Etiology surveillance of hand-foot-mouth disease in Henan province between 2008 and 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand etiological types and distribution features of hand-foot-mouth disease (HFMD) in Henan province between 2008 and 2011.</p><p><b>METHODS</b>A total of 30 486 specimens of feces, rectal swabs or throat swabs from HFMD patients were collected by each Municipal CDC in Henan from 2008 to 2011. The enterovirus 71 (EV71), coxsackie virus A16 (CA16) and other enterovirus (EV) were detected by RT-PCR or real time RT-PCR. The VP1 gene of EV71 was amplified and the sequences were analyzed by bioinformatics software. A genetic evolution tree of the sequence was constructed as well.</p><p><b>RESULTS</b>The positive rates of EV71, CA16 and other EV were 62.70% (11 209/17 876), 12.03% (2150/17 876), 25.27% (4517/17 876) in 17 876 laboratory diagnosed cases, respectively. The differences were statistically significant (χ(2) = 157.17, P < 0.05). The positive rates of EV71, CA16 and other EV were 63.40% (7370/11 624), 11.58% (1346/11 624) and 25.02% (2908/11 624) in male patients and 61.40% (3839/6252), 12.86% (804/6252) and 25.74% (1609/6252) in female patients, respectively. The differences were statistically significant (χ(2) = 4.06, P < 0.05). The children under 5 years old were high-risk population of HFMD, accounting to 97.67% (17 459/17 876) of the laboratory-diagnosed patients.86.92% (15 537/17 876) cases were children between 1 to 3 years old. Constituent ratio of EV71 changed seasonally during a year, there was a high infection ratio of EV71 between April and June, especially in May, the infection ratio reached 69.34% (2384/3438). The positive rates of EV71, CA16 and other EV were 82.48% (5715/6929), 1.76% (122/6929) and 15.76% (1092/6929) among the 6929 laboratory-diagnosed severe cases, respectively. The positive rates of EV71 was higher than CA16 and other EV (χ(2) = 9259.17, 6170.81, P < 0.05, respectively). There were 117 deaths because of severe HFMD, 55 (47.01%) of which were laboratory confirmed. 50 death cases were infected by EV71, and according to the genetic evolution analysis, the VP1 gene of EV71 strain was belonged to subtype C4 of gene C.</p><p><b>CONCLUSION</b>The EV71 and CA16 were the main pathogens which caused HFMD in Henan province, and EV71 virus was the dominant strain, belonging to C4 subtype of gene C.</p>

Analysis of the epidemic characteristics of fever and thrombocytopenia syndrome in Henan province, 2007 - 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the epidemiological characteristics of fever thrombocytopenia and leukopenia syndrome (FTLS) in Henan province, China in 2007 - 2011.</p><p><b>METHODS</b>Data from specific surveillance system for FTLS in Henan and Information Management System of Chinese Center for Disease Control and Prevention were used to collect the information of the cases.Descriptive epidemiological methods were used to analyze the surveillance data during 2007 - 2011. Patients' sera were collected to detect new bunyavirus using fluorescent RT-PCR and virus isolation.</p><p><b>RESULTS</b>During 2007 - 2011, 1021 FTLS cases were reported in Henan province. The fatality rate was 2.25%with 23 deaths. The cases reported in Xinyang city were 1007, accounting for 98.75%.Cases were mainly occurred between April and October, accounting for 96.47% (985/1021). Epidemic peak was May to July, accounting for 59.16% (604/1021). The second peak occurred in September, accounting for 12.05% (123/1021). The age of the cases ranged from 1 to 88 years old with the median age of 59. Sex ratio (male:female) was 1:1.50 (408:613). In all cases, 93.73% (957/1021) were farmers. In 465 patients' sera, the positive rate of new bunyavirus was 69.25% (322/465) using fluorescent RT-PCR. In 164 patients' sera, 67 strains of new bunyavirus were isolated with isolation rate of 40.85% (67/164).</p><p><b>CONCLUSION</b>FTLS in Henan province is caused mainly by the new bunyavirus and has certain regional and seasonal characteristics. Most cases are female older farmers.</p>

Analysis on the diagnosis and treatment of a cluster of cases infected by new bunyavirus / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze and summarize the clinical characteristics, experience of diagnosis and treatment of cases infected by new bunyavirus, which occurred in Henan province in 2010.</p><p><b>METHODS</b>The clinical characteristics and effect of diagnosis and treatment of 5 cases were analyzed using descriptive epidemiological method. Blood specimens were detected by RT-PCR and pathogen separation.</p><p><b>RESULTS</b>PCR testing was positive for all 5 cases. New bunyavirus were isolated from 2 cases. In 5 cases, fever (5/5), the whole body aches (5/5), fatigue (5/5), anorexia (5/5), nausea (5/5), the chills (4/5), cough (4/5), expectoration (4/5), vomiting (3/5), conjunctival hyperemia (3/5); Leukocyte reduction (5/5), thrombocytopenia (5/5), elevated alanine aminotransferase (4/5), elevated aspartate aminotransferase (4/5), elevated lactate dehydrogenase (5/5), creatine kinase elevations (4/5), urinary protein (3/5). By symptomatic and supportive treatment and prophylactic antibiotics, the first case died and the other 4 cases were cured. The average course of disease was 15.4 days.</p><p><b>CONCLUSION</b>Cases infected by new bunyavirus have complicated clinical feature and multiple organ damage. If symptomatic treatment is in time, prognosis will be good.</p>

Analysis on clinical and epidemiological characteristics of severe cases infected by EV71 / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the clinical and epidemiological characteristics of serious cases of hand-foot-and-mouth disease (HFMD) infected by EV71, in order to provide scientific evidence for prevention and control of HFMD.</p><p><b>METHODS</b>Information was collected by questionaires through consulting medical cases. Data was input by Epidata, and analysed by software SAS 9.13.</p><p><b>RESULT</b>201 severe cases were investigated. 84.65% of the cases were below 3 years old. The youngest one was 5 months and the oldest one was 8 years old. The ratio for male and female was 2.2: 1.85. 08% of the cases were distributed sporadically. 51.74% of them lived in rural, 29.36% of them lived in urban and 19.9% of them lived at the fringe area of rural and urban. 81.59% of the cases became serious between 1 and 4 days after infected. 100% cases had fever and 99.95% of them had a rash. 96.52% of them had nerve system symptoms. The main complications were virulent spinal encephalitis, pneumonia and breathing exhaustion. 98.01% of the patients were recovered or cured.</p><p><b>CONCLUSION</b>The cases aged below 3 years old are high risk persons. Rural area and the fringe area of rural and urban are the key area for disease control. 1-4 days after onset is the key period to prevent complications.</p>