Abstract
Hand, foot and mouth disease (HFMD), caused by various viral pathogens, is an emerging infectious disease in children in Asia. Understanding the composition of these pathogens is necessary to prevent and control this disease. In the present study, the pathogens in 436 HFMD patients (from 2009 to 2011) with concurrent clinical indications of encephalitis, meningoencephalitis, or both, were defined using the semi-nested PCR. A systematic analysis of the composition of these pathogens was performed. Various enteroviruses that are capable of inducing central nervous system (CNS) damage in HFMD patients were identified, including enterovirus 71, coxsackievirus A16, and Echovirus 9. Most of these pathogens were found co-infecting the patients. The composition of the pathogens that induced CNS damage in the HFMD patients was dynamically modulated in the cases.