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Pharyngitis
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
This is usually caused by enterovirus 71 or coxsackieviruses, but untypable enteroviruses and mixed cultures may also be responsible. It is characterized by a vesicular eruption in the oral cavity and oropharynx causing dysphagia and dehydration, accompanied by vesicles on the hands and feet. It is normally accompanied by pyrexia, malaise and vomiting. The illness is short-lived and mainly affects young children but has been associated with mortality, for example in the 1998 epidemic in Taiwan. Fulminant enterovirus 71 infection may lead to severe neurological complications, acute pulmonary embolus and cardiopulmonary decompensation. Age younger than 3 years has been associated with higher mortality as have larger families and kindergarten attendance. Hospital admission, careful staging and stage-based management reduce the fatality rate in those with cardiac complications. Initial investigations include stool cultures and a white blood cell count. Currently, hand, foot and mouth disease is not susceptible to antiviral agents or vaccination, and prevention of outbreaks in high-risk areas requires high-level surveillance and public health interventions.
The Child With an Acute Rash
Published in Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan, Diagnosing and Treating Common Problems in Paediatrics, 2017
Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan
Hand, foot and mouth disease is caused by Coxsackie A virus. It is highly contagious and commonly occurs during the summer months. Children develop painful vesicular lesions on the hands, feet, mouth and tongue. Systemic features are mild and include a low-grade fever and malaise. Oral lesions resolve spontaneously in 5–7 days.
Protein Subunit Vaccines and Recombinant DNA Technology
Published in F. Y. Liew, Vaccination Strategies of Tropical Diseases, 2017
Foot-and-mouth disease virus (FMDV) represents another class of vaccine. Conventional vaccine technology has already produced a very good vaccine despite having over 60 distinct subtypes. However, this vaccine is difficult to produce needing full virulent strains (requiring a high level of containment), the preparations are unstable needing refrigeration, and some viral subtypes are difficult to grow.
Analysis of the coverage of inactivated enterovirus 71 (EV71) vaccine and adverse events following immunization with the EV71 vaccine among children from 2016 to 2019 in Guangzhou
Published in Expert Review of Vaccines, 2021
Zhi-qun Li, Zi-qi Qin, Hui-feng Tan, Chun-huan Zhang, Jian-xiong Xu, Jian Chen, Li-Hong Ni, Xue-xia Yun, Min Cui, Yong Huang, Wen Wang, Zhou-bin Zhang
There are many pathogens that cause hand, foot and mouth disease, and the routes of transmission are complicated. A total of 277,305 cases were reported in Guangzhou from 2016 to 2019, with an incidence rate of 486.95 cases/100,000 inhabitants. The number of EV71 infection cases has been declining annually, and the proportions of annual EV71 infections in laboratory diagnosed cases from 2017 to 2019 were 29.45%, 20.18%, and 17.42%. These results show that the EV71 vaccine launched in August 2016 has an effect on the prevention and control of severe deaths from hand, foot, and mouth disease. There is currently no specific antiviral drug for hand, foot and mouth disease, and vaccination is considered to be the most effective way to prevent and control this disease [10]. From August 2016 to December 2019, a total of 1,228,125 doses of the EV71 vaccine were administered, and the annual vaccination rate in 11 districts showed an upward trend (Figures 2,3). The coverage rate for one dose from August 2016 to 2019 was between 8.20 and 32.94%, and the coverage rate for the whole course of 2 doses was between 5.96 and 26.32%. The inoculation rate of manufacturer A’s vaccine was between 3.97% and 13.98%, the inoculation rate of manufacturer B’s vaccine was between 1.99% and 14.79%, and the inoculation rate of manufacturer C’s vaccine was between 6.33% and 7.84%. The EV71 vaccine coverage rate in Guangzhou is still low, which is lower than the rate of 38.30% for 1 dose and 35.05% for 2 doses in Shanghai in children under 5 years old [11].
Foot and mouth disease vaccine strain selection: current approaches and future perspectives
Published in Expert Review of Vaccines, 2018
Foot and mouth disease (FMD) is a highly contagious disease that predominantly affects animals of the order artiodactyla, with the primary hosts being cattle, sheep, pigs, and goats [1]. Globally FMD is one of the most economically important livestock diseases and is currently endemic in all parts of the world except North America, Oceania, Europe and most parts of South America [2](Figure 1). Although FMD does not have a high mortality rate in adult animals, morbidity rates can be very high (up to 100%) often with dramatical reduction in the productivity of infected herds mainly through reduced milk yield, draught power, and weight gain [3]. FMD also seriously affects the economic capability of the agricultural sector of enzootic countries by impeding exports of livestock and livestock products. Global losses are seen through both direct (reduced production and altered herd structure) and indirect (control costs and reduced market access) costs that are estimated to be US$6.5–21 billion annually [3].
Serum interleukin-6 levels as an indicator of aseptic meningitis among children with enterovirus 71-induced hand, foot and mouth disease
Published in Postgraduate Medicine, 2018
Joo Young Lee, Minji Son, Jin Han Kang, Ui Yoon Choi
Enterovirus (EV) 71 is a single-stranded ribonucleic acid (RNA) virus. As a member of the Picornaviridae family, Enterovirus genus, it is the major pathogen of hand, foot, and mouth disease (HFMD) in children. EV71-induced HFMD is often benign and self-limiting, but it can be associated with neurologic complications. These complications include encephalitis, aseptic meningitis, transverse myelitis, cerebellar ataxia, and Guillain–Barre syndrome [1–3]. Outbreaks of EV71-induced HFMD with neurologic complications have been reported in several European countries [4], Russia [5], Brazil [6], Australia [7], and many Asian countries [8–13]. Korea experienced a large outbreak in 2009, and annual epidemics occur in summer. Aseptic meningitis was reported as the most common neurologic complication of EV71-induced HFMD in Korea [14–16]. According to a nationwide sentinel surveillance conducted by Korea Centers for Disease Control and Prevention, aseptic meningitis constitutes more than half of neurologic complication cases among EV71-induced HFMD [16].