Abstract:

Objective To analyze the laboratory determination results of hand-foot-mouth disease to reveal the enterovirus infection and the results of routine determination items in children with hand-foot-mouth disease at Fuyang, and to provide the reference for diagnosis, treatment, prevention and control. Methods Both throat swab and vesicle fluid were collected from 497 children with hand-foot-mouth disease (severe case: 102 cases and common case: 395 cases). Specific RNA of enterovirus primer (EV), enterovirus 71 (EV71) and coxsackievirus A16(CA16)were detected by real-time fluorescence polymerase chain reaction (RT-PCR). Simultaneously, white blood cell (WBC),C reactive protein(CRP),creatine kinase MB isoenzyme(CK-MB), aspartate aminotransferase (AST),lactic dehydrogenase (LDH) and glucose (Glu) were determined, and the results were analyzed. Results Among the 497 children, 339 cases were positive for EV, 286 cases were positive for EV71, and only 22 cases were positive for CA16.The positive rates were 68.21%, 57.55% and 4.43%, respectively. In the 102 hand-foot-mouth disease severe cases,EV71 positive rate was the highest(95 cases, 93.14%). There was no statistical significance in EV, EV71 and CA16 positive rates between boys and girls (P> 0.05).The age distribution was mainly in the group under 3-year-old (398 cases, 80.08%). In the group under 3-year-old, there were 96 severe cases (94.12%), and the EV71 positive rate was the highest (94.79%, 91/96). The increasing cases of WBC was 80 cases (78.43%),CRP 81 cases (79.41%),Glu 52 cases (50.98%) and AST 64 cases (62.75%) in the severe cases of hand-foot-mouth disease. In the common cases, the increasing cases of WBC was 70 cases (17.72%),CRP 87 cases (22.03%),Glu 26 cases (6.58%) and AST 78 cases (19.75%). The positive rates in the severe cases were higher than those in the common cases (P<0.01). The levels of CK-MB and LDH increased in the common and severe cases of hand-foot-mouth disease,and the positive rates of CK-MB and LDH were obviously higher than the other routine determination items. Conclusions The hand-foot-mouth disease appeared in Fuyang in 2011 is mainly related to the EV71 infection, and EV71 is the main pathogen causing the severe cases of hand-foot-mouth disease. The monitoring should be strengthened especially in the group under 3-year-old. The severe cases should be early recognized in order to reduce the occurrence of the severe cases and the death.

Key words: Hand-foot-mouth disease, Reverse transcription polymerase chain reaction, Enterovirus, Coxsackievirus