Clinical Features And Pathogenic Analysis Of Severe Hand,Foot Mouth Disease In Xiangxi Autonomous Prefecture From 2014 To 2019

Objective: To reveal the clinical characteristics and pathogens of severe hand,foot and mouth disease(SHFMD)in the People’s Hospital of Xiangxi Autonomous Prefecture,and to provide a reference for clinical diagnosis and treatment.Methods: The clinical data was collected from 1506 patients with severe hand,foot and mouth disease who were diagnosed and treated in the People’s Hospital of Xiangxi Autonomous Prefecture between January2014 and December 2019.The clinical characteristics and pathogens of those patients were revealed by using retrospective research methods.SPSS 20.0 software package was used for logistic regression analysis of related factors.Results: Based on the analysis of data collected from the 1506 patients,the pathogen detection rate was 94.56%(1424 positive and 82negative)in which 60.63%(913)were male,39.37%(593)were female and 92.96%(1400)were no more than 3 years old.The incidence rates ofeach month from January to December were 1.93%,1.66%,2.59%,16.53%,23.71%,16.93%,13.94%,3.78%,4.25%,6.05%,4.78%,and 3.85% respectively.Obviously,the incidence rates between April and July(>10%)are higher than others.The deterioration of the condition was indicated by seven indicators,including breathing rate,heart rate,limb jitter,body temperature,blood sugar,lactic acid,and brain natriuretic peptides.Among them,breathing rate,heart rate,limb jitter,and body temperature were usually used for clinical criteria for diagnosis and blood glucose,lactic acid,brain natriuretic peptide were used as laboratory reference indexes.The number of patients admitted each year from 2014 to 2019 were 473,79,423,283,155,and 11 cases respectively.Pathogen analysis showed that EV-71,Cox A16 and other viruses infections accounted for 66.09%(941 cases),8.43%(120 cases),and 25.48%(363 cases)respectively.Conclusions:(1)The incidence number of severe hand,foot and mouth disease in Xiangxi Autonomous Prefecture is much large,mainly among the children under 3 years old and boys suffer a higher rate than girls.In the season of onset,there are two peaks and appears between April and July and appears between September and December.(2)Severe hand,foot and mouth disease has 7 indicators that can indicate the deterioration of the condition,including breathing,heart rate,limb shaking,body temperature,blood sugar,lactic acid,brain natriureticpeptide.Among them,faster breathing,faster heart rate,limb shaking,and body temperature are clinical reference indexes,while blood glucose,lactic acid and brain natriuretic peptide are laboratory reference indexes.(3)The main pathogen of severe hand,foot and mouth disease in Xiangxi Autonomous Prefecture is EV-71.After using vaccine of EV-71,the incidence of severe hand,foot and mouth disease was significantly reduced.(4)Currently,there is no specific treatment for severe hand,foot and mouth disease.Vaccination of hand,foot and mouth disease is the most economical strategy.EV-71 vaccination should continue to be encouraged.At the same time,it is strongly recommended to develop a multivalent vaccine.