Shen Jun, Zhao Chao, Cao Ping, Shi Peng, Cao Lingfeng, Zhu Qirong
Department of Infectious Disease, Children's Hospital of Fudan University Shanghai, China.
Key laboratory of medical molecular virology, Fudan University Shanghai, China.
Int J Clin Exp Pathol. 2015 Sep 1;8(9):11608-14. eCollection 2015.
This study aimed to explore the correlation between clinical symptoms, including rash and fever, and serum antibody reaction to enterovirus 71 (EV71) infection in children hospitalized due to hand-foot-mouth disease (HFMD). From May 2014 to July 2014, a total of 547 children hospitalized due to HFMD in Children's Hospital of Fudan University were enrolled retrospectively. RNA levels of EV71 and CA16 in fecal, serum, and cerebrospinal fluid specimens were measured using quantitative real-time RT-PCR, and EV71-IgM antibody in the serum was detected using immune colloidal gold assays. Of the 547 fecal specimens, 296 were EV71 RNA positive, 109 were CA16 RNA positive, and 8 were positive for both EV71 RNA and CA16 RNA. The total positive rate for either EV71 or CA16 in feces was 72.58% (397/547). Additionally, 544 serum specimens were collected, and 409 were EV71-IgM positive (75.18%). The duration of rash and fever was found to be correlated to the positive rate of serum EV71-IgM, and the positive rate of serum EV71-IgM plus EV71 RNA in feces. The positive rates of serum EV71-IgM and serum EV71-IgM plus EV71 RNA in fecal collected at day 3 of fever were 79.7% and 52.8%, respectively. In conclusion, EV71 and CA16 were found to be the major pathogens responsible for the epidemics of HFMD in children during May to July 2014 in Shanghai, China. There is a close relationship between the positive rate of serum EV71-IgM and the duration of fever and rash.
本研究旨在探讨因手足口病（HFMD）住院儿童的临床症状（包括皮疹和发热）与肠道病毒71型（EV71）感染血清抗体反应之间的相关性。回顾性纳入2014年5月至2014年7月在复旦大学附属儿科医院因手足口病住院的547例儿童。采用定量实时逆转录聚合酶链反应（RT-PCR）检测粪便、血清和脑脊液标本中EV71和CA16的RNA水平，采用免疫胶体金法检测血清中EV71-IgM抗体。547份粪便标本中，296份EV71 RNA阳性，109份CA16 RNA阳性，8份同时为EV71 RNA和CA16 RNA阳性。粪便中EV71或CA16的总阳性率为72.58%（397/547）。此外，收集了544份血清标本，其中409份EV71-IgM阳性（75.18%）。发现皮疹和发热持续时间与血清EV71-IgM阳性率以及血清EV71-IgM加粪便中EV71 RNA阳性率相关。发热第3天采集的粪便中，血清EV71-IgM和血清EV71-IgM加EV71 RNA的阳性率分别为79.7%和52.8%。总之，发现EV71和CA16是2014年5月至7月中国上海儿童手足口病流行的主要病原体。血清EV71-IgM阳性率与发热和皮疹持续时间密切相关。
