Hand, Foot and Mouth Disease: A Single Centre Retrospective Study of 403 New Cases and Brief Review of Relevant Indian Literature to Understand Clinical, Epidemiological, and Virological Attributes of a Long-Lasting Indian Epidemic.
Hand, Foot and Mouth Disease: A Single Centre Retrospective Study of 403 New Cases and Brief Review of Relevant Indian Literature to Understand Clinical, Epidemiological, and Virological Attributes of a Long-Lasting Indian Epidemic.
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手足口病：403例新病例的单中心回顾性研究和对印度相关文献的简要回顾，以了解长期印度流行病的临床、流行病学和病毒学特征。
DOI：
10.4103/idoj.idoj_701_21
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发表时间：
2022-05
影响因子：
1.7
通讯作者：
Chauhan A
中科院分区：
文献类型：
--
作者：
Sharma A;Mahajan VK;Mehta KS;Chauhan PS;Manvi S;Chauhan A
自 1997 年以来，手足口病 (HFMD) 一直存在零星和周期性的大规模流行，病例有显着发病率和死亡率的风险，特别是自 1997 年以来的东南亚和自 2003 年初以来的印度。我们回顾性研究了 2009 年至 2019 年记录的 403 例病例，并回顾了 2004 年至 2019 年期间发表的相关印度文献，以了解该疾病的临床、流行病学和病毒学特征持久的 印度疫情。 96.8%的儿童和青少年（男:女1.6:1）年龄在2个月至18岁之间，84%的年龄<5岁。成人家庭接触者占 3.2%。 2009-2011年仅发生12例散发病例，2012-2015年病例数有所增加，2013年达到峰值，占病例数的30.8%，随后缓慢下降，直至2019年，2018年小幅回升。主要高峰出现在夏季，小高峰出现在秋季。文献综述显示，2004 年至 2019 年印度各邦出现的 3332 例病例具有相似的流行病学趋势，而血清分型分别鉴定出 83% 的柯萨奇病毒 A16 (CV A16)、17% 的柯萨奇病毒 A6 (CV A6)、4.1% 的肠道病毒 71 和 11.7% 的样本中存在多种毒株。此次手足口病疫情持续时间较长的总体特点； 5 岁以下儿童的发病率高于成人，少数患者无神经或肺部并发症，或很少出现神经或肺部并发症，高峰发生在夏季和秋季，致病病毒的特性与全球趋势一致。然而，该疾病在全国范围内的持续传播似乎与中国和台湾的疫情前期同步。它呼吁持续监测，并将手足口病列为印度的法定疾病。
There have been sporadic and periodic large-scale epidemics of hand, foot, and mouth disease (HFMD) with cases at risk for significant morbidity and mortality particularly in Southeast Asia since 1997 and in India since early 2003. We retrospectively studied 403 cases recorded from 2009 to 2019 and reviewed relevant Indian literature published between 2004 and 2019 to understand clinical, epidemiological, and virological attributes of this long-lasting Indian epidemic. There were 96.8% children and adolescents (M:F 1.6:1) aged 2 months to 18 years and 84% were aged <5 years. Adult family contacts comprised 3.2%. Only 12 sporadic cases occurred during 2009-2011 followed by increased number from 2012 to 2015 peaking with 30.8% cases in 2013 and declining slowly until the year 2019 with small resurge in 2018. The major peaks occurred during summers with small peaks in autumns. Literature review showed 3332 cases presenting between 2004 and 2019 across Indian states with similar epidemiological trends whereas serotyping identified Coxsackievirus A16 (CV A16) in 83%, Coxsackievirus A6 (CV A6) in 17%, Enterovirus 71 in 4.1%, and multiple strains in 11.7% samples, respectively. The overall features of this long-lasting HFMD epidemic; affecting children aged <5 years more often than adults, none or minimum neurological or pulmonary complications in few patients, peaks occurring during summer and autumn months, and identity of the pathogenic virus coincide with global trends. However, the continuous spread of the disease across the country appears in sync with pre-epidemic periods of China and Taiwan. It calls for a continuous surveillance and making HFMD a notifiable disease in India.