PMID- 32543714
OWN - NLM
STAT- Publisher
LR  - 20240227
IS  - 1096-9071 (Electronic)
IS  - 0146-6615 (Linking)
DP  - 2020 Jun 16
TI  - Prevalence and Management of Severe Hand, Foot, and Mouth Disease in Xiangyang, 
      China from 2008-2013.
LID - 10.1002/jmv.26186 [doi]
AB  - Therapeutic strategies for severe hand, foot, and mouth disease (HFMD) are 
      currently either inconsequent or deficient in evidence. We retrospectively 
      surveyed HFMD outbreaks in Xiangyang from June 2008 to December 2013. HFMD is 
      staged form I to V according to clinical severity and the case with central 
      nervous system involvement is defined as a severe one. We analyzed risk factors 
      for fatality of severe cases and compared the efficiency and outcome of some 
      therapies by binary logistic regression. The overall HFMD cases included 637 
      (1.26%) severe cases, 38 fatalities (0.75 per thousand). Analysis indicates that age (<3 y), 
      enterovirus 71 (+), autonomic nervous system dysregulation, pulmonary 
      edema/hemorrhage, CRP (>40 mg/L) and cardiac troponin I (>0.04 ng/mL) are risk 
      factors for fatality (all P < 0.05). Intravenous immunoglobulin (IVIG) and 
      mechanical ventilation applied only in early stage IV significantly improved HFMD 
      progression (both P < 0.05) with odds ratios of 0.24 (95% CI: 0.10-0.57) and 0.01 
      (95% CI: 0.00-0.10), respectively. Neither methylprednisolone nor milrinone 
      administered in any stage made any significant difference on mortality (all P > 
      0.05). Precise recognition of the severe HFMD cases in early stage IV and prompt 
      IVIG and mechanical ventilation application may decrease mortality. Mechanical 
      ventilation training programs and dispatching specialists to county-level or 
      district hospitals when there is no chance of transfer critical HFMD cases to a 
      superior hospital are two key successful administrative initiatives. This article 
      is protected by copyright. All rights reserved.
CI  - This article is protected by copyright. All rights reserved.
FAU - Liu, Jian
AU  - Liu J
AUID- ORCID: 0000-0003-1772-7575
AD  - Department of Pediatrics, Affiliated Baoan Hospital of Shenzhen, The Second 
      School of Clinical Medicine, Southern Medical University.
AD  - Department of Pediatrics, The Second Affiliated Hospital, Shenzhen University, 
      No. 118 Longjing Second Road, Baoan District, Shenzhen, 518101, PR China.
FAU - Qi, Jing
AU  - Qi J
AD  - Department of Neurology, Affiliated Shenzhen Baoan Hospital, Southern Medical 
      University.
LA  - eng
PT  - Journal Article
DEP - 20200616
PL  - United States
TA  - J Med Virol
JT  - Journal of medical virology
JID - 7705876
SB  - IM
OTO - NOTNLM
OT  - Hand, foot, and mouth disease
OT  - contagious disease
OT  - coxsackievirus A16
OT  - human enterovirus 71
OT  - lung-protective ventilation
EDAT- 2020/06/17 06:00
MHDA- 2020/06/17 06:00
CRDT- 2020/06/17 06:00
PHST- 2020/06/17 06:00 [entrez]
PHST- 2020/06/17 06:00 [pubmed]
PHST- 2020/06/17 06:00 [medline]
AID - 10.1002/jmv.26186 [doi]
PST - aheadofprint
SO  - J Med Virol. 2020 Jun 16. doi: 10.1002/jmv.26186.