Atypical hand-foot-mouth disease in Belém, Amazon region, northern Brazil, with detection of coxsackievirus A6.

Background: Enterovirus (EV) A71 and coxsackievirus (CV) A16 were the most frequent serotypes involved in hand, foot, and mouth disease (HFMD) outbreaks throughout Asia. In the past 5 years, however, CV-A6 has emerged as a new important pathogen worldwide, and more severe and extensive dermatologic presentations has been reported.

Objectives: Identify the clinical spectrum for atypical HFMD and enterovirus serotypes in Belém, Pará, Amazon region of northern Brazil.

Re-emergence of a coxsackievirus A24 variant causing acute hemorrhagic conjunctivitis in Brazil from 2017 to 2018.

A large outbreak (over 200,000 cases) of acute hemorrhagic conjunctivitis (AHC) took place in Brazil during the summer of 2017/2018, seven years after a nationwide epidemic, which occurred in 2011. To identify the etiological agent, 80 conjunctival swabs from patients with a clinical presentation suggestive of AHC were analyzed at the national enterovirus laboratory. Real-time RT-PCR for human enteroviruses was performed, and enterovirus RNA was detected in 91.