Identification of enterovirus 71 isolates from an outbreak of hand, foot and mouth disease (HFMD) with fatal cases of encephalomyelitis in Malaysia

Sazaly Abubakar, Hui Yee Chee, Muhannad F. Al-Kobaisi, Jiang Xiaoshan, Kaw Bing Chua, Sai Kit Lam

Research output: Contribution to journalShort survey

178 Citations (Scopus)

Abstract

Thirteen enterovirus 71 (EV71) isolates were obtained from both fatal and non-fatal infections of patients seen in Peninsula Malaysia and in Sarawak during an outbreak of hand, foot and mouth disease (HFMD) in Malaysia in 1997, with incidences of fatal brainstem encephalomyelitis. The isolates were identified using immunofluorescence staining, neutralization assays, and partial sequencing of the 5' untranslated regions (UTR). Assessment of the potential genetic relationships of the isolates using the partial 5'UTR sequences suggested clustering of the isolates into at least two main clusters. Isolates from Peninsula Malaysia were found in both clusters whereas Sarawak-derived isolates clustered only in cluster II. Isolates derived from fatal infections, however, occurred in both clusters and no distinctive nucleotide sequences could be attributed to the fatal isolates. Examination of the nucleotide sequences revealed at least 13 nucleotide positions in all the isolates which differ completely from the previously reported EV71 5'UTR sequences. In addition, at least 11 nucleotide position differences within the 5'UTR were noted which differentiated cluster I from cluster II. Predicted secondary RNA structures drawn using the nucleotide sequences also suggested differences between isolates from the two clusters. These findings suggest the presence of at least two potentially virulent EV71 co-circulating in Malaysia during the 1997 HFMD outbreak. Copyright (C) 1999 Elsevier Science B.V.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalVirus Research
Volume61
Issue number1
DOIs
Publication statusPublished - May 1999

Fingerprint

Hand, Foot and Mouth Disease
Encephalomyelitis
Enterovirus
Malaysia
Disease Outbreaks
5' Untranslated Regions
Nucleotides
Infection
Brain Stem
Fluorescent Antibody Technique
Cluster Analysis
RNA
Staining and Labeling
Incidence

Keywords

  • 5' untranslated regions
  • Encephalomyelitis
  • Enterovirus
  • Hand, foot and mouth disease
  • Malaysia
  • Sarawak

ASJC Scopus subject areas

  • Cancer Research
  • Infectious Diseases
  • Virology

Cite this

Identification of enterovirus 71 isolates from an outbreak of hand, foot and mouth disease (HFMD) with fatal cases of encephalomyelitis in Malaysia. / Abubakar, Sazaly; Chee, Hui Yee; Al-Kobaisi, Muhannad F.; Xiaoshan, Jiang; Bing Chua, Kaw; Kit Lam, Sai.

In: Virus Research, Vol. 61, No. 1, 05.1999, p. 1-9.

Research output: Contribution to journalShort survey

Abubakar, Sazaly ; Chee, Hui Yee ; Al-Kobaisi, Muhannad F. ; Xiaoshan, Jiang ; Bing Chua, Kaw ; Kit Lam, Sai. / Identification of enterovirus 71 isolates from an outbreak of hand, foot and mouth disease (HFMD) with fatal cases of encephalomyelitis in Malaysia. In: Virus Research. 1999 ; Vol. 61, No. 1. pp. 1-9.
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abstract = "Thirteen enterovirus 71 (EV71) isolates were obtained from both fatal and non-fatal infections of patients seen in Peninsula Malaysia and in Sarawak during an outbreak of hand, foot and mouth disease (HFMD) in Malaysia in 1997, with incidences of fatal brainstem encephalomyelitis. The isolates were identified using immunofluorescence staining, neutralization assays, and partial sequencing of the 5' untranslated regions (UTR). Assessment of the potential genetic relationships of the isolates using the partial 5'UTR sequences suggested clustering of the isolates into at least two main clusters. Isolates from Peninsula Malaysia were found in both clusters whereas Sarawak-derived isolates clustered only in cluster II. Isolates derived from fatal infections, however, occurred in both clusters and no distinctive nucleotide sequences could be attributed to the fatal isolates. Examination of the nucleotide sequences revealed at least 13 nucleotide positions in all the isolates which differ completely from the previously reported EV71 5'UTR sequences. In addition, at least 11 nucleotide position differences within the 5'UTR were noted which differentiated cluster I from cluster II. Predicted secondary RNA structures drawn using the nucleotide sequences also suggested differences between isolates from the two clusters. These findings suggest the presence of at least two potentially virulent EV71 co-circulating in Malaysia during the 1997 HFMD outbreak. Copyright (C) 1999 Elsevier Science B.V.",
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AB - Thirteen enterovirus 71 (EV71) isolates were obtained from both fatal and non-fatal infections of patients seen in Peninsula Malaysia and in Sarawak during an outbreak of hand, foot and mouth disease (HFMD) in Malaysia in 1997, with incidences of fatal brainstem encephalomyelitis. The isolates were identified using immunofluorescence staining, neutralization assays, and partial sequencing of the 5' untranslated regions (UTR). Assessment of the potential genetic relationships of the isolates using the partial 5'UTR sequences suggested clustering of the isolates into at least two main clusters. Isolates from Peninsula Malaysia were found in both clusters whereas Sarawak-derived isolates clustered only in cluster II. Isolates derived from fatal infections, however, occurred in both clusters and no distinctive nucleotide sequences could be attributed to the fatal isolates. Examination of the nucleotide sequences revealed at least 13 nucleotide positions in all the isolates which differ completely from the previously reported EV71 5'UTR sequences. In addition, at least 11 nucleotide position differences within the 5'UTR were noted which differentiated cluster I from cluster II. Predicted secondary RNA structures drawn using the nucleotide sequences also suggested differences between isolates from the two clusters. These findings suggest the presence of at least two potentially virulent EV71 co-circulating in Malaysia during the 1997 HFMD outbreak. Copyright (C) 1999 Elsevier Science B.V.

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