The epidemiological and clinical characteristics of hand, foot and mouth disease in Hangzhou, China, 2016-2018

2019 ◽  
Author(s):  
Jie Wang ◽  
Jun Zhou ◽  
Guoliang Xie ◽  
Shufa Zheng ◽  
Bin Lou ◽  
...  
Keyword(s):  
Clinical Status ◽  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Rt Pcr ◽  
Foot And Mouth ◽  
Epidemiological Characteristics ◽  
The Relationship ◽  
Children Under 5

Abstract Background Hand, foot and mouth disease (HFMD) is most frequently caused by several serotypes of human enterovirus (EV) including Enterovirus 71 (EV71), Coxsackievirus A16 (CV-A16) or other types of EV. Children under 5 years old are the most susceptible to HFMD. The aim of this study was to determine the epidemiological characteristics and the relationship between severe and mild HFMD. Methods We collected 4760 probable HFMD cases with skin papular or vesicular rashes on the hands, feet, mouth or buttocks in Hangzhou from 2016 to 2018. Specimens of these cases were collected and the pathogen of EV71, CV-A16, CV-A6, CV-A10, CV-A2 and CV-A5 was classified by RT-PCR. Then the pathogen distribution and clinical status of children with HFMD were described. Results From Jan. 1, 2016 to Dec. 31, 2018, the incidence and prevalence of HFMD were seasonal each year. Among the 4760 probable HFMD cases, 3559 cases were confirmed (74.8%, 3559/4760), including 426 cases of EV71 infections (8.9%, 426/4760, 249 cases of CV-A16 infections (5.2%, 249/4760) and 2884 cases of other enteroviruses infections (60.6%, 2884/4760). The percentage of EV positive HFMD cases with non-EV71 and non-CV-A16 was more than 80% (2884/3559), which increased year by year. The percentage of EV71 decreased year by year in the last three years especially in 2018. Among the 1297 cases randomly selected of other EV infections in 2017 and 2018, there were 835 (64.4%) cases of CV-A6 infections, 177 (13.6%) cases of CV-A10 infections, 100 (7.7%) cases of CV-A2 infections, 40 (3.1%) cases of CV-A5 infections, 3 (0.02%) cases of mixed infections and 11.0% untyped enteroviruses infections. Preschool children were still the primary population susceptible to HFMD, and the age of the children infected with other enteroviruses tended to be younger. In severe cases, EV71 infection was the main cause. Conclusions The other EV especially CV-A6 increased obviously and EV71 decreased obviously in the three years. Characterizing the epidemiology and the relationship between severe and common cases of HFMD would provide relevant evidences for the prevention and treatment of HFMD.

scholarly journals The Epidemiological and Clinical Characteristics of Hand, Foot, and Mouth Disease in Hangzhou, China, 2016 to 2018

2020 ◽  
Vol 59 (7) ◽  
pp. 656-662
Author(s):  
Jie Wang ◽  
Jun Zhou ◽  
Guoliang Xie ◽  
Shufa Zheng ◽  
Bin Lou ◽  
...  
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Foot And Mouth ◽  
Polymerase Chain ◽  
Epidemiological Characteristics ◽  
The Relationship ◽  
Epidemiologic Characteristics ◽  
Selection Of

Hand, foot, and mouth disease (HFMD) is most frequently caused by several serotypes of human enterovirus (EV) including Enterovirus 71 (EV-A71), coxsackievirus A16 (CV-A16), or other types of EV. The aim of this study was to determine the epidemiological characteristics of HFMD and to describe the epidemiologic characteristics of HFMD among severe and mild cases. We collected 4760 HFMD cases in Hangzhou from 2016 to 2018. Specimens from these cases were collected and tested for EV-A71, CV-A16, CV-A6, CV-A10, CV-A2, and CV-A5 by reverse transcriptase polymerase chain reaction. From 2016 to 2018, the prevalence of HFMD was seasonal each year. Among the 4760 probable HFMD cases, 3559 cases were confirmed (74.8%), including 426 cases of EV-A71 infections (8.9%), 249 cases of CV-A16 infections (5.2%), and 2884 cases of other EV infections (60.6%). The percentage of other EV infections was more than 80%, which increased year by year. Random selection of samples for detection of other EV infections in 2017 and 2018, among the 1297 cases, showed there were 835 (64.4%) cases of CV-A6 infections, 177 (13.6%) cases of CV-A10 infections, 100 (7.7%) cases of CV-A2 infections, 40 (3.1%) cases of CV-A5 infections, 3 (0.02 %) cases of mixed infections, and 11.0% untyped EV infections. Preschool children were still the primary population susceptible to HFMD. In severe cases, EV-A71 infection was the main cause. Characterizing the epidemiology and the relationship between severe and common cases of HFMD would provide relevant evidences for the prevention and treatment of HFMD.

scholarly journals Echovirus 4 associated to hand, foot and mouth disease

2006 ◽  
Vol 48 (4) ◽  
pp. 197-199 ◽  
Author(s):  
Denise Hage Russo ◽  
Adriana Luchs ◽  
Bráulio Caetano Machado ◽  
Rita de Cássia Carmona ◽  
Maria do Carmo Sampaio Timenetsky
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Immunofluorescence Assay ◽  
Mouth Disease ◽  
Epidemiological Surveillance ◽  
Clinical Samples ◽  
Rt Pcr ◽  
Enteroviral Infection ◽  
Two Samples ◽  
Foot And Mouth

Hand, foot and mouth disease (HFMD) is a contagious enteroviral infection occurring primarily in children and characterized by vesicular palmoplantar eruptions and erosive stomatitis. Echovirus 4 (EV-4) has been commonly associated with aseptic meningitis. The association of HFMD with EV-4 has not been reported previously. Two samples of a 14-month child who presented mild fever, sores in the mouth, rash with blisters on the palm of hands and soles of feet were sent to Enteric Viruses Laboratory of Adolfo Lutz Institute. Clinical samples were inoculated in three different cell lines, and those which presented cytopathic effect (CPE), were submitted to Indirect Immunofluorescence Assay (IFA) and "one step" RT-PCR. Agarose gel electrophoresis from RT-PCR product, showed a product with 437 bp, which is characteristic of Enterovirus group. Echovirus 4 was identified by IFA. Although HFMD is a viral infection associated mainly with Enterovirus 71 (HEV-71) and Coxsackievirus A16 (CV-A16), our results demonstrate a diversity of serotype related to HFMD and stress the importance of epidemiological surveillance to this disease and its complications.

scholarly journals Onychomadesis associated with hand, foot, and mouth disease: a prospective observational study from North Chennai

2020 ◽  
Vol 6 (3) ◽  
pp. 367
Author(s):  
Saraswathy Pichaachari ◽  
Jayanthi Nagappan Subramaniam ◽  
Sajeetha Sundaram
Keyword(s):  
Clinical Diagnosis ◽  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Time Interval ◽  
Benign Condition ◽  
Human Enterovirus 71 ◽  
Foot And Mouth ◽  
Hands And Feet

<p class="abstract"><strong>Background:</strong> Hand, foot, and mouth disease (HFMD) is a common febrile illness caused by coxsackievirus A16 and human enterovirus 71 characterized by vesicular eruptions on hands and feet and enanthem on oral mucosa. Resolves usually without complications but onychomadesis can occur as a late sequlae sometimes.</p><p class="abstract"><strong>Methods:</strong> Children with clinical diagnosis of HFMD between April to June 2018 were included in the study. Age, sex, duration of illness, cutaneous features and nail changes were noted at initial visit and during every week for next 6 weeks.<strong></strong></p><p class="abstract"><strong>Results:</strong> 58 children were recruited in the study with boys to girl’s ratio 1.2:1. The average age was 5.3 years. The vesicular lesions predominantly involved palms and soles (88.3%). 65.5% had history of fever and pruritis was the commonest cutaneous symptom. 27 children (48.21%) developed onychomadesis during follow up with average time interval of 3.2 weeks between the clinical diagnosis and nail shedding. Reassurance about spontaneous resolution of the condition given to the parents.</p><p class="abstract"><strong>Conclusions:</strong> Our study strengthened the association between the HFMD and occurrence of onychomadesis. Physician’s awareness about this benign condition is needed to avoid parental anxiety, unnecessary investigations and treatment for the children.   </p>

scholarly journals Hand, Foot and Mouth Disease (HFMD): An Update

2017 ◽  
Vol 40 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Probir Kumar Sarkar ◽  
Nital Kumar Sarker ◽  
Md Abu Tayab
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Coxsackie Virus ◽  
Asia Pacific ◽  
Human Enterovirus ◽  
Small Scale ◽  
Human Enterovirus 71 ◽  
Mild Disease ◽  
Foot And Mouth

Hand, foot, and mouth disease (HFMD) also known as vesicular stomatitis with exanthema, first reported in New Zealand in 1957 is caused by Coxsackie virus A16 (CVA16), human enterovirus 71 (HEV71) and occasionally by other HEV-A serotypes, such as Coxsackie virus A6 and Coxsackie virus A10, are also associated with HFMD and herpangina. While all these viruses can cause mild disease in children, EV71 has been associated with neurological disease and mortality in large outbreaks in the Asia Pacific region over the last decade. It is highly contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. This is characterized by erythrematous papulo vesicular eruptions over hand, feet, perioral area, knee, buttocks and also intra-orally mostly in children, typically occurs in small epidemics usually during the summer and autumn months. HFMD symptoms are usually mild and resolve on their own in 7 to 10 days. Treatment is symptomatic but good hygiene during and after infection is very important in preventing the spread of the disease. Though only small scale outbreaks have been reported from United States, Europe, Australia Japan and Brazil for the first few decade, since 1997 the disease has conspicuously changed its behavior as noted in different Southeast Asian countries. There was sharp rise in incidence, severity, complications and even fatal outcomes that were almost unseen before that period. There are reports of disease activity in different corners of India since 2004, and the largest outbreak of HFMD occurred in eastern part of India in and around Kolkata in 2007and Bhubaneswar, Odisha in 2009. In recent years there are cases of HFMD have been seen in Bangladesh also. Although of milder degree, continuous progress to affect larger parts of the neighboring may indicate vulnerability of Bangladesh from possible future outbreaks.Bangladesh J Child Health 2016; VOL 40 (2) :115-119

scholarly journals Gambaran Klinis dan Karakteristik Genetik Human Enterovirus 71 Penyebab Hand Foot and Mouth Disease di Banjarmasin – Kalimantan Selatan Tahun 2016

Sari Pediatri ◽  
2020 ◽  
Vol 21 (5) ◽  
pp. 271
Author(s):  
Edi Hartoyo
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Human Enterovirus 71 ◽  
Foot And Mouth

Latar belakang. Hand foot and mouth desease (HFMD) adalah infeksi virus akut yang biasanya menyerang anak dibawah 10 tahun, sangat menular dan dapat menimbulkan komplikasi fatal. Tujuan. Untuk mengetahui gejala klinis, komplikasi, dan serotipe penyebab HFMD di Banjarmasin. Metode. Penelitian deskriptif, sampel diambil di poliklinik RSUD Ulin dan RS. Islam Banjarmasin periode November 2015 sampai dengan Febuari 2016 yang terdiagnosis HFMD oleh dokter spesialis anak, terdapat 23 sampel.Hasil. Dari 23 pasien secara klinis HFMD terdapat 18 (78%) positif entero virus, 71, 2 (9%) positif campak, dan 3 (13%) negatif. Umur rata rata ±20,77 bulan, laki laki 12 (52%) dan perempuan 11 (48%). Gejala klinis demam 17 (74%), rash/ lesi kulit 23 (100%), susah makan 14(61%), batuk 8(35%), pilek 9(39%), diare 5(22%), konjungtivitis 2(9%), muntah 4(17%), nyeri menelan 14(61%), dan kenjang 2(9%).Kesimpulan. Penyebab HFMD terbanyak adalah EV71, umur tesering kurang dari 3 tahun, gejala klinis terbanyak lesi kulit, demam dan tidak didapatkan komplikasi serius (intakranial).

scholarly journals Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Jiang ◽  
Hongchao Jiang ◽  
Xin Tian ◽  
Xueshan Xia ◽  
Tian Huang
Keyword(s):  
Vaccination Coverage ◽  
Yunnan Province ◽  
Enterovirus 71 ◽  
Case Fatality ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Vaccination Coverage Rate ◽  
Foot And Mouth ◽  
Before And After ◽  
Epidemiological Characteristics

Abstract Background Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province. Methods Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination. Results A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province. Conclusions Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.

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