Abstract

While the underlying determinants are unclear, hand, foot and mouth disease (HFMD) presents a wide spectrum of clinical manifestations with varying severity in different individuals. Recently, many studies identified the human microbiome as a critical factor in the pathogenesis of various diseases. Therefore, we here investigated the ecological dynamics of the oral microbiome changes during the HFMD infection. After targeted enrichment of all known vertebrate viruses, the virome profiles of symptomatic and asymptomatic HFMD patients were examined and revealed to be significantly altered from those of healthy individuals, with nine discriminative viruses detected. Further characterization of the prokaryotic microbiome revealed an elevated level of Streptococcus sp. as the most important signature of the symptomatic HFMD cohort, positively correlating to the level of enterovirus A RNA. In addition, we found that while coxsackievirus A5 is detected in saliva RNA of all asymptomatic cases, coxsackievirus A6 dominates the majority of the symptomatic cohort.

Highlights

  • Hand, foot and mouth disease (HFMD) is a highly contagious common viral childhood illness

  • In recent years, HFMD caused by CV-A6 has become increasingly common[7]

  • It was first associated with HFMD in Finland[8] and Singapore[9] outbreaks in 2008, and subsequently, CV-A6-associated HFMD outbreaks became widespread in other parts of Europe and Asia[3,10,11], as well as in North America from 2011 to 201212,13

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Summary

Introduction

Foot and mouth disease (HFMD) is a highly contagious common viral childhood illness. 1234567890():,; Fig. 1 Comparison of salivary virome in healthy, symptomatic and asymptomatic for HFMD samples (n = 38).

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