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National Academy of Agricultural Sciences (NAAS)
NAAS Score: *5.38 (2020)
[Effective from January 1, 2020]
For more details click here
ICV 2023: 95.56
Index Copernicus ICI Journals Master List 2023 - IJCMAS--ICV 2023: 95.56
For more details click here
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Original Research Articles Volume : 15, Issue : 9, September, 2026

PRINT ISSN : 2319-7692
Online ISSN : 2319-7706
Issues : 12 per year
Publisher : Excellent Publishers
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Editor-in-chief: Dr.M.Prakash
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Int.J.Curr.Microbiol.App.Sci.2026.15(9) : 152-160
DOI : https://doi.org/10.20546/ijcmas.2026.1509.017


The A6 Shift: A Systematic Review of Coxsackievirus-Associated HFMD across Indian and Global Cohorts

Seema Bhamu, Deepak Kanjani*, Kartik Saini and Smita Kulshrestha
Department of Microbiology, Dr. Sampurnanand Medical College (SNMC), Jodhpur, Rajasthan 342001, India
*Corresponding author
Abstract:

Coxsackievirus A6 (CV-A6) has become a leading global cause of hand, foot and mouth disease (HFMD), and the disease it produces often departs from the classical picture. These atypical presentations are easily missed, and the result is delayed diagnosis. In India, variable clinical presentation and uneven access to molecular testing are likely to compound the problem. PRISMA 2020–compliant systematic search of PubMed/MEDLINE, PMC, Scopus, Web of Science, IndMED, and ICMR-NIC repositories (January 2000–December 2024). Two independent reviewers screened studies (Cohen’s kappa: abstract κ = 0.84; full-text κ = 0.91). Twenty studies met the inclusion criteria (7 Indian, 13 global). Both groups showed CV-A6 and CV-A16 co-circulating, with a shift toward CV-A6 dominance after 2015 — reaching roughly 55% of typed isolates globally and about 42% in India. The neuroinvasive burden of Coxsackievirus in India remains essentially uncharacterised (GRADE: very low certainty). The rise of CV-A6 has widened the clinical spectrum of HFMD, and of the factors shaping outcome, diagnostic delay is the one most open to intervention. Pairing updated clinical recognition criteria with targeted molecular testing could reduce unnecessary treatment in resource-limited settings. The clearest research priority is a prospective Indian cohort study combining CSF enterovirus RT-PCR with structured clinical phenotyping.


Keywords: Coxsackievirus A6; hand, foot and mouth disease; diagnostic delay; RT-PCR; molecular epidemiology

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How to cite this article:

Seema Bhamu, Deepak Kanjani, Kartik Saini and Smita Kulshrestha. 2026. The A6 Shift: A Systematic Review of Coxsackievirus-Associated HFMD across Indian and Global Cohorts Int.J.Curr.Microbiol.App.Sci. 15(9): 152-160 doi: https://doi.org/10.20546/ijcmas.2026.1509.017
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