Pediatr Infect Vaccine.  2016 Apr;23(1):46-53. 10.14776/piv.2016.23.1.46.

Epidemiology and Clinical manifestations of Enterovirus in Pediatric Inpatient in Incheon

• Cho BW
• Kwon SE
• Kwon MJ
• Hur MJ
• Kim KS
• Hong YJ
• Kim SK
• Kwon YS
• Kim DH

• KMID: 2163223
• DOI: http://doi.org/10.14776/piv.2016.23.1.46

Abstract

PURPOSE
Enterovirus (EV) infection in children can manifest various diseases from asymptomatic infection to nonspecific febrile illness, hand-foot-mouth disease, and aseptic meningitis. This study was aimed to investigate epidemiology and clinical significance of various genotypes of EV infections in pediatric inpatient.
METHODS
We collected the stool samples from the admitted pediatric patients in Inha University Hospital from March 2014 to March 2015. EV detection and genotype identification were performed by real-time RT-PCR and semi-nested RT-PCR. Phylogenetic trees were constructed by neighbor joining method.
RESULTS
A total of 400 samples were collected during study period and 112 patients (28%) were diagnosed with EV infections. The mean age of EV positive patients was 2.66 years (0.1-14) and sex ratio was 1.73:1. Genetic sequences of EVs were identified; coxsackievirus B5 (17, 15.2%), coxsackievirus A16 (13, 11.6%), enterovirus 71 (10, 8.9%), and coxsackievirus A2 (9, 8.0%). Nonspecific febrile illness (96, 86%) was the most common clinical manifestation and the duration of fever was 0-11 days (mean 3.1 days). Rash (44, 39%) and meningitis (43, 38%) were followed. Patients who were attending daycare center or had siblings accounted for 82.1%. Phylogenetic relationship tree revealed 6 distinct genogroups among 56 types of EVs.
CONCLUSIONS
This study is the report of epidemiology, serotype distribution and clinical manifestations of children with EV infection in Incheon. This data will be helpful for further study about the epidemiology of EV infection in Korea.

Keyword

Enterovirus; Epidemiology; Children; Genotype

MeSH Terms

Asymptomatic Infections
Child
Enterovirus*
Epidemiology*
Exanthema
Fever
Genotype
Humans
Incheon*
Inpatients*
Korea
Meningitis
Meningitis, Aseptic
Sex Ratio
Siblings
Trees

Figure

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  Fig. 1 Monthly distribution of enterovirus-positive patients in Incheon, 2014–2015.

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  Fig. 2 Phylogenetic Relationship in Patients with Enterovirus Infections in Incheon, 2014–2015.

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  Fig. 3 Geographical distribution in patients with enterovirus infections in Incheon, 2014–2015. Green, CVB5/CC10 strains; Brown, CVB5/2000/CSF/KOR; Blue, CVB5/Faulkner; Red, Enterovirus 71; Violet, Coxsackievirus A16, genotype A; Orange, Coxsackievirus A16, genotype B1a; Pink, Coxsackievirus A2.

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