The Epidemiological Characteristics And Clinical Manisfestions Of Hand-foot-mouth Disease In Quanzhou Area During2009to2010

Objective: To reveal the epidemic characteristics of the Hand-foot-mouthdisease (HFMD),and provide a reference to the prevention and treatment of HFMDby investigating the incidence of HFMD in Quanzhou area and analyzing the clinicaldata of hospitalized patients with HFMD.Methods: We analysed the epidemic season,region,gender,age and differenttypes of infected virus of HFMD in Quanzhou area during September2009toSeptember2010.According to the patient’s condition,323patients with HFMD inour hospital,were divided into two groups-the ordinary case group and the severecases with encephalitis group(i.e. the encephalitis group).And clinicalmanifestations,laboratory findings,etiologic examination were analysed between thetwo groups or among patients with encephalitis infected by different virus type ofHFMD.Results:(1) The epidemiological characteristics: There were new HFMDcases in Quanzhou area all year round from september2009to september2010.Thehighest incidence season was shown from April to July and another higher incidencerate was during September to October.The scattered children were vulnerablepopulations.Male patients accounted for64.9%and female patients accounted for35.1%.Male to female ratio was1.9:1.The overall incidence rate was0.2%.Theoverall incidence rate accounted for1.3%in Anxi,1.3%in Dehua,13.3%in Fortressdistrict,13.9%in Hui’an,0.7%in Jinjiang,28.6%in Licheng district,5.0%inLuojiang district,accounted for13.7%in Nanan,8.1%in Quangang district,0.8%inQuanzhou economic developing zone,10.9%in Shishi and2.4%in YongchunCounty.Children under less5years of age accounted for94.9%,of which1to2yearsold accounted for54.31%.The age of majority of encephalitis cases were less than2years old, in particular,1to2years old.974eligible throat swab specimens werecollected,66.5%for EV71infection,6.8%for CoxA16infection,and26.7%for otherviral infections.(2) Clinical manifestations: Skin and/or mucosal lesions,or feverwere the most common clinical manifestations of HFMD.All patients had skinand/or mucosal damage.The number of rash was little related to the severity ofillness.The oral ulcers in cases of the ordinary group were more obvious than thosein the encephalitis group.The majority of patients had fever for five days in whichmost of them had middle or high fever.The patients in the encephalitis group hadhigher and longer-term fever.(3)Laboratory tests:48.3%cases of HFMD showed increased WBC in peripheral blood,and68.1%of them was classified to NG.Therewere more cases had higher GLU,CK,CK-MB of blood in the encephalitis groupthan in the ordinary group.(4)Cerebrospinal fluid characteristic in the cases withencephalitis: EV71,CoxA16or other viruses could not be detected in cerebrospinalfluid.75%of throat swab pathogen was detected EV71.The cell count incerebrospinal fluid of EV71infectied encephalitis was significantly higher thanthose with CoxA16infected.Conclusion: HFMD cases increase significantly between summer and autumnat Quanzhou area during September2009to September2010.Densely populatedareas have higher incidence rates.EV71infected cases are most common.Childrenunder5-year-old,especially less than2-year-old are prone to infection of HFMD.Theordinary cases and the severe cases with encephalitis have their own clinicalcharacteristics. The patients with few rash,less oral herpes or ulcers shall be closelyobserved to vigilant merger encephalitis.The brain damage in patients with EV71infection encephalitis may be more serious than those with CoxA16infectionencephalitis.Early comprehensive intervention is useful to block the progress of thedisease.