Analysis Of 635 HFMD Death Cases

ObjectiveWe collected 635 HFMD death cases in 2010 to analyze epidemiological characteristics, diagnosis and treatment process, medical history, clinical features and pathogenic features of hand, foot and mouth disease caused death to explore possible risk factors, in ordr to reduce the mortality of hand, foot and mouth disease, to provide the useful information for early intervention and prevention strategy.MethodsDescriptive epidemiological method was used for statistical analysis of data collected, there were deaths cases collected, we used Epidata 3.02 for double entry, SPSS 17.0 was used for statistical analysis.Results1. The total cases collected were 635 cases of HFMD deaths, male to female ratio was 2.1:1 (427/208); scattered lived children accounted for 89.3%(567 cases), children in Kindergarten accounted for 10.1%(64 cases), primary school students accounted for 0.7%(4 cases); there were 518 cases lived in rural areas (81.6%), and 117 cases lived in urban area(18.4%); children with transient parents accounted for 8.7%(57 cases).2. The median age of deaths was 1 years and 5 months,under 3 years of age accounted for 97.8%, under 5 years of age accounted for 98.9%.3. There were 49.9% cases visited village-level clinics for first medical visiting, there were 38.8% of the initial medical visiting diagnosed as hand, foot and mouth disease, it was statistically significant for correct diagnose rate between the municipal hospitals and village clinics.4. The clinical progress of death cases deteriorated very quickly, the median time of onset to death was 3 days, cases died in 3 days accounted for 60.1% (382/635), in 5 days accounted for 86.9% (552/635).5. The median age of children in Kindergarten was 35 months, and 17 months for scattered lived children; the length of medical treatment, the time from severe status to death is longer among urban cases than rural cases.6. The EV71 positive rate among samples were 92.3% (40/477)7. The risk factors of death might be high fever, first onset of skin rash; poor pupillary light reflex, Myoclonic jerks,ataxia, tremors, lethargy, limb weakness, and other neurological Symptoms; shortness of breath, cyanosis of lips, tachypnea, labored breathing, and other respiratory symptoms; resting Heart rate, profuse sweating, cold limbs and other symptoms of the circulatory system; vomiting and other gastrointestinal Symptoms.8. The lab test abnormality of death cases were the increases of white blood cells, blood glucose, serum potassium, troponin, CK-MB, C reactive protein, and the decrease of blood oxygen saturation. Conclusion1. There were more male cases than female cases, most of cases lived in rural areas, and most were scattered lived children.2. The most death cases were under 3 years of agewith a median of 17 months.3.The first medical visitingwas the village clinics, correct diagnose rate of HFMD was higher in the municipal hospitals.4. The clinical progress of death cases deteriorated very quickly, the median time of onset to death was 3 days5. The most cases were infected with EV71 virus.6. The main clinical manifestations were high fever, rash, poor pupillary light reflex, myoclonic jerks, ataxia, tremors, lethargy, limb weakness, cyanosis of lips, tachypnea, labored breathing, resting Heart rate, cold limbs and vomiting.7. The lab test abnormality of death cases were the increases of white blood cells, blood glucose, serum potassium, troponin, CK-MB, C reactive protein, and the decrease of blood oxygen saturation...