Korean J Pediatr.
2010 May;53(5):639-643. 10.3345/kjp.2010.53.5.639.
Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009
- Affiliations
-
- 1Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea. kaykim@ewha.ac.kr
- 2Department of Radiology, School of Medicine, Ewha Womans University, Seoul, Korea.
- 3Division of Enteric and Hepatitis Viruses, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Seoul, Korea.
- 4Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- KMID: 2042067
- DOI: http://doi.org/10.3345/kjp.2010.53.5.639
Abstract
- PURPOSE
Hand-foot-mouth disease (HFMD) is a common viral illness in children, which is usually mild and self-limiting. However, in recent epidemics of HFMD in Asia, enterovirus 71 (EV71) has been recognized as a causative agent with severe neurological symptoms with or without cardiopulmonary involvement. HFMD was epidemic in Korea in the spring of 2009. Severe cases with complications including death have been reported. The clinical characteristics in children with neurologic manifestations of EV71 were studied in Ewha Womans University Mokdong Hospital.
METHODS
Examinations for EV71 were performed from the stools, respiratory secretion or CSF of children who presented neurologic symptoms associated with HFMD by realtime PCR. Clinical and radiologic data of the patients were collected and analyzed.
RESULTS
EV71 was isolated from the stool of 16 patients but not from respiratory secretion or CSF. Among the 16 patients, meningitis (n=10) was the most common manifestation, followed by Guillain-Barre syndrome (n=3), meningoencephalitis (n=2), poliomyelitis-like paralytic disease (n=1), and myoclonus (n=1). Gene analysis showed that most of them were caused by EV71 subgenotype C4a, which was prevalent in China in 2008.
CONCLUSION
Because EV71 causes severe complications and death in children, a surveillance system to predict upcoming outbreaks should be established and maintained and adequate public health measures are needed to control disease.
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