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1.
Article in Chinese | WPRIM | ID: wpr-934026

ABSTRACT

Objective:To analyze the etiological distribution and phylogenetic characteristics of hand, foot and mouth disease (HFMD) in Qujing city of Yunnan Province in 2020.Methods:Stool samples were collected from HFMD cases in Qujing city in 2020 and virus RNA was extracted directly from treated stool suspensions. Virus VP4 gene sequences were firstly amplified using MD91/OL68-1 primer pairs and sequenced, then the virus serotypes were determined by BLAST search on the GenBank. Virus entire VP1 gene sequences were amplified and sequenced. Virus serotypes were identified online using Enterovirus Genotyping Tool Version 0.1. Sequences of reference virus genotypes/sub-genotypes were downloaded according to references. Phylogenetic trees were constructed by MEGA5.2 software and the genetic characteristics were analyzed.Results:A total of 47 strains of enteroviruses (EVs) were detected with a detection rate of 10.22% (47/460). The detected viruses were coxsackievirus A4 (CVA4, 0.65%, 3/460), CVA6 (7.83%, 36/460), CVA10 (0.87%, 4/460) and CVA16 (0.87%, 4/460). All were enterovirus species A (EVA), while other group viruses were not detected. The predominant virus was CVA6, accounting for 7.83% (36/460). EVA71 was not detected. CVA4 strains of C2 and C4 subgenotypes were co-circulating strains in Qujing city. CVA6 subgenotype D3a and CVA16 subgenotype B1a were also circulated in Qujing city. All CVA10 strains were in a separate lineage.Conclusions:Similar to the previous situation in China, the detection rates of EVA71 and CVA16 were very low, even zero. This study showed that CVA6 was the predominant virus, indicating a HFMD outbreak caused by CVA6 in Qujing city in 2020. The phylogenetic analysis showed CVA10 isolates belonged to a separate lineage, which might be unique to Qujing city. Laboratory and molecular epidemiological surveillance of non-EVA71 and non-CVA16 viruses, especially CVA6 and CVA10 should be strengthened in the future.

2.
Article in Chinese | WPRIM | ID: wpr-930805

ABSTRACT

Objective:To detect the expression level of vitamin D receptor(VDR) in children with hand, foot, and mouth disease(HFMD), and explore its potential value in the diagnosis and treatment of children with HFMD.Methods:A total of 82 children with HFMD hospitalized in the Second Affiliated Hospital of Xi′an Jiaotong University and Xi′an Children′s Hospital from May 2017 to May 2019 were selected as the case group.At the same time, 42 healthy children who underwent physical examination in the Child Health Department during the same period were randomly selected as the control group.Peripheral blood of two groups of children was extracted to detect and compare the expression levels of VDR mRNA in mononuclear cells, and the correlation between the expression level of VDR and HFMD and the correlation with various clinical characteristics were analyzed.Results:The relative expression of VDR in children with EV71 HFMD was 2.03%±0.38%, which was lower than that in children of control group(3.11%±1.29%), and the difference was statistically significant( t=-3.586, P=0.001). However, the relative expression of VDR in children with CA16 HFMD was 3.69%±1.79%, which was higher than that in children of control group, and the difference was not statistically significant( t=1.043, P=0.305). Among children with EV71 HFMD, the relative expression level of VDR was significantly different between the mild group and the severe group(2.18%±0.44% vs. 1.84%±0.17%, t=2.199, P= 0.041). There was no statistical difference regarding the relative expression level of VDR between mild and severe CA16 HFMD(4.16%±1.73% vs. 2.93%±1.73%, t=1.587, P=0.129). Conclusion:Compared with healthy children, the expression level of VDR is significantly lower in children with EV71 HFMD, and may be related to the severity of EV71 HFMD.

3.
Journal of Preventive Medicine ; (12): 507-510, 2022.
Article in Chinese | WPRIM | ID: wpr-923706

ABSTRACT

Objective@#To investigate the genotypes of enteroviruses causing hand, foot and mouth disease ( HFMD ) in Shaoxing City, so as to provide insights into HFMD control.@*Methods@#The anal and pharyngeal swab specimens were collected from HFMD cases under 14 years of age reported by sentinel hospitals of HFMD in Shaoxing City from 2018 to 2020. The enterovirus genotypes were determined by quantitative real-time PCR (qPCR) assay and sequenced by BLAST, and the constitution and temporal distribution of enterovirus genotypes were descriptively analyzed.@*Results@#A total of 1 267 anal and pharyngeal swab specimens were collected from children with HFMD, and 661 specimens were positive for enteroviruses, with a positive rate of 52.17%. Among the 661 enterovirus-positive specimens, 70 specimens were tested positive for EV71 ( 5.52% ), 208 specimens tested positive for CoxA16 ( 16.42% ), 239 specimens tested positive for CoxA6 ( 18.86% ); 23 specimens tested positive for CoxA10 (1.82%), and 121 specimens tested positive for other 10 genotypes, including CoxA2, CoxA4, and CoxA5. The prevalence rates of EV71 were 14.08%, 0.72% and 1.84% from 2018 to 2020, and the detection of EV71 peaked during the period between April and July, 2018. The prevalence rates of CoxA16 were 10.98%, 26.57% and 11.98 from 2018 to 2020, and the detection of CoxA16 peaked during the period between April and August, and between November and December, 2019. The prevalence rates of CoxA6 were 10.50%, 14.73% and 30.88% from 2018 to 2020, and the detection of CoxA6 peaked during the period between May and December, 2020.@*Conclusions@#EV71, CoxA16 and CoxA6 were predominant enterovirus genotypes causing HFMD in Shaoxing City from 2018 to 2020, and the detection of CoxA6 appeared a tendency towards a rise.

4.
Article in Chinese | WPRIM | ID: wpr-923327

ABSTRACT

Objective To analyze the spatial and temporal characteristics of hand, foot and mouth disease (HFMD) in Hunan Province from 2016 to 2020. Methods The data of HFMD in Hunan Province from 2016 to 2020 were collected from China's Disease Prevention and Control Information System. HFMD spatial autocorrelation analysis was conducted by ArcGIS 10.2 software at county level, and spatial-temporal scan statistical analysis was performed by SaTScan 9.7 software. Results A total of 714 157 cases was reported in Hunan Province during 2016-2020, with an average annual incidence rate of 208.36/100 000. Global spatial autocorrelation showed that HFMD had a positive spatial correlation on the county scale in Hunan Province during this period. Local spatial autocorrelation indicated that the hot spots were mainly concentrated in the north of central Hunan, the east of central Hunan and the west of Hunan. Spatial-temporal scanning analysis revealed the first class clusters (RR = 6.65, P< 0.001) covering 34 counties in northern and central Hunan, mainly distributed in Yueyang City, Changsha City, Zhuzhou City, Yiyang City and Xiangtan City from May 2018 to June, and the second class clusters (RR = 3.02, P < 0.001) covering 40 counties in western Hunan and central and southwest Hunan from April 2016 to June 2016. Conclusion HFMD incidence exhibits seasonal and regional characteristics in Hunan Province. The prevention and control of HFMD should be guided by combining the characteristics of spatial-temporal clustering.

5.
Journal of Preventive Medicine ; (12): 307-310, 2022.
Article in Chinese | WPRIM | ID: wpr-920773

ABSTRACT

Objective@#To investigate the epidemiological characteristics of hand, foot and mouth disease ( HFMD ) in Zhejiang Province, so as to provide insights into HFMD control.@*Methods@#The incidence of HFMD in Zhejiang Province from 2016 to 2019 was collected from National Notifiable Disease Reporting System. The temporal distribution, human distribution, regional distribution and pathogenic typing of HFMD were descriptively analyzed in Zhejiang Province from 2016 to 2019.@*Results@#Totally 642 305 cases with HFMD were reported in Zhejiang Province from 2016 to 2019, including 121 severe cases and 9 fatal cases. The annual incidence of HFMD was 335.88/105, 147.76/105, 435.63/105 and 221.77/105, respectively. The incidence of HFMD peaked from May to July each year, and the three highest annual incidence included Ningbo, Jinhua and Wenzhou cities, while the lowest annual incidence was seen in Zhoushan City. The HFMD cases were predominantly found in children at ages of 1 to 5 years ( 537 738 cases, 83.72% ), and in children living at home ( 419 408 cases, 65.30% ). The average annual incidence of HFMD was higher in males than in females ( 328.23/105 vs. 239.99/105; P<0.05). The dominant pathogens gradually shifted from enterovirus 71 ( EV71 ) to Coxsachievirus A16 ( CA16 ), and other enteroviruses remained as the main pathogenic subtypes.@*Conclusions@#The incidence HFMD was high in summer and autumn in Zhejiang Province from 2016 to 2019. Children living at home are at a high risk of HFMD, and CA16 type gradually became the dominant pathogen of HFMD.

6.
Journal of Preventive Medicine ; (12): 217-221, 2022.
Article in Chinese | WPRIM | ID: wpr-920755

ABSTRACT

Objective@#To establish a prediction model of herpangina epidemic trend based on Baidu index and hand, foot and mouth disease, so as to provide insights into analyses of communicable disease epidemics with limited or missing surveillance data.@*Methods@#The incidence of hand, foot and mouth disease in Zhejiang Province during the period from the first week of 2015 through the 39th week of 2021 was retrieved from the China Information System for Disease Control and Prevention, and the Baidu index of hand, foot and mouth disease and herpangina was collected via the Baidu search engine during the same period. The correlation between the Baidu index and time series of hand, foot and mouth disease was examined using wavelet analysis. In addition, a random forest training model was created based on the Baidu index and incidence of hand, foot and mouth disease, and the fitting effectiveness was evaluated using the mean percentage error, while the Baidu index of herpangina was included in the model to predict the epidemic trend of herpangina during the study period.@*Results@#The Baidu index of herpangina and hand, foot and mouth disease, and the Baidu index and incidence of hand, foot and mouth disease all appeared two peaks at the 26th and 52th week. The phase difference was less than 0.1 week between the Baidu index and time series of hand, foot and mouth disease, and the mean percentage error of the training model was 13.07%, with high concordance between the predicted number and actual report number of cases with hand, foot and mouth disease. The numbers of herpangina cases were predicted to be 28 822, 27 341, 28 422, 51 782, 52 457 and 5 691 from 2015 to 2020, and there were totally 48 702 herpangina cases reported until the 39th week of 2021. Like hand, foot and mouth disease, the incidence of herpangina peaked between May and July.@*Conclusion@#The random forest training model based on the Baidu index and incidence of hand, foot and mouth disease is feasible to predict the epidemic trend of herpangina.

7.
Article in Chinese | WPRIM | ID: wpr-928061

ABSTRACT

This study aims to investigate the inhibitory effect of Pien Tze Huang(PZH) on enterovirus 71(EV71). To be speci-fic, chemiluminescence method was adopted to evaluate the toxicity of PZH to African green monkey kidney(Vero) cells and human rhabdomyosarcoma(RD) cells, and cytopathic effect(CPE) method to assess the inhibition on EV71-GFP reporter virus and EV71 C4 wild-type virus. The results showed that PZH had low cytotoxicity to Vero cells and RD cells, with the half-maximal cytotoxic concentration(CC_(50)) of about 0.691 3-0.879 2 mg·mL~(-1) for the two. In addition, PZH can effectively inhibit the replication of EV71 within the non-cytotoxic concentration range, and dose-dependently alleviate the cytopathic changes caused by virus infection, with the half-maximal effective concentration(EC_(50)) of 0.009 2-0.106 3 mg·mL~(-1). On the basis of the above results, the green fluorescent protein(GFP), indirect immunofluorescence assay(IFA), and median tissue culture infective dose(TCID_(50)) were employed to assess and verify the anti-EV71-GFP and anti-EV71 C4 activity of PZH. The results demonstrated that PZH can dose-dependently lower the expression of GFP by EV71-GFP and structural protein VP-1 by EV71 C4 and decrease the production of progeny infectious viruses. The EC_(50) of PZH for EV71-GFP and EV71 C4 was about 0.006 0-0.006 2 mg·mL~(-1) and 0.006 6-0.025 6 mg·mL~(-1), respectively. This study suggested that PZH may exert antiviral activity by acting on EV71 and interfering with the expression of VP-1. At the moment, there is still a lack of specific anti-EV71 drugs. This study proposed a new idea for the symptomatic treatment of EV71 infections such as hand-foot-mouth disease and verified an effective drug for the treatment of EV71 infections.


Subject(s)
Animals , Chlorocebus aethiops , Drugs, Chinese Herbal/pharmacology , Enterovirus A, Human/physiology , Hand, Foot and Mouth Disease , Vero Cells
8.
An. bras. dermatol ; 97(3): 321-325, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383578

ABSTRACT

Abstract Hand, foot, and mouth disease is a viral rickettsial disease caused by Coxsackievirus A16 and Enterovirus 71 in most cases. It is commonly seen in children under ten years old, who present oral enanthema and a macular, maculopapular, or vesicular rash on their hands and feet. However, an increase in cases caused by other viral serotypes was observed in adults in recent years with various clinical presentations and a troublesome diagnosis. Three cases of hand, foot, and mouth disease are reported to show the clinical variability and diagnostic complexity that this disease may present in adult patients.

9.
Article in English | LILACS-Express | LILACS | ID: biblio-1360805

ABSTRACT

ABSTRACT Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks.

10.
Article in Chinese | WPRIM | ID: wpr-923962

ABSTRACT

Objective To study the epidemiological features of hand, foot, and mouth disease (HFMD) in Minhang District of Shanghai and to explore the possible effects of meteorological factors on the onset of HFMD, aiming to provide a reference for the prevention and control of HFMD. Methods The incidence data of HFMD in Minhang District from 2014 to 2018 were collected for descriptive analysis. The data of meteorological factors that might affect HFMD were analyzed by Pearson analysis and multiple linear stepwise regression. Results The average incidence rate of HFMD in Minhang District from 2014 to 2018 was 271.51 per 100 000. The incidence of Huacao, Pujiang and Maqiao community were the highest. The incidence of HFMD in males was higher than in females and the 0‒5 age group had the largest number of cases, mainly in scattered children and children in kindergartens. The results of multiple linear stepwise regression analysis showed that the incidence of HFMD was negatively correlated with the weekly average air pressure ( b =-4.32, P =0.004), and was positively correlated with the weekly minimum temperature ( b =2.62, P =0.040) and the weekly average relative humidity ( b =1.71, P =0.010). The correlation with weekly average temperature, weekly maximum temperature, weekly precipitation, weekly average air pressure and weekly average water vapor pressure was not significant. Conclusion Meteorological factors in Minhang District of Shanghai are closely related to the occurrence of HFMD. Comprehensive measures should be taken to prevent and control HFMD.

11.
Article in Chinese | WPRIM | ID: wpr-923960

ABSTRACT

Objective To determine the epidemiological and etiological characteristics of hand,foot,and mouth disease (HFMD) in Pujiang County from 2008 through 2020, so as to provide scientific evidence for prevention and control measures. Methods Descriptive epidemiological analysis was used to analyze HFMD cases retrieved in the Chinese Information System for Disease Control and Prevention in Pujiang County during 2008‒2020. Results From 2008 through 2020, a total of 9 393 cases were documented in Pujiang County, with an annual incidence of 182.3 per 100 000, showing a trend of alternating high-incidence and low-incidence years. The seasonal distribution was bimodal, and the incidence peaked in May-July and November-December. The incidence of HFMD in urban areas was significantly higher than that in rural areas, and the incidence was positively correlated with population density. Majority of cases (94.9%) were children under 5 years old, of which boys had higher incidence than girls. The number of documented cases was the highest among preschool children living in families and kindergartens, accounting for 97.3%. Totally, 558 cases were laboratory confirmed in Pujiang County in 2008-2020, of which severe cases were all caused by EV71 infection. Conclusion Enterovirus serotypes in HFMD have continually changed from 2008 through 2020 in Pujiang County. However, severe HFMD remains principally attributable to EV71 infection, suggesting that it is necessary to strengthen the surveillance on the etiology of HFMD. In addition, it warrants further promotion of EV71 vaccination.

12.
Article in Chinese | WPRIM | ID: wpr-923940

ABSTRACT

Objective To study the epidemiological features of hand, foot, and mouth disease (HFMD) in Minhang District of Shanghai and to explore the possible effects of meteorological factors on the onset of HFMD, aiming to provide a reference for the prevention and control of HFMD. Methods The incidence data of HFMD in Minhang District from 2014 to 2018 were collected for descriptive analysis. The data of meteorological factors that might affect HFMD were analyzed by Pearson analysis and multiple linear stepwise regression. Results The average incidence rate of HFMD in Minhang District from 2014 to 2018 was 271.51 per 100 000. The incidence of Huacao, Pujiang and Maqiao community were the highest. The incidence of HFMD in males was higher than in females and the 0‒5 age group had the largest number of cases, mainly in scattered children and children in kindergartens. The results of multiple linear stepwise regression analysis showed that the incidence of HFMD was negatively correlated with the weekly average air pressure ( b =-4.32, P =0.004), and was positively correlated with the weekly minimum temperature ( b =2.62, P =0.040) and the weekly average relative humidity ( b =1.71, P =0.010). The correlation with weekly average temperature, weekly maximum temperature, weekly precipitation, weekly average air pressure and weekly average water vapor pressure was not significant. Conclusion Meteorological factors in Minhang District of Shanghai are closely related to the occurrence of HFMD. Comprehensive measures should be taken to prevent and control HFMD.

13.
Article in Chinese | WPRIM | ID: wpr-923938

ABSTRACT

Objective To determine the epidemiological and etiological characteristics of hand,foot,and mouth disease (HFMD) in Pujiang County from 2008 through 2020, so as to provide scientific evidence for prevention and control measures. Methods Descriptive epidemiological analysis was used to analyze HFMD cases retrieved in the Chinese Information System for Disease Control and Prevention in Pujiang County during 2008‒2020. Results From 2008 through 2020, a total of 9 393 cases were documented in Pujiang County, with an annual incidence of 182.3 per 100 000, showing a trend of alternating high-incidence and low-incidence years. The seasonal distribution was bimodal, and the incidence peaked in May-July and November-December. The incidence of HFMD in urban areas was significantly higher than that in rural areas, and the incidence was positively correlated with population density. Majority of cases (94.9%) were children under 5 years old, of which boys had higher incidence than girls. The number of documented cases was the highest among preschool children living in families and kindergartens, accounting for 97.3%. Totally, 558 cases were laboratory confirmed in Pujiang County in 2008-2020, of which severe cases were all caused by EV71 infection. Conclusion Enterovirus serotypes in HFMD have continually changed from 2008 through 2020 in Pujiang County. However, severe HFMD remains principally attributable to EV71 infection, suggesting that it is necessary to strengthen the surveillance on the etiology of HFMD. In addition, it warrants further promotion of EV71 vaccination.

14.
Vaccimonitor (La Habana, Print) ; 30(1)ene.-abr. 2021. tab
Article in English | LILACS, CUMED | ID: biblio-1150246

ABSTRACT

Foot and mouth disease is a highly contagious viral disease of cloven-hoofed animals that has a significant economic impact on livestock. A recent outbreak was detected and recorded as exotic strain of foot and mouth disease virus SAT2 (Serotype SAT2, topotype VII, Lib-12 lineage). The emergency vaccine was produced and assessed in vivo and large number of vaccine batches were urgently needed. The present work was aimed to provide a rapid evaluation of inactivated foot and mouth disease SAT2 oily vaccine to exclude the unsatisfactory batches during emergency circumstances and to reduce time, effort and cost. The extraction of foot and mouth disease antigen content from oily adjuvanted vaccine was carried out using isopropyl myristate and benzyl alcohol methods. The extracted viral antigen was identified by foot and mouse disease serotyping ELISA and 146S content was quantified using sucrose density gradient analysis. Evaluations were carried out instantly and at 2h, 6h and 24h. The results indicated the efficiency of benzyl alcohol to breakdown the oil emulsion either MONTANIDE™ ISA 206 VG or MONTANIDE™ ISA 50 V2, while the isopropyl myristate was efficient for MONTANIDE™ ISA 50 V2 only. The identification and quantification of 146S for extracted antigen using benzyl alcohol indicated significant stable records at different time intervals for the vaccine batches, while the extraction using isopropyl myristate indicated unstable records at different time intervals. It was concluded that the evaluation of monovalent foot and mouse disease vaccine could be conducted in vitro, using serotyping ELISA and quantification of 146S for the extracted antigen, either using benzyl alcohol or isopropyl myristate (MONTANIDE™ ISA50 V2 only), with the consideration that 146S content should not less than 4 μg/mL(AU)


La fiebre aftosa es una enfermedad viral altamente contagiosa de los animales de pezuña hendida que tiene un impacto económico significativo en el ganado. Se detectó un brote reciente que se registró como causado por una cepa exótica del virus de la fiebre aftosa (serotipo SAT2, topotipo VII, linaje Lib-12). La vacuna de emergencia se elaboró y evaluó in vivo, existiendo una urgente necesidad de contar con un gran número de lotes de la misma. El presente trabajo tuvo como objetivo proporcionar una evaluación rápida de la vacuna oleosa inactivada (SAT2) contra la fiebre aftosa, para excluir los lotes insatisfactorios durante circunstancias de emergencia, reduciendo tiempo, esfuerzo y costo. La extracción del contenido de antígeno de fiebre aftosa, de la vacuna oleosa adyuvada, se llevó a cabo utilizando miristato de isopropilo y alcohol bencílico. El antígeno viral extraído se identificó utilizando un ELISA de serotipificación y se cuantificó el contenido de 146S mediante análisis de gradiente de densidad de sacarosa. Las evaluaciones se realizaron de forma instantánea y a las 2h, 6h y 24h. Los resultados indicaron la eficacia del alcohol bencílico para separar la emulsión de aceite para MONTANIDE ™ ISA 206 VG o MONTANIDE™ ISA 50 V2, mientras que el miristato de isopropilo fue eficaz para MONTANIDE™ ISA 50 V2 únicamente(AU)


Subject(s)
Animals , Enzyme-Linked Immunosorbent Assay/methods , Foot-and-Mouth Disease , Vaccines , Egypt
15.
Article in Chinese | WPRIM | ID: wpr-862731

ABSTRACT

Objective To analyze the epidemiological characteristics and seasonal distribution of hand, foot and mouth disease (HFMD) in a suburban town in Shanghai from 2012 to 2018, and to provide a scientific basis for formulating effective prevention and control strategies. Methods The incidence data of a suburban town in Shanghai from 2012 to 2018 was collected through the Chinese disease prevention and control information system and analyzed by descriptive epidemiological methods. Results From 2012 to 2018, a total of 538 cases of hand, foot and mouth disease were reported in the suburban town in Shanghai, with an average annual incidence of 186.27/100,000. The difference in incidence between each year was statistically significant (χ2=107.95, P<0.05). The age of onset was mainly children under 5 years old. Peak incidence was from May to September. The main occupation was scattered children. HFMD outbreaks mainly occurred in nurseries and schools, accounting for 60.53% of the total number of outbreaks. Conclusion From 2012 to 2018, the incidence of HFMD in a suburban town in Shanghai had a certain seasonality. It is recommended to implement preventive measures against HFMD for key populations and key places before the high incidence period to reduce the occurrence of severe cases and epidemic situations.

16.
Article in Chinese | WPRIM | ID: wpr-912090

ABSTRACT

Objective:To analyze the etiology of hand, foot and mouth disease (HFMD) cases collected from Wenshan prefecture from 2014 to 2018 and the molecular epidemiology of coxsackievirus A6(CV-A6).Methods:Viruses were isolated by RD cells and Hep-2 cells from stool samples collected from HFMD patients in Wenshan prefecture from 2014 to 2018. Virus RNA was extracted and virus VP4/VP2 junction region sequence was firstly amplified and sequenced by MD91 and OL68-1 primer pairs, then the virus serotype was determined. Virus entire VP1 gene sequences were determined by relative primer pairs according to the references. The reference sequences of CV-A6 virus entire VP1 gene were downloaded from the GenBank and the phylogenetic tree was constructed and the genetic characteristics and molecular epidemiology were analyzed.Results:During five years of study period, a total of 581 strains of enteroviruses (EVs) was isolated with an isolation rate of 20.40% (581/2 848). Among 581 strains, 74 strains were CV-A6, accounting for 12.74% (74/581); 124 were CV-A16, accounting for 21.34% (124/581); 374 were EV-A71, accounting for 64.37% (374/581); nine were other EVs, accounting for 1.55% (9/581). The entire VP1 sequences of 74 CV-A6 strains were filtered by constructing a phylogenetic tree and the completely same strains were excluded from analysis. We finally analyzed the phylogenetic characteristics of 22 strains isolated in this study with 52 reference strains. The results showed that all 22 Wenshan strains belonged to D3a sub-genotype, of which 21 strains belonged to cluster 1, and only one strain belonged to cluster 2.Conclusions:From 2014 to 2018, the outbreaks of HFMD in Wenshan prefecture were mainly caused by EV-A71, CV-A16 and CV-A6, accounting for 64.37%, 21.34% and 12.74% respectively. Phylogenetic analysis showed, similar to the situation in China, the sub-genotype D3a of CV-A6 was the predominant virus and the cluster 1 was the main sub-genotype in this outbreak.

17.
Article in Chinese | WPRIM | ID: wpr-910884

ABSTRACT

Objective:To explore the clinical significance of serum Chromogranin A (CGA) level in predicting the prognosis of children with severe hand, foot, and mouth disease (HFMD) and complicating neurogenic pulmonary edema (NPE).Methods:A total of 162 patients with HFMD admitted in our hospital from January 2017 to December 2019 were enrolled in the study; and 40 age-matched healthy children were selected as controls. According to the disease severity and complication the patients were divided into three groups: mild group ( n=88), severe without NPE group ( n=46) and severe with NPE group ( n=28). In 72 severe HFMD patients 16 cases died (fatal group) and 56 cases survived (survival group) within 28 days of hospitalization. The serum CGA, LAC, GLU, WBC, PCT, IL-6, cTnT were measured in all subjects. SPSS 23.0 software was used for data analysis, and the receiver operating characteristic (ROC) curve was used to evaluate the various indicators for predicting the prognosis of severe HFMD combined with NPE. Results:The serum CGA, GLU, LAC, IL-6 and cTnT levels in severe HFMD group with NPE significantly higher than those in the other three group ( H=61.554, 79.031, 86.994, 36.477, 75.021, all P<0.05 ). The serum CGA, LAC, GLU and IL-6 levels in the fatal group were significantly higher than those in survival group ( Z=-6.094, -4.621, -4.283, -5.504, all P<0.05). There was no significant difference in the levels of WBC, PCT and cTnT between the survival group and the fatal group ( P>0.05). The area under the receiver operating curve (AUC) of serum CGA was 0.890 (95% CI: 0.833-0.947) for predicting the prognosis of patients and the best cut-off value was 120.59 μg/L. Conclusion:The detection of serum CGA levels may be beneficial for the early diagnosis of severe HFMD with NPE, and can be used as one of the predictors of death from severe HFMD.

18.
Article in Chinese | WPRIM | ID: wpr-909822

ABSTRACT

Objective:To investigate the epidemiological and etiological characteristics of hand-feet-mouth disease (HFMD) in Dali Bai Autonomous Prefecture and to provide scientific evidence for the prevention of HFMD.Methods:The HFMD cases during January 2015 to December 2019 in Dali Bai Autonomous Prefecture were collected through the Chinese Information System for Disease Control and Prevention. The demographic data, incidence rate of HFMD and epidemiological characteristics were analysed. Coxsackie virus A16(CoxA16), enterovirus 71(EV71) and other enterovirus nucleic acid in stool samples of HFMD patients were detected by real-time reverse transcription polymerase chain reaction. Chi-square test was used as statistical method.Results:From 2015 to 2019, 30 730 cases of HFMD were reported in Dali Bai Autonomous Prefecture. The annual incidence rate was 171.50/100 000, and the incidence rate was on rise from 2016 to 2019. There were 24(0.08%) severe cases. Yongping County, Binchuan County and Dali City were with the top three average annual incidence rate. The peak incidence was from June to July in summer, 9 168 cases (29.83%) were reported. The peak incidence was from September to October in autumn, 5 988 cases (19.49%) were reported. The epidemic intensity in summer was higher than that in autumn. Among 30 730 cases, there were 17 373 males and 13 357 females. The annual incidence rate of male patients was 120.29/100 000, and that of female was 75.83/100 000. The difference was statistically significant ( χ2=1 637.467, P<0.01). The highest incidence was in infancy (one to <three years old), followed by preschool stage (three to <six years old) and the incidence rate was 4 158.96/100 000 and 1 953.11/100 000, respectively. From infancy, the incidence decreased with age. Severe cases concentrated in infancy with a total of 16 cases, accounting for 66.67% of severe cases. The affected population was mainly scattered children, and a total of 20 516 cases (66.76%) were reported. Among the 1 294 laboratory confirmed cases, 792 (61.21%) were CoxA16 infected cases, 320 (24.73%) were EV71 infected cases, and 182(14.06%) were other enterovirus infected cases. Conclusions:The incidence of HFMD in Dali Bai Autonomous Prefecture has obvious seasonal, age and population characteristics. It is necessary to strengthen the cooperation among departments, health education and strict implementation of prevention and control measures in order to reduce the incidence and improve the ability of early identification and treatment of severe cases.

19.
Article in Chinese | WPRIM | ID: wpr-909177

ABSTRACT

Objective:To investigate the clinical significance of early detection of serum procalcitonin in children with hand-foot-and-mouth disease complicated by bacterial infection and provide reference for clinical diagnosis of the disease in children.Methods:A total of 126 children patients with hand-foot-and-mouth disease who received treatment in the First People's Hospital of Taizhou between December 2017 and December 2018 were included in this study. They were assigned into viral plus bacterial infection group and simple viral infection group ( n = 63/group) according to whether they suffered from bacterial infection. An additional 20 healthy children who concurrently received physical examination in the First People's Hospital of Taizhou were included in the control group. Serum levels of interleukin-6, interleukin-10, white blood cell count, C-reactive protein, and procalcitonin were compared among the three groups and bacterial infection was analyzed. Results:Serum levels of interleukin-6, interleukin-10 and C-reactive protein in the simple viral infection group were (3.75 ± 0.76) ng/L, (55.31 ± 11.27) ng/L, (10.91 ± 1.16) mg/L, respectively, which were significantly higher than those in the control group [(1.39 ± 0.41) ng/L, (11.72 ± 9.58) ng/L,(2.16 ± 0.65) ng/L, t = 8.040, 16.982, 7.825, all P < 0.05]. Serum levels of interleukin-6 and interleukin-10 in the bacterial plus viral infection group were (4.10 ± 1.09) ng/L and (66.64 ± 7.42) ng/L, respectively, which were significantly higher than those in the control and simple viral infection groups ( t = 13.088, 9.053, 10.031, 15.021, all P < 0.05). Serum C-reactive protein level in the bacterial plus viral infection group was significantly higher than that in the simple viral infection group [(26.28 ± 4.35) mg/L vs. (10.91 ± 1.16) mg/L, t = 21.938, P < 0.05]. Serum procalcitonin level and white blood cell counts in the bacterial plus viral infection group were (0.63 ± 0.04) μg/L, (15.12 ± 3.97) × 10 9/L, respectively, which were significantly higher than those in the control group [(0.13 ± 0.02) μg/L, (7.93 ± 1.91) × 10 9/L, both P < 0.05] and simple virus infection group [(0.07 ± 0.01) μg/L, (8.78 ± 1.12) × 10 9/L, both P < 0.05]. The infection rates of enterovirus 71 and universal enterovirus in the simple viral infection group were significantly lower than those in the bacterial plus viral infection group ( χ2 = 20.329, 31.924, both P < 0.05). Conclusion:Serum procalcitonin level is highly specific and accurate for the diagnosis of hand-foot-and-mouth disease. Serum procalcitonin level and white blood cell can be used together as a sensitive index to identify whether bacterial infection occurs in children with hand-foot-and-mouth disease.

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Article in Chinese | WPRIM | ID: wpr-906639

ABSTRACT

Objectve To analyze the EV71 vaccination of children in Hannan District of Wuhan, providing a reference for the adjustment of EV71 vaccination strategy. Methods Based on the Hubei Province Immunization Program Information Management System, the general information and the Immunization information of the inactivated EV71 vaccine in children born between January 1, 2016 and December 31, 2019 managed by the inoculation department of Hannan was collected. Descriptive statistical analysis was used to calculate the vaccination rate and vaccination quality. Results Vaccination rate for first dose and full vaccination of EV71 vaccine of children in Hannan were 49.95% and 42.82% . Vaccination rate for first dose of local children was lower than that of ecdemic children (P <0.005), and Vaccination rate for full vaccination was slightly higher than that of ecdemic children (P=0.859). Vaccination rate for first dose and full vaccination of children in rural  areas were lower than those in urban areas (P <0.005) ). Vaccination rates were obvious differences among children of various age groups (P <0.005). Full vaccination rate of 6-11 months of age were 15.66%, full vaccination rate of children of the later the time of birth were the higher(P <0.005), full vaccination rate of the local children were lower than the ecdemic children (P <0.005), while which of children in urban areas were higher than children in rural areas (P <0.005). Between the two dose of vaccination, the unqualified vaccination rate was 5.54%, the timely vaccination rate was 66.94%, and the qualified vaccination rate was 27.52%. The timely vaccination rate of children of the later the time of birth were the higher (P <0.005). The unqualified vaccination and timely vaccination of local children were higher than ecdemic children (P = 0.02), Unqualified vaccination for children in urban areas is lower and timely vaccination is higher than that in rural areas (P <0.005). Conclusion The EV71 vaccination rate of children in Hannan increased year by year, but was far from establishing herd immunity barrier. Propaganda of HFMD prevention and control knowledge must be strengthened, increasing the coverage rate of full vaccination of children before 1 year of age and the timely vaccination rate of the second dose.

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