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A 3-year-and-7-month-old girl with Down's syndrome had papules and vesicles on hands, feet and buttocks, and vesicular lesions in the oral cavity. A positive culture of enterovirus in vesicular fluid confirmed the clinical diagnosis 'hand-foot-mouth disease'.
In order to investigate the effects of global warming, we attempted to establish seasonal models to predict fluctuations in rates of herpangina (HA) and hand-foot-mouth disease (HFMD) associated with weather conditions and calendar months in Tokyo, Japan. Surveillance data tracking HA/HFMD incidences in Tokyo was retrieved from the Infectious Agents Surveillance Report, published by the National Institute of Infectious Diseases in Japan. From the Meteorological Agency, we obtained data for 54 weather condition parameters. The annual fluctuations in reported HA cases comprising start, peak, and end weeks almost exactly matched the model, although peak levels for each fluctuation did not always match in HFMD. Furthermore, for the HA model, 88% of the variations among observed HA cases were explained by the linear relationship with the seasonal parameters investigated, which was higher than the 64% observed for the HFMD model. The HA and HFMD models were applied to data from the years 1999 to 2002, and demonstrated correlations of 86% and 64%, respectively. These models predicted that warmer climate conditions would lead to an increased number of HA and HFMD cases. These results suggest that our seasonal models may quantify the dependency of infectious diseases on seasonal parameters and simulate the impact of global warming.
Two patients, a Surinamese man aged 50 and a Surinamese woman aged 56 exhibited a mycetoma of the foot, 30 and 28 years, respectively, after a local injury. Pathological examination revealed an aspecific chronic granulomatous inflammation. As causative agents a Fusarium species and a Cladosporium normodendrum, respectively, were cultured. The treatment consisted of curettage of fistulous ducts and administration of itraconazole.
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Foot-and-mouth disease (FMD) is an economically important disease of livestock. Eliminating FMD outbreaks in previously disease-free countries often relies on restriction of animal movement and massive slaughter of infected and in-contact susceptible animals. To develop a more effective and humane FMD control strategy, we explored the possibility of using type I interferon (IFN-alpha/beta) as a novel anti-FMD agent. We have demonstrated previously that swine inoculated with replication-defective human adenovirus type 5 (Ad5) vector expressing porcine IFN-alpha (Ad5-PoIFN-alpha) were completely protected from FMD virus (FMDV) challenge. To extend this approach to bovines, we constructed Ad5 vectors that express bovine IFN-alpha or IFN-beta (Ad5-BoIFN-alpha and Ad5-BoIFN-beta). Cells infected with these viruses produced high levels of biologically active BoIFN-alpha/beta, but despite expression in vitro, no detectable IFN-induced biologic activity was found in cattle inoculated with Ad5-BoIFN-alpha. Because PoIFN-alpha inhibits FMDV replication in bovine cells, we evaluated the potential use of PoIFN-alpha against FMD in cattle. In cattle inoculated with Ad5-PoIFN-alpha, the appearance of vesicles was delayed after challenge with FMDV and disease was less severe than in control animals. One Ad5-PoIFN-alpha-inoculated animal never developed clinical disease. Similarly, although all the Ad5-PoIFN-alpha-inoculated animals developed viremia, it was delayed for 1 day as compared with the control group. These results suggest that in vivo expression of PoIFN-alpha partially protected cattle from FMD.
Diabetic foot disease is a severe complication to diabetes mellitus. Preventive measures can reduce its occurrence and consequences. The present study was performed in order to assess the prevalence of diabetic foot disease in an urbanized area with well developed medical facilities. The study was based on a mail questionnaire to a stratified, randomized sample of 742 diabetics living in the Stockholm county. Only one third of these patients were free of diabetic foot symptoms. Many patients with severe signs found it difficult to take care of their feet, were living alone and did not seek professional help for their foot problems. Only 66% of the patients with severe foot disease utilized hospitals for their diabetes care. Furthermore, only half of them relied on some type of professional care for their feet.
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Coxsackievirus A16 (CA16) and enterovirus 71 (EV71) are known to be major causative agents of hand-foot-and-mouth disease prevalent in summer in Japan. Discrimination and identification of these viruses were often hampered by a nonneutralizable or nontypable virus. Therefore, a Southern blot hybridization that utilizes mixed probes specific to serotype was developed. Firstly, an approximately 650 bases spanning 5'-noncoding region to one third of VP2 including entire VP4 was amplified with a set of primers containing enterovirus common sequences and a genomic RNA as template. Secondary, the nucleotide sequences were determined using seven CA16 and eighteen EV71 strains including the standard strains, and the deduced amino acid sequences of VP4 were searched to find residues which are conserved in the same serotypes but diverged among different serotypes. Candidate positions for the mixed probes were defined at the carboxyl terminus of VP4. Thirdly, Southern blot analyses were carried out using thirty-nine enterovirus standard strains, seven CA16 isolates and sixty-six EV71 isolates previously identified by the neutralization test. The results revealed that each mixed probe exclusively bound to the homologous DNAs but not to the heterologous ones. In an attempt to determine serotypes without virus isolation, clinical specimens from hand-foot-and-mouth disease were examined. Of 78 throat swabs and 15 vesicular fluids, 71 (91.0%) and 13 (86.7%) specimens were clearly identified, indicating that the method described here offer advantages over the traditional neutralization assay: It is rapid, specific and less labor-consuming.
Hand, foot and mouth disease (HFMD) is a common illness of infants and young children <10 years of age. It is characterized by fever, ulcers in the oral cavity, and rashes with blisters that appear on the palm and sole. The most common causal agents of HFMD are coxsackievirus A16 (CV-A16) and human enterovirus 71 (HEV71), but other enteroviruses, including CV-A5 and CV-A10, can also cause it. When caused by CV-A16 infection, it is usually a mild disease, and patients normally recover without requiring any special medical attention.
Those afflicted with diabetes mellitus have high rates of morbidity and mortality owing to the many complications of the disease. The complications can manifest themselves as ophthalmic, renal, vascular, neurologic, and pedal diseases. Unfortunately, the most often overlooked or neglected complications involve the feet. It is estimated that in the United States foot disease is five times more prevalent in diabetic patients than in those without diabetes. In fact, 20% of all diabetic patients admitted to hospitals in the United States are admitted for foot disease, with foot and ankle ulcers being the most common presentation.
Economically, foot-and-mouth disease is the most important viral-induced livestock disease worldwide. The disease is highly contagious and foot-and-mouth disease virus replicates and spreads extremely rapidly. Recent outbreaks in previously foot-and-mouth disease-free countries and the potential use of foot-and-mouth disease virus by terrorist groups have demonstrated the vulnerability of countries and the need to develop control strategies that can rapidly inhibit or limit spread of the disease. The current vaccine, an inactivated whole-virus preparation, has a number of limitations for use in outbreaks in disease-free countries. This review discusses the potential of the antiviral agent, Type I interferon, to produce rapid protection and proposes a combination strategy of an antiviral agent and a foot-and-mouth disease vaccine to induce both immediate and long-lasting protective responses.
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Improved foot and mouth disease (FMD) vaccines which have increased efficiency and stability are highly desirable. Work which aims to increase the stability of FMD virus particles for vaccine use is described and the use of these particles and of antigenic fragments of the virus for controlled release vaccine products is considered.
Hand-foot-and-mouth disease is a highly contagious disease most often seen in children during the summer. It is caused most commonly by the virus coxsackie A16, but other enteroviruses have been implicated. It presents with low grade fever, and a vesicular eruption on the hands, feet, and mouth. More serious manifestations are seen less commonly. Diagnosis is most often clinical and treatment is symptomatic in nature. The infection in a male adult is presented.
Foot-and-mouth disease virus causes a highly contagious disease of agricultural livestock and is of enormous economic importance. Replication of the RNA genome of the virus, via negative strand intermediates, involves an RNA-dependent RNA polymerase (3Dpol). RNA aptamers specific to this enzyme have been selected and characterized. Some of these molecules inhibit enzymatic activity in vitro, with IC50 values of <20 nM and Ki values of 18-75 nM. Two of these show similarity, both with each other and with regions of the viral genome. Furthermore, truncated versions of one of the aptamers have been used to define the parts of the molecule responsible for its inhibitory activity.
Foot-and-mouth disease virus (FMDV) is an aphthovirus of the family Picornaviridae and the etiological agent of the economically most important animal disease. As a typical picornavirus, FMD virions are nonenveloped particles of icosahedral symmetry and its genome is a single stranded RNA of about 8500 nucleotides and of positive polarity. FMDV RNA is infectious and it replicates via a complementary, minus strand RNA. FMDV RNA replication is error-prone so that viral populations consist of mutant spectra (quasispecies) rather than a defined genomic sequence. Therefore FMDV in nature is genetically and antigenically diverse. This poses important challenges for the diagnosis, prevention and control of FMD. A deeper understanding of FMDV population complexity and evolution has suggested requirements for a new generation of anti-FMD vaccines. This is relevant to the current debate on the adequacy of non-vaccination versus vaccination policies for the control of FMD.
Foot-and-mouth disease (FMD) is one of the most dangerous diseases of cloven-hoofed animals and is a constant threat in the Middle-East and other regions throughout the world despite intensive vaccination programs. In this work, we describe the ability of FMDV expression constructs to protect pigs from FMDV challenge when used as a vaccine. The construct consists of encephalomyocarditis virus (EMCV) internal ribosome entry site (IRES), the entire P1 and 2A together with 3CD sequences, all in the same reading frame. Another plasmid that was tested, carries the serotype O1 (G) VP1, Asia1 VP1 and O1 (G) 3C. Between each of the genes the 3C cleavage sequences were inserted. All constructs carried the cytomegalo virus (CMV) promoter. Using immunofluorescent and immunoblot techniques, we could show the expression and processing of viral proteins. Following the application of FMDV expression constructs into pigs skin by 'Gene Gun', pigs were partially protected from FMDV challenge.