Distribution of enteroviruses in hospitalized children with hand, foot and mouth disease and relationship between pathogens and nervous system complications.

In recent years, these viruses have shown an increasing trend as causes of HFMD; in particular, CVA6 and CVA 10 have recently emerged as pathogens of HFMD outbreaks in other countries, including Singapore and Finland [ 40 , 41 ] With the exception of ECHO14, the echovirus serotypes identified and the CVB group viruses, including CVB3, CVB4 and CVB5, have been previously associated with cases of HFMD [ 18 , 42 ].

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