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    184 results match your criteria Pediatrics Hand-Foot-and-Mouth Disease

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    Acute pancreatitis in hand, foot and mouth disease caused by Coxsackievirus A16: case report.
    Korean J Pediatr 2017 Oct 20;60(10):333-336. Epub 2017 Oct 20.
    Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
    Coxsackievirus A16 (CA16), which primarily causes hand, foot, and mouth disease (HFMD), is associated with complications, such as encephalitis, acute flaccid paralysis, myocarditis, pericarditis, and shock. However, no case of pancreatitis associated with CA16 has been reported in children. We report a case of CA16-associated acute pancreatitis in a 3-year-old girl with HFMD. Read More

    A 3.0-Angstrom Resolution Cryo-Electron Microscopy Structure and Antigenic Sites of Coxsackievirus A6-Like Particles.
    J Virol 2017 Nov 1. Epub 2017 Nov 1.
    National Center for Protein Science Shanghai, State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
    Coxsackievirus A6 (CVA6) has recently emerged as one of the predominant causative agents of hand, foot, and mouth disease (HFMD). Structure of CVA6 mature viral particle has not been solved thus far. Our previous work shows that recombinant virus-like particles (VLPs) of CVA6 represent a promising CVA6 vaccine candidate. Read More

    Intestinal probiotics in relieving clinical symptoms of severe hand, foot, and mouth disease and potential mechanism analysis.
    Eur Rev Med Pharmacol Sci 2017 Sep;21(18):4214-4218
    Department of Emergency, Xuzhou Children's Hospital affiliated to Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
    Objective: In this prospective cohort study, the efficacy and action mechanism of an intestinal probiotic formulation, Golden Bifid, in severe hand, foot, and mouth disease (HFMD) were determined in 63 consecutively admitted patients successfully treated in the Pediatrics Emergency Department of our hospital.

    Patients And Methods: All patients had a persistent fever; 43 patients had rashes on hands, feet, crissum, and hips; and 45 patients had neurological signs and symptoms. Patients were treated with standard supportive therapy along with ventilator-assisted respiration combined with bedside hemofiltration for removal of circulatory toxins and to achieve acid-base equilibrium and electrolyte stability. Read More

    Protective effect of an alpha 7 nicotinic acetylcholine receptor agonist against enterovirus 71 infection in neuronal cells.
    Antiviral Res 2017 Oct 9. Epub 2017 Oct 9.
    Laboratory of Virology, Beijing Municipal Laboratory of Infection and Immunity, Capital Institute of Pediatrics, Beijing 100020, China. Electronic address:
    Enterovirus 71, as one of the dominant pathogens associated with severe hand, foot, and mouth disease, has been well reported to trigger severe neurological symptoms among young children over the last decade, particularly among children in the Asia-Pacific region. To date, no effective antiviral agent has been developed for the treatment of severe enterovirus 71 infection. PNU-282987, a selective alpha 7 nicotinic acetylcholine receptor (α7nAChR) agonist, has been reported to have a neuroprotective effect by participating in inflammatory regulation in previous studies. Read More

    Epitope-associated and specificity-focused features of EV71-neutralizing antibody repertoires from plasmablasts of infected children.
    Nat Commun 2017 Oct 2;8(1):762. Epub 2017 Oct 2.
    Division of Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, 33305, Taiwan.
    Protective antibody levels are critical for protection from severe enterovirus 71 infection. However, little is known about the specificities and functional properties of the enterovirus 71-specific antibodies induced by natural infection in humans. Here we characterize 191 plasmablast-derived monoclonal antibodies from three enterovirus 71-infected children, each of whom shows a distinct serological response. Read More

    B-type brain natriuretic peptide as a measure of the severity of hand-foot-mouth disease: a case-control study.
    BMC Infect Dis 2017 Sep 29;17(1):651. Epub 2017 Sep 29.
    Department of Emergency, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 Road, Yuzhong district, Chongqing, 400014, China.
    Background: Hand-foot-mouth disease (HFMD) is an acute infectious disease caused by enteroviruses, and HFMD complicated by cardiopulmonary failure has a high mortality. B type natriuretic peptide (BNP) is widely applied in monitoring cardiovascular disorders, and thus, we investigated whether this index was associated with the severity of HFMD and the outcome in severe HFMD.

    Methods: Serum BNP, lactate, and glucose levels as well as white blood cell (WBC) count, PaO2/FiO2, and cardiac output (CO) were analyzed in the 83 enrolled HFMD patients according to different conditions (common, severe, and critical; with and without complication; and survivors and non-survivors). Read More

    A Selective Bottleneck Shapes the Evolutionary Mutant Spectra of Enterovirus A71 during Viral Dissemination in Humans.
    J Virol 2017 Dec 14;91(23). Epub 2017 Nov 14.
    Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
    RNA viruses accumulate mutations to rapidly adapt to environmental changes. Enterovirus A71 (EV-A71) causes various clinical manifestations with occasional severe neurological complications. However, the mechanism by which EV-A71 evolves within the human body is unclear. Read More

    Cost-effectiveness of a national enterovirus 71 vaccination program in China.
    PLoS Negl Trop Dis 2017 Sep 11;11(9):e0005899. Epub 2017 Sep 11.
    Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
    Background And Aims: Enterovirus 71 (EV71) has caused great morbidity, mortality, and use of health service in children younger than five years in China. Vaccines against EV71 have been proved effective and safe by recent phase 3 trials and are now available in China. The purpose of this study was to evaluate the health impact and cost-effectiveness of a national EV71 vaccination program in China. Read More

    Development of a luciferase-based biosensor to assess enterovirus 71 3C protease activity in living cells.
    Sci Rep 2017 Sep 4;7(1):10385. Epub 2017 Sep 4.
    Key Laboratory of Special Pathogens and Biosafety, Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
    Enterovirus 71 (EV71) is a major pathogen of hand, foot, and mouth disease (HFMD). To date, no antiviral drug has been approved to treat EV71 infection. Due to the essential role that EV71 3 C protease (3C(pro)) plays in the viral life cycle, it is generally considered as a highly appealing target for antiviral drug development. Read More

    Relationship between catecholamine level and gene polymorphism of β1 adrenergic receptor G1165C in children with EV71 infection in hand foot and mouth disease.
    Asian Pac J Trop Med 2017 May 18;10(5):473-477. Epub 2017 May 18.
    Pediatric Intensive Care Unit, Maternal and Child Health Care Hospital of Hainan Province (Children's Hospital of Hainan Province), Haikou 570206, China. Electronic address:
    Objective: To investigate the relationship between the levels of plasma adrenaline and norepinephrine and gene polymorphism of β1 adrenergic receptor G1165C in children with enterovirus 71 (EV71) infection in hand foot and mouth disease (HFMD).

    Methods: The polymerase chain reaction (PCR) was used to detect the expression of gene polymorphism of β1 adrenergic receptor G1165C in vitro. The levels of plasma adrenaline and norepinephrine were measured by enzyme-linked immunosorbent assay (ELISA). Read More

    Enterovirus 71-induced has-miR-21 contributes to evasion of host immune system by targeting MyD88 and IRAK1.
    Virus Res 2017 Jun 12;237:27-36. Epub 2017 May 12.
    Department of Pediatrics, Affiliated Hospital of Yanan University, China. Electronic address:
    Enterovirus71(EV71), the etiological agent of hand-foot-and-mouth disease, has increasingly become a public health challenge around the world. Type I interferons (IFNs) are an important family of cytokines that regulate innate and adaptive immune responses to pathogens.These pathways are tightly regulated by the host to prevent an inappropriate cellular response, but viruses can modulate these pathways to proliferate and spread. Read More

    Association of the OAS3 rs1859330 G/A genetic polymorphism with severity of enterovirus-71 infection in Chinese Han children.
    Arch Virol 2017 Aug 25;162(8):2305-2313. Epub 2017 Apr 25.
    Department of Pediatrics, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao, 266000, China.
    The 2'5'-oligoadenylate synthetase (OAS) is an interferon (IFN)-induced protein that plays an important role in the antiviral action of IFN, with OAS3 being one of the four OAS classes (OAS1, OAS2, OAS3, OASL). The effect of OAS on several infectious viral diseases has been reported; however, a study of the effect of OAS3 on enterovirus 71 (EV71) is lacking. The purpose of this study was to evaluate the association of the OAS3 rs1859330 G/A genetic polymorphism with susceptibility and severity of EV71 infection. Read More

    Epidemiology of 45,616 suspect cases of Hand, Foot and Mouth Disease in Chongqing, China, 2011-2015.
    Sci Rep 2017 Apr 19;7:45630. Epub 2017 Apr 19.
    Laboratory Medicine Center, Children's Hospital, Chongqing Medical University, Chongqing, 400014, China.
    Epidemiology and etiology of hand, foot, and mouth disease (HFMD) based on large sample size or evaluation of detection for more enterovirus serotypes are not well investigated in Chongqing of China. 45,616 suspect HFMD patients were prospectively enrolled among whom 21,615 were laboratory confirmed HFMD cases over a 5-year period (January 2011 to December 2015). Their epidemiological, clinical, and laboratory data were extracted and stratified by month, age, sex, disease severity, and enterovirus serotype. Read More

    Therapeutic efficacy of phentolamine in the management of severe hand, foot and mouth disease combined with pulmonary edema.
    Exp Ther Med 2017 Apr 7;13(4):1403-1407. Epub 2017 Feb 7.
    Department of First Pediatric Internal Medicine, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China.
    The aim of this study was to examine the effects of phentolamine on severe hand, foot and mouth disease (HFMD) combined with pulmonary edema (PE). From May 2008 to December 2012, 53 children with severe HFMD plus PE were enrolled in the treatment group, receiving phentolamine intravenously at a loading dose of 5 µg/kg/min. The control group comprised 52 children with the same disease who did not receive phentolamine infusion. Read More

    Paediatric Virology: A rapidly increasing educational challenge.
    Exp Ther Med 2017 Feb 23;13(2):364-377. Epub 2016 Dec 23.
    Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece.
    The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 in Athens, Greece, provided an overview on recent views and advances on Paediatric Virology. Emphasis was given to HIV-1 management in Greece, a country under continuous financial crisis, hepatitis B vaccination in Africa, treatment options for hepatitis C virus in childhood, Zika virus in pregnancy and infancy, the burden of influenza on childhood, hand-foot-mouth disease and myocarditis associated with Coxsackie viruses. Other general topics covered included a critical evaluation of Paediatric Accident and Emergency viral infections, multimodality imaging of viral infections in children, surgical approaches of otolaryngologists to complex viral infections, new advances in the diagnosis and treatment of viral conjunctivitis and novel molecular diagnostic methods for HPV in childhood. Read More

    Shedding light on onychomadesis.
    Cutis 2017 Jan;99(1):33-36
    School of Public Affairs and Administration and the Departments of Dermatology, Pathology, and Pediatrics, Rutgers University New Jersey Medical School, Newark, USA.
    Onychomadesis is the proximal separation of the nail plate from the nail matrix due to a temporary cessation of nail growth. It can occur in children of all ages including neonates. Diagnosis is made clinically through palpation and inspection of the nail plate. Read More


    A novel Enterovirus 96 circulating in China causes hand, foot, and mouth disease.
    Virus Genes 2017 Jun 7;53(3):352-356. Epub 2017 Feb 7.
    BGI-Shenzhen, Shenzhen, 518083, China.
    Enterovirus 96 (EV-96) is a recently described member of the species Enterovirus C and is associated with paralysis and myelitis. In this study, using metagenomic sequencing, we identified a new enterovirus 96 strain (EV-96-SZ/GD/CHN/2014) as the sole pathogen causing hand, foot, and mouth disease (HFMD). A genomic comparison showed that EV-96-SZ/GD/CHN/2014 is most similar to the EV-96-05517 strain (85% identity), which has also been detected in Guangdong Province. Read More

    Correlation of symptomatic enterovirus infection and later risk of allergic diseases via a population-based cohort study.
    Medicine (Baltimore) 2017 Jan;96(4):e5827
    aDepartment of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Taiwan bDepartment of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan cDepartment of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
    Infants who are exposed to the rhinovirus or respiratory syncytial virus are at a higher risk of subsequently developing wheezing or asthma. This study aims to determine whether preschoolers with a history of symptomatic enterovirus infection are at an increased risk of developing allergic diseases or not.We used data from the Taiwan National Health Insurance Research Database from 1999 to 2006 for this nationwide population-based cohort study. Read More

    An Outbreak of Kingella Kingae Infections Complicating a Severe Hand, Foot, And Mouth Disease Outbreak in Nice, France, 2016.
    Pediatr Infect Dis J 2017 May;36(5):530-532
    From the *URMITE " Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes", UM63, Inserm 1095, CNRS 7278, IRD 198, Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille University, Marseille, France; †Childcare Centers, Nice, France; ‡Laboratoire de Virologie, Centre National de Référence des Enterovirus et Parechovirus-laboratoire associé, CHU de Clermont-Ferrand, Clermont-Ferrand, France; §Department of Pediatric Cardiac Surgery, La Timone Children's Hospital, Aix-Marseille University, Marseille, France; ¶Department of Pediatric Emergency Medicine, North Hospital, Marseille, France; ‖Department of Pediatrics, Foundation Lenval Children's Hospital, Nice, France; **Laboratory of Foundation Lenval Children's Hospital, Nice, France; and ††IRD French Institute of Research and Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales," Institut Hospitalo-Universitaire Méditerranée-Infection, Aix Marseille Université, Marseille, France.
    We report the investigation methods for the diagnosis of an epidemic and culture-negative Kingella kingae endocarditis complicating a severe outbreak of hand, foot and mouth disease in a childcare center. The diagnosis was confirmed by polymerase chain reaction testing performed from cardiac tissue. Our findings argue for the systematic investigation of K. Read More

    Hand Foot and Mouth Disease Like Illness in Office Practice.
    Indian J Pediatr 2017 Mar 12;84(3):216-218. Epub 2016 Dec 12.
    Department of Pediatrics, Vinayaka Missions Medical College, Karaikal, Puducherry, 609609, India.
    Objective: To describe the clinical profile of Hand Foot and Mouth Disease (HFMD) like illness in a cluster of cases.

    Methods: Children presenting with papulovesicular skin lesions with or without oral lesions were clinically examined, treated and followed up.

    Results: Out of 21 cases, 18 (85. Read More

    Efficacy of Scutellaria baicalensis for the Treatment of Hand, Foot, and Mouth Disease Associated with Encephalitis in Patients Infected with EV71: A Multicenter, Retrospective Analysis.
    Biomed Res Int 2016 20;2016:5697571. Epub 2016 Oct 20.
    Department of Pediatrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
    This study aimed to evaluate the clinical efficacy and safety of using the traditional Chinese herbal medicine Scutellaria baicalensis for the treatment of severe HFMD in 725 patients aged >1 year in a multicenter, retrospective analysis. The patients were divided into the S. baicalensis and ribavirin groups, and the temperatures, presence or absence of skin rashes and oral lesions, nervous system (NS) involvement, and viral loads of the patients, as well as the safety of the treatments, were evaluated. Read More

    Enterovirus 71 infection and neurological complications.
    Korean J Pediatr 2016 Oct 17;59(10):395-401. Epub 2016 Oct 17.
    Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
    Since the outbreak of the enterovirus 71 (EV71) infection in Malaysia in 1997, large epidemics of EV71 have occurred in the Asia-Pacific region. Many children and infants have died from serious neurological complications during these epidemics, and EV71 infection has become a serious public health problem in these areas. EV71 infection causes hand, foot and mouth disease (HFMD) in children, and usually resolves spontaneously. Read More

    Immunodominant IgM and IgG Epitopes Recognized by Antibodies Induced in Enterovirus A71-Associated Hand, Foot and Mouth Disease Patients.
    PLoS One 2016 2;11(11):e0165659. Epub 2016 Nov 2.
    Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
    Enterovirus A71 (EV-A71) is one of the main causative agents of hand, foot and mouth disease (HFMD). Unlike other enteroviruses that cause HFMD, EV-A71 is more frequently associated with severe neurological complications and fatality. To date, no effective licensed antivirals are available to combat EV-A71 infection. Read More

    A severe pediatric infection with a novel enterovirus A71 strain, Thuringia, Germany.
    J Clin Virol 2016 11 19;84:90-95. Epub 2016 Oct 19.
    Institute of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.
    Infection by Enterovirus A71 (EV-A71) is an important cause of hand, foot, and mouth disease (HFMD). Outbreaks including severe cases with neurological and cardiopulmonary complications have been reported particularly from Southeast Asia. In Europe, the epidemiology of EV-A71 is not well understood. Read More

    Short-term effects of meteorological factors on pediatric hand, foot, and mouth disease in Guangdong, China: a multi-city time-series analysis.
    BMC Infect Dis 2016 Sep 29;16(1):524. Epub 2016 Sep 29.
    State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
    Background: Literature shows inconsistency in meteorological effects on Hand, foot, and mouth disease (HFMD) in different cities. This multi-city study aims to investigate the meteorological effects on pediatric HFMD occurrences and the potential effect modification by geographic factors.

    Methods: Based on daily time-series data in eight major cities in Guangdong, China during 2009-2013, mixed generalized additive models were employed to estimate city-specific meteorological effects on pediatric HFMD. Read More

    Prevalence and molecular characterization of human rhinovirus in stool samples of individuals with and without acute gastroenteritis.
    J Med Virol 2017 May 11;89(5):801-808. Epub 2016 Oct 11.
    Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand.
    Human rhinovirus (RV) most often causes mild upper respiratory tract infection. Although RV is routinely isolated from the respiratory tract, few studies have examined RV in other types of clinical samples. The prevalence of RV was examined in 1,294 stool samples collected mostly from children with acute gastroenteritis residing in Bangkok and Khon Kaen province of Thailand between January 2010 and October 2014. Read More

    Molecular epidemiology of the enteroviruses associated with hand, foot and mouth disease/herpangina in Dongguan, China, 2015.
    Arch Virol 2016 Dec 21;161(12):3463-3471. Epub 2016 Sep 21.
    Department of Pediatric Infectious Diseases, Children's Hospital of Dongguan, Dongguan, Guangdong, China.
    Enteroviruses (EVs) are the etiological agents involved in most cases of hand, foot and mouth disease (HFMD) and herpangina (HA). Information on the epidemiology profiles of EVs in China is very limited, as the present surveillance system of China focuses on CAV16 and EV71, and no published data are available in Dongguan. The aim of this study is to determine the prevalence of EVs among patients with HFMD and HA in Dongguan, China, during 2015. Read More

    Efficacy and safety of interferon-α2b spray in the treatment of hand, foot, and mouth disease: a multicenter, randomized, double-blind trial.
    Arch Virol 2016 Nov 12;161(11):3073-80. Epub 2016 Aug 12.
    Department of Pediatric Infection, The Second Affiliated Hospital of Wenzhou Medical University, 109th Xueyuanxi Road, Wenzhou, Zhejiang, China.
    Hand, foot, and mouth disease (HFMD) is a common infectious enterovirus disease, occurring mostly in infants and children younger than 7 years with potentially fatal complications. Therefore, we evaluated the clinical efficacy and safety of recombinant human interferon (IFN)-α2b spray for treating mild HFMD in 400 patients in a randomized, open, controlled clinical trial. The patients were randomized to the IFN-α2b spray and placebo groups, and their temperature, skin rash, oral lesions, and appetite were monitored, while pathogen levels and safety were evaluated with a 7-day follow-up. Read More

    Changes in enterovirus serotype constituent ratios altered the clinical features of infected children in Guangdong Province, China, from 2010 to 2013.
    BMC Infect Dis 2016 Aug 9;16:399. Epub 2016 Aug 9.
    Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong ye da dao zhong, Guangzhou, 510282, People's Republic of China.
    Background: Enterovirus (EV)-related hand, foot, and mouth disease/herpangina (HFMD/HA) has been prevalent in Guangdong Province, China, since 2010.

    Methods: Clinical data for EV-related HFMD/HA inpatients admitted to the Department of Paediatrics of Zhujiang Hospital from 2010 to 2013 were retrospectively reviewed. The corresponding EV serotypes were also determined by reverse transcription-polymerase chain reaction or BLAST analysis of the sequenced partial lengths of the viral protein1/5'-untranslated region. Read More

    Effect of integrated Chinese and Western medicine therapy on severe hand, foot and mouth disease: A prospective, randomized, controlled trial.
    Chin J Integr Med 2016 Jul 9. Epub 2016 Jul 9.
    Department of Pediatrics, Kaifeng Children's Hospital, Kaifeng, Henan Province, 475003, China.
    Objective: To evaluate the effificacy and safety of Chinese medicine (CM) plus Western medicine (WM) in the treatment of pediatric patients with severe hand, foot and mouth disease (HFMD) by conducting a prospective, controlled, and randomized trial.

    Methods: A total of 451 pediatric patients with severe HFMD were randomly assigned to receive WM therapy alone (224 cases, WM therapy group) or CM [Reduning Injection ( ) or Xiyanping Injection ()] plus WM therapy (227 cases, CM plus WM therapy group) for 7-10 days, according to a web-based randomization system. The primary outcome was fever clearance time, which was presented as temperature decreased half-life time. Read More

    Antiviral activity of Lactobacillus reuteri Protectis against Coxsackievirus A and Enterovirus 71 infection in human skeletal muscle and colon cell lines.
    Virol J 2016 Jun 24;13:111. Epub 2016 Jun 24.
    Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Centre for Life Sciences, 28 Medical Drive, #03-05, Singapore, 117456, Singapore.
    Background: Recurrence of hand, foot and mouth disease (HFMD) pandemics continues to threaten public health. Despite increasing awareness and efforts, effective vaccine and drug treatment have yet to be available. Probiotics have gained recognition in the field of healthcare worldwide, and have been extensively prescribed to babies and young children to relieve gastrointestinal (GI) disturbances and diseases, associated or not with microbial infections. Read More

    Enterovirus infections in Singaporean children: an assessment of neurological manifestations and clinical outcomes.
    Singapore Med J 2017 04 1;58(4):189-195. Epub 2016 Jun 1.
    Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
    Introduction: Enterovirus infections in childhood can be associated with significant neurological morbidity. This study aimed to describe the prevalence and range of neurological manifestations, determine the clinical characteristics and assess differences in clinical outcomes for Singaporean children diagnosed with enterovirus infections.

    Methods: In this single-centre, case-control study, clinical data was collected retrospectively from patients admitted to National University Hospital, Singapore, from August 2007 to October 2011 and diagnosed with enterovirus infection, based on the enterovirus polymerase chain reaction test, or cultures from throat and rectal swabs or cerebrospinal fluid samples. Read More

    Milrinone in Enterovirus 71 Brain Stem Encephalitis.
    Front Pharmacol 2016 29;7:82. Epub 2016 Mar 29.
    Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung UniversityTainan, Taiwan.
    Enterovirus 71 (EV71) was implicated in a widespread outbreak of hand-foot-and-mouth disease (HFMD) across the Asia Pacific area since 1997 and has also been reported sporadically in patients with brain stem encephalitis. Neurogenic shock with pulmonary edema (PE) is a fatal complication of EV71 infection. Among inotropic agents, milrinone is selected as a therapeutic agent for EV71- induced PE due to its immunopathogenesis. Read More

    Elevated expression of circulating miR876-5p is a specific response to severe EV71 infections.
    Sci Rep 2016 Apr 7;6:24149. Epub 2016 Apr 7.
    Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial and Children's Hospital, Linkuo, Taiwan.
    Human enterovirus 71 (EV71) is a major causative agent of hand, foot, and, mouth disease, accounting for more than 65% of recent outbreaks. Following enteroviral infection, the host responses are crucial indicators for the development of a diagnosis regarding the clinical severity of EV71 infections. In this study, we implemented NanoString nCounter technology to characterize the responses of serum microRNA (miRNA) profiles to various EV71 infection diseases. Read More

    Saffold Cardiovirus Infection in a 2-Year-Old Boy with Acute Pancreatitis.
    Jpn J Infect Dis 2017 Jan 18;70(1):105-107. Epub 2016 Mar 18.
    Department of Pediatrics, Nantan General Hospital.
    Saffold cardiovirus (SAFV), first identified in a stool sample in 2007, is thought to be associated with respiratory disease and gastroenteritis. On the other hand, animal experiments suggested that the major viral load, following intraperitoneal inoculation of SAFV in mice, may be detected in the pancreas. However, until now, no cases of SAFV in patients with pancreatitis have been reported. Read More

    Enterovirus-related diarrhoea in Guangdong, China: clinical features and implications in hand, foot and mouth disease and herpangina.
    BMC Infect Dis 2016 Mar 16;16:128. Epub 2016 Mar 16.
    Laboratory of Emerging Infectious Diseases and Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, No. 253 Gong Ye Da Dao Zhong, Guangzhou, 510282, China.
    Background: A series of complications caused by enteroviruses, including meningitis, encephalitis, acute flaccid paralysis, acute cardiopulmonary failure, respiratory infection, and myocardial injury have been reported in hand, foot and mouth disease/herpangina (HFMD/HA). However, the complication of diarrhoea caused by enteroviruses has been neglected, and a summary of its clinical features and impact on HFMD/HA is unavailable.

    Methods: We included inpatients with HFMD/HA admitted to the Paediatric Department of Zhujiang Hospital during 2009-2012. Read More

    Development and evaluation of a real-time method for testing human enteroviruses and coxsackievirus A16.
    Diagn Microbiol Infect Dis 2016 May 5;85(1):36-41. Epub 2016 Feb 5.
    Shanghai Rendu Biotechnology Co., Ltd., No. 590 Ruiqing Road, East Area ZhangjiangHigh-Tech Park, Pudong Shanghai, 201201, China.
    Hand, foot, and mouth disease (HFMD) is a common infectious disease caused by a group of the human enteroviruses (HEV), including coxsackievirus A16 (CA16) and enterovirus 71 (EV71). In recent years, another HEV-A serotype, CA6 or CA10, has emerged to be one of the major etiologic agents that can induce HFMD worldwide. The objective of this study is to develop specific, sensitive, and rapid methods to help diagnose HEV and CA16 specifically by using simultaneous amplification testing (SAT) based on isothermal amplification of RNA and real-time detection of fluorescence technique, which were named as SAT-HEV and SAT-CA16, respectively (SAT-HEV/SAT-CA16). Read More

    Acute Cerebellar Ataxia: An Unusual Pediatric Case.
    J Emerg Med 2016 May 15;50(5):769-72. Epub 2016 Feb 15.
    Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/University of South Florida, Morsani College of Medicine, Allentown, Pennsylvania.
    Background: Acute cerebellar ataxia is a clinical syndrome with sudden onset of uncoordinated gait and normal mental status in young children. Although it has a benign clinical course, it often requires an exhaustive diagnostic work-up in order to rule out potentially life-threatening etiologies that present similarly. The wide differential encompasses causes from infections, brain masses, drugs, toxins, trauma, paraneoplastic syndromes, as well as hereditary or congenital disorders. Read More

    Disease burden of enterovirus infection in Taiwan: Implications for vaccination policy.
    Vaccine 2016 Feb 6;34(7):974-80. Epub 2016 Jan 6.
    Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan. Electronic address:
    Objectives: This study aimed to assess the disease burden and economic impacts of human nonpolio enteroviruses (NPEV) and enterovirus A71 (EV-A71) infection in Taiwan.

    Materials And Methods: We included children under five years old (n=983,127-1,118,649) with ICD-9-CM codes 0740 (herpangina) or 0743 (hand-foot-and-mouth disease) from the 2006 to 2010 National Health Insurance Database. Severity of enterovirus infection was assessed from outpatient/emergency visits, hospitalization (with/without intensive care unit [ICU] admission), infection with severe complications, and death. Read More

    An outbreak of hand-foot-mouth disease: A report from the hills of northern India.
    Natl Med J India 2015 May-Jun;28(3):126-8
    Department of Paediatrics, Sri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India.
    Background: Hand-foot-mouth disease (HFMD) is known to cause outbreaks around the world as well as in India. We report the clinical characteristics of an outbreak in Dehradun, Uttarakhand.

    Methods: The study was done in the Department of Paediatrics of a tertiary care referral teaching hospital in northern India. Read More

    [Analysis on the change of genotype of enteroviruses associated hand, foot and mouth disease in Beijing during 2013 to 2014].
    Zhonghua Er Ke Za Zhi 2015 Aug;53(8):610-5
    Objective: To analyze the genotype, epidemic pattern and the characteristics of the disease of enteroviruses during the epidemic season of hand, foot and mouth disease (HMFD) in children from 2013 to 2014 in Beijing to provide the scientific evidence for prevention and treatment of HFMD.

    Method: During April to September in 2013 and March to October in 2014, a total of 977 throat swabs were collected from children who visited the Children's Hospital Affiliated to Capital Institute of Pediatrics, including 147 from patients with HFMD in 2013, 343 with HFMD, 201 with atypical HFMD, 83 with herpangina, 25 with fever with convulsions, 64 fever with rash and 114 with rash in 2014. Enteroviruses universal type (EV), Enteroviruses type 71 (EV71) and Coxsackievirus group A 16 (CA16) were detected by real-time RT-PCR respectively. Read More

    Prognostic Value of B-Type Natriuretic Peptide, Leukocytosis, and Hyperglycemia in Children with Severe Hand, Foot, and Mouth Disease.
    Shock 2016 Jun;45(6):620-5
    *Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Douliou †Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan ‡Department of Critical Care Medicine, Hunan Children's Hospital §Department of Pediatrics, Hunan Provincial People's Hospital, Changsha, Hunan Province, China.
    Objective: Our goal is to determine the prognostic value of serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP), leukocytosis, and hyperglycemia in patients with severe hand, foot, and mouth disease (HFMD).

    Design: This is a prospective cohort study conducted from March 2011 through October 2012 at Hunan Children's Hospital.

    Setting: Hunan Children's Hospital, a large children's teaching hospital with 1,500-beds located in the Changsha region of Hunan Province in China. Read More

    Enteroviruses in the early 21st century: new manifestations and challenges.
    Curr Opin Pediatr 2016 Feb;28(1):107-13
    aDepartment of Pediatrics bMolecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, USA.
    Purpose Of Review: Enteroviruses cause a wide variety of diseases with neurologic, respiratory, skin, and gastrointestinal findings. The purpose of this review is to clarify changes in the classification of enteroviruses, provide information about recent disease outbreaks, and to summarize progress toward the treatment and prevention of these infections.

    Recent Findings: Enteroviruses are now classified into four distinct species. Read More

    Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study.
    Biomed Res Int 2015 26;2015:802046. Epub 2015 Nov 26.
    Department of Infectious Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
    Background: Hand-foot-and-mouth disease (HFMD) is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD.

    Methods: 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected. Read More

    Diagnostic uncertainty of herpangina and hand-foot-and-mouth disease and its impact on national enterovirus syndromic monitoring.
    Epidemiol Infect 2016 05 23;144(7):1512-9. Epub 2015 Nov 23.
    Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health,Taipei,Taiwan.
    The community burden of enterovirus is often monitored through syndromic monitoring systems based on reported cases of enterovirus-related infection (EVI) diagnoses. The extent to which this is affected by under- and over-diagnosis has not been reported. In Taiwan, children often make more than one healthcare visit during an episode of infection. Read More

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