and mouth disease caused by coxsackievirus A6, Thailand, 2012. Emerg. Infect. Dis. 19:641–643.


Sinclair C., E. Gaunt, P. Simmonds, D. Broomfield, N. Nwafor,L. Wellington, K. Templeton, L. Willocks, O. Schofield andH. Haravala. 2014. Atypical hand, foot, and mouth disease associated with coxsackievirus A6 infection, Edinburgh, United Kingdom, January to February 2014. Euro Surveill. 19: 20745.


Tamura K., G. Stecher, D. Peterson, A. Filipski and S. Kumar S. 2013. MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol. Biol. Evol. 30: 2725–2729.


Wei S.H., Y.P. Huang, M.C. Liu, T.P. Tsou, H.C. Lin, C.Y. Tsai, Y.N. Chao, L.Y. Chang and C.M. Hsu. 2011. An outbreak of coxsackievirus A6 hand, foot, and mouth disease associated with ony-chomadesis in Taiwan, 2010. BMC Infect. Dis. 11: 346.


WHO. 2004. Polio laboratory manual. World Health Organization, Geneva, Switzerland.


Wieczorek M. and A. Krzysztoszek. 2016. Molecular characterization of enteroviruses associated with acute flaccid paralysis cases in Poland, 1999–2014. Pol. J. Microbiol. 65.


Wu Y., A. Yeo, M.C. Phoon, E.L. Tan, C.L. Poh, S.H. Quak and V.T. Chow. 2010. The largest outbreak of hand, foot and mouth disease in Singapore in 2008: the role of enterovirus 71 and coxsackievirus A strains. Int. J. Infect. Dis. 14: e1076–1081.