Etiology study on severe cases caused by hand-foot-mouth disease in children from Henan province, 2014.

Xingle LI; Yi LI; Baifan Zhang; Meili Sui; Jingjing Pan; Zhijuan Chen; Ningning Cheng; Yanhua DU; Haiyan Wei; Bianli XU; Xueyong Huang

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Etiology study on severe cases caused by hand-foot-mouth disease in children from Henan province, 2014.

VernacularTitle:河南省2014年手足口病重症病例病原学分析
Author: Xingle LI ¹ ; Yi LI ¹ ; Baifan ZHANG ¹ ; Meili SUI ² ; Jingjing PAN ¹ ; Zhijuan CHEN ² ; Ningning CHENG ² ; Yanhua DU ¹ ; Haiyan WEI ¹ ; Bianli XU ¹ ; Xueyong HUANG ¹
Author Information

1. Institute of Infectious Disease Prevention and Control, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.
2. College of Public Health, Zhengzhou University, Zhengzhou 450052, China.
Publication Type:Journal Article
MeSH: Amino Acids; genetics; Biometry; Child; Enterovirus A, Human; classification; genetics; isolation & purification; Enterovirus Infections; epidemiology; virology; Evolution, Molecular; Genotype; Hand, Foot and Mouth Disease; epidemiology; prevention & control; virology; Hospitals; statistics & numerical data; Humans; Real-Time Polymerase Chain Reaction
From: Chinese Journal of Epidemiology 2016;37(4):568-571
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo investigate the etiology of severe hand-foot-mouth disease (HFMD) in children in Henan province.
METHODSA total of 244 HFMD cases admitted to a hospital in Zhengzhou from April to June of 2014 were recruited for research sampling, Real-time RT-PCR, virus isolation, VP1 sequencing and alignment methods were used to test the enterovirus-related etiology. SPSS 17.0 was used in performing statistical analysis.
RESULTSThere were 109 severe and 135 mild cases among all the 244 HFMD cases. The number of enterovirus positive stool samples was 229, with positive rate as 93.85%. EV71, Cox A16 and Cox A10 made up 83.84%, 5.68% and 8.30% of the enterovirus etiologicy, strains, respectively. EV71 infection caused 8 HFMD cases with heart-lung failure and 2 death, Cox A10 infection led to 1 HFMD case with heart-lung failure and death. There were statistically differences seen regarding the enterovirus infection rates between severe and the mild HFMD cases (χ(2)=5.312,P=0.021). Statistically significant difference was seen in the constituent ratio of EV71, Cox A16 and the others by Fisher' s exact test (P=0.048). There was statistically significant difference seen between the cardiorespiratory failure rate and the fatality rate by EV71 and Cox A10 infection (χ(2)=0.051,P=0.821; χ(2)=2.198,P=0.138). Cox A10 strains idenfied in Henan in 2014 belonged to genotype 6. The rates on homology of nucleotide and amino acid among the Cox A10 strains in Henan in 2014 were 94.3%-99.7% and 96.3%-100.0% respectively.
CONCLUSIONSEV71 still remained the most common pathogen that causing severe HFMD in children, with the increasing Cox A10 percentage in the pathogens spectrum of HFMD infection. Cox A10 strains in Henan in 2014 belonged to genotype 6. Genotype 6 Cox A10 had appeared and widely distributed in Henan for long time, but not yet variated or reconstructed. Cox A10 infection could lead to cardio-respiratory failure thus called for the monitoring program on non-EV71 and non-Cox A16 enterovirus, especially Cox A10 to be strenthened.