Hand, foot, and mouth disease outbreak by Coxsackievirus A6 during COVID-19 pandemic in 2021, São Paulo, Brazil.

INTRODUCTION: Hand, foot, and mouth disease (HFMD) is an acute febrile illness characterized by fever; sore throat; and vesicular eruptions on the hands, feet, and oral mucosa. Outbreaks of HFMD in children aged <5 years have been reported worldwide and the major causative agents are Coxsackievirus (CV)A16, enterovirus (EV)-A71 and recently CVA6. AIM AND METHODS: The aim of this study was to investigated a large outbreak of Hand, foot, and mouth disease during COVID-19 pandemic in 2021 from clinical samples of 315 suspected cases, in São Paulo State, Brazil. Diagnostic evaluation was performed by RT-qPCR, culture cell isolation and serological neutralization assay. EV-positive were genotyped by partial VP1 genome sequencing. RESULTS: One hundred and forty-nine cases analyzed were positive for enterovirus (47.3%; n = 149/315) by neutralizing test (n = 10 patients) and RT-qPCR (n = 139 patients), and identified as CVA6 sub-lineage D3 by analysis of VP1 partial sequences. CONCLUSIONS: This finding indicated the reemergence of CVA6 in HFMD, soon after the gradual easing of non-pharmaceutical interventions during-pandemic COVID-19 and the relevance of continued surveillance of circulating enterovirus types in the post-COVID pandemic era.

A phase I clinical trial of a new 5-valent rotavirus vaccine.

We conducted a phase I, double-blind, placebo-controlled trial to evaluate a new 5-valent oral rotavirus vaccine's safety and immunogenicity profiles. Subjects were randomly assigned to receive 3 orally administered doses of a live-attenuated human-bovine (UK) reassortant rotavirus vaccine, containing five viral antigens (G1, G2, G3, G4 and G9), or a placebo. The frequency and severity of adverse events were assessed. Immunogenicity was evaluated by the titers of anti-rotavirus IgA and the presence of neutralizing antibodies anti-rotavirus. No severe adverse events were observed. There was no difference in the frequency of mild adverse events between experimental and control groups. The proportion of seroconversion was consistently higher in the vaccine group, for all serotypes, after each one of the doses. The 5-valent vaccine has shown a good profile of safety and immunogenicity in this small sample of adult volunteers.

Rotavirus genotype G4P[8] and enteric adenovirus in HIV-positive patients with and without diarrhoea in São Paulo State, Brazil.

The present study was carried out in order to identify rotavirus and enteric adenovirus in HIV-positive patients with and without diarrhoea, collected in a pre- and early highly active antiretroviral therapy era. Rotavirus was detected in 2.5% (3/118) and adenovirus in 14.4% (17/118) of the samples from patients without diarrhoea. In the patients with diarrhoea, rotavirus was identified in 1.5% (2/133) and adenovirus in 7.5% (10/133). These findings suggest no increased frequency of virus excretion in HIV-infected patients with diarrhoea. The genotype G4P[8] was characterized in all positive rotavirus samples, and this is the first report of rotavirus molecular characterization in HIV-positive patients in Brazil.