Intestinal detoxification time of hand-foot-and-mouth disease in children with EV71 infection and the related factors.

BACKGROUND: Hand-foot-and-mouth disease (HFMD) is a common pediatric infectious disease caused by a variety of intestinal viruses. Enterovirus 71 (EV71) is the primary pathogen that might cause severe symptoms and even death in children with HFMD. This study aimed to investigate the intestinal detoxification time of HFMD children with EV71 infection and its related factors. METHODS: Sixty-five HFMD children with EV71 infection were followed up. Their stool samples were collected once every 4 to 7 days. Viral nucleic acids were detected by fluorescent polymerase chain reaction until the results became negative. The positive rates of viral nucleic acids were analyzed by the Kaplan-Meier method. The Log-rank test and Cox-Mantel test were used to analyze factors affecting the HFMD children with EV71 infection. RESULTS: On the 2nd, 4th, 6th and 10th week, the positive rates of viral nucleic acids in stool samples of the 65 children were 94.6%, 48.1%, 17.2% and 0, respectively. Univariate analysis showed that the intestinal detoxification time of the children were related to gender, pre-admission disease course, severity of disease, and use of steroids or gamma globulin (P<0.05). Multivariate analysis showed that the severity of disease was an independent factor affecting the intestinal detoxification time (P<0.05), with a relative risk of 2.418. CONCLUSIONS: The longest intestinal detoxification time of HFMD children with EV71 infection was 10 weeks. The severity of disease was an important factor affecting the intestinal detoxification time of HFMD children with EV71 infection. Severe HFMD children with EV71 infection had a longer intestinal detoxification time.

[Observation on virus shedding periods of enterovirus-71 and coxsackievirus A 16 monitored by nucleic acids determination in stool samples of children with hand, foot and mouth disease].

OBJECTIVE: To observe the duration of enterovirus-71 (EV71) and coxsackievirus A 16 (CoxA16) viral shedding in stool samples of children with hand, foot and mouth disease (HFMD) infected with EV71 and CoxA16 and to explore the relationship between the duration of intestinal virus shedding and the severity of illness of children with HFMD. METHOD: Totally 113 laboratory-confirmed cases of children with HFMD infected with EV71 and CoxA16 were followed up. The stool samples were collected with the interval of 4 to7 days and the viral nucleic acids were detected by fluorescent PCR until the stool viral nucleic acids of infected children turned to be negative. The cases in EV71 group were further divided into "ordinary EV71 group" and "severe EV71 group" according to the severity of the illness. The positive rates of viral nucleic acid and the differences of distribution among different groups were analyzed by Kaplan-Meier survival analysis during the follow-up period. RESULT: The 113 cases of infected children were grouped as follows: 65 cases of EV71 positive children, 44 cases of CoxA16 positive children, 4 cases of EV71/CoxA16 mixed infection. The median duration of the stool viral nucleic acids turning to negative was 26 (18.25-32.50) days in EV71 group and 27 (14.50-33.75) days in CoxA16 group (Z = 1.51, P > 0.05). At 1, 4, 6 and 10 weeks, the positive rates of stool viral nucleic acid of children with HFMD in EV71 group were 100%, 48.1%, 17.2% and 0 respectively. At 1, 4 and 6 weeks, the positive rates of stool viral nucleic acid of children with HFMD in CoxA16 group were 95.5%, 53.8% and 0 respectively (χ(2) = 0.18, P > 0.05). At 1, 4 and 6 weeks, the positive rates of stool viral nucleic acid of children with HFMD in ordinary EV71 group were 100%, 23.5% and 0 respectively, while at 1, 4, 6 and 10 weeks, the positive rates of stool viral nucleic acid of children with HFMD in severe EV71 group were 100%, 62.4%, 26.0% and 0 respectively (χ(2) = 5.689, P < 0.05). CONCLUSION: The duration of enterovirus shedding in stool samples of children with HFMD lasted for a long period. The maximum duration of EV71 and CoxA16 in stool of children with HFMD was 10 weeks and 6 weeks, respectively. The duration of intestinal virus shedding of children with HFMD infected with EV71 was related with the severity of the illness.

[The clinical epidemiology characteristics of HFMD in 2010 of Hangzhou].

OBJECTIVE: To analyze clinical epidemiology characteristics of HFMD in children from April 2010 to October in Hangzhou. METHODS: 1848 HFMD hospital patients are admitted to clinical epidemiological analysis. RESULTS: Onset ages of HFMD primarily under 3 years, boys more than girls, social above diasporas, rural above town. The highest peak in 5-7 months. Mostly clinical symptoms are mild, the prognosis is good. CONCLUSION: HFMD has obvious susceptible population and susceptibility season. Increase health interventions to susceptible regions and the crowd in popular season, early detection, active therapy, most prognosis is good.