Co-detection in the pathogenesis of severe hand-foot-mouth disease

Li-Juan Liu, Hong-Mei Xu, Xiu-Jun Li, Jun Wang, Xian-Jun Wang, Shu-Jun Ding, Fang Tang, Jing Wang, Ying-Jie Zhang
2012 Archives of Virology  
It still needs to be elucidated whether codetection of EV71 with other intestinal tract viruses plays a role in the pathogenesis of severe hand-foot-mouth disease (HFMD). A total of 680 stool specimens collected from clinically diagnosed mild and severe-HFMD patients were tested for EV71, CA16, norovirus, bocavirus and rotavirus. The results showed that EV71 was significantly associated with severe-HFMD patients. Co-detection of EV71 with norovirus and rotavirus was also significantly
more » ... with severe-HFMD patients: The OR (95 % CI) value was 6.466 (2.735, 15.283) and 7.561 (3.560, 16.057), p \ 0.001, respectively. Co-detection of EV71 with rotavirus or norovirus is probably associated with severe HFMD. Keywords Hand-foot-mouth disease Á enterovirus 71 Á co-detection Hand-foot-mouth disease (HFMD) is a cluster of manifestations with fever and exanthema of the hands, feet and palm, which is mild, and recovery occurs 4-6 days in most instances [1] [2] [3] . It is spread by fecal-oral transmission, and it prevails all over the world. Previous studies have demonstrated that enterovirus 71 (EV71) and coxsackievirus A16 (CA16) were the common agents of the disease; however, after EV71 infection, only a small proportion of the patients developed severe HFMD, accompanied by neurological complications, cardiopulmonary collapse or death. In recent decades, HFMD has become severe publichealth concern, especially in the Western Pacific Region [1, 4, 5] . The largest and most severe EV71-associated HFMD outbreak took place in Taiwan in 1998, when 405 pediatric HFMD patients developed severe neurological complications and pulmonary edema, and 78 children died [6] . In mainland China, several outbreaks of HFMD with severe complications have been reported since 2003, and the numbers of reported cases are increasing. Even in the first half of 2010, approximately one million cases were reported, including 15,501 severe cases and 537 deaths [7]. Clinical observations revealed that severe HFMD occurred in only a small percentage of HFMD patients, and
doi:10.1007/s00705-012-1396-6 pmid:22791110 pmcid:PMC3488190 fatcat:zflhzoltijds5pp5vk4jw6z4n4