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KMID : 1130320100530050639
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Korean Journal of Pediatrics
2010 Volume.53 No. 5 p.639 ~ p.643
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Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009
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Cho Hye-Kyung
Lee Na-Yong
Lee Hyun-Ju
Kim Hae-Soon
Seo Jeong-Wan
Hong Young-Mi
Lee Seung-Joo
Lee Sun-Wha
Cheon Doo-Sung
Hong Ji-Young
Kang Byung-Hak
Kim Jong-Hyun
Kim Kyung-Hyo
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Abstract
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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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KEYWORD
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Human enterovirus 71, Hand- foot-mouth disease, Neurologic manifestation
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