Epidemiology and Infection

Short Report

Hand, foot and mouth disease

Onychomadesis after a hand, foot, and mouth disease outbreak in Spain, 2009

M. CABRERIZOa1 c1, T. DE MIGUELa1, A. ARMADAa2, R. MARTÍNEZ-RISCOa2, A. POUSAa3 and G. TRALLEROa1

a1 Virology Department, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain

a2 Servicio de Alertas Epidemiológicas del Departamento Territorial de Sanidad, La Coruña, Spain

a3 Servicio de Epidemiología de la Dirección General de Salud Pública y Planificación, Santiago de Compostela, Spain

SUMMARY

Few reports exist regarding the association between onychomadesis and an enterovirus infection presenting clinically as hand, foot, and mouth disease (HFMD). In February 2009, an outbreak of HFMD occurred in a Spanish nursery school, followed by onychomadesis 36–69 days later. Twelve of 17 children with HFMD developed nail shedding; enterovirus was detected in stool samples from eight (47%) of the 17. However, in only three of the children could an enterovirus serotype coxsackievirus B1 be identified. The epidemiological results of this study confirm onychomadesis as a complication in HFMD. In future outbreaks, molecular characterization of enterovirus from appropriate clinical samples should be studied.

(Accepted August 23 2010)

(Online publication September 21 2010)

Correspondence:

c1 Author for correspondence: Dr M. Cabrerizo, Enterovirus Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo km 2, Madrid, Spain. (Email: mcabrerizo@isciii.es)

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