Epididymitis Caused by Coxsackievirus A6 in Association with Hand,Foot, and Mouth Disease

Coxsackievirus A6 (CV-A6) caused hand, foot, and mouth disease (HFMD) with a unique manifestation of epididymitis. The patient underwent operation due to suspicion of testicular torsion. Epididymitis was diagnosed by ultrasound examination. Enterovirus was detected from epididymal fluid by PCR and typed by partial sequencing of viral protein 1 as CV-A6.     

554例儿童重症手足口病的临床特征分析

目的 分析儿童重症手足口病的临床特点,以便于早期诊断。方法 回顾性分析玉林市红十字会医院2012年4月~2016年10月收治的554例重症HFMD患儿的临床资料。结果 554例重症HFMD患儿中3岁以下468例（84.48%）,发烧432例（77.98%）,平均峰值温度为（38.20±0.93）℃,平均持续时间（2.06±1.26）d。552例（99.64%）患儿伴有不同数量皮疹或疱疹,休克40例（7.22%）,神经系统受累511例（92.24%）,神经系统受累平均时间为（2.46±1.24）d,主要表现有精神反应差（91.52%）,双眼凝视（11.37%）,易惊（90.97%）,肢体抖动（67.32%）,呕吐（6.86%）,嗜睡（3.97%）,烦躁（4.87%）,昏迷（1.81%）等。白细胞升高421例（75.99%）,血糖升高357例（64.44%）,乳酸升高341例（61.55%）。EV71病毒阳性390例（70.40%）,柯萨奇A16型阳性16 例（2.89%）,肠道通用病毒阳性285例（52.44%）。29例（5.23%）死于神经源性肺水肿和呼吸衰竭,8例（1.44%）并发中枢性尿崩症,5例（0.90%）有残余神经系统后遗症。结论 高热,长期发热,精神不佳,易惊,四肢抖动,呕吐,嗜睡,烦躁,高白细胞,高血糖,高乳酸是重症手足口病的临床特征,特别伴有休克,双眼凝视,呼吸急促,持续性心率增快是早期鉴定重症病例的特征性表现,早期识别重症病例,及时干预,把治疗关口前移是降低死亡率和后遗症的关键。     

Molecular phylogeny of Coxsackievirus A16 in Shenzhen, China, from 2005 to 2009

Phylogenetic analysis of a Coxsackievirus A16 (CA16) sequence from Shenzhen, China, and other Chinese and international CA16 sequences revealed a pattern of endemic cocirculation of strains of clusters B2a and B2b within subtype B2 viruses. Amino acid evolution and nucleotide variation in the VP1 region were slight for 5 years.     

Risk Factors for Neurologic Complications of Hand,Foot and Mouth Disease in the Republic of Korea, 2009

In 2009, the first outbreak of hand, foot and mouth disease (HFMD) or herpangina (HP) caused by enterovirus 71 occurred in the Republic of Korea. This study inquired into risk factors associated with complications of HFMD or HP. A retrospective medical records review was conducted on HFMD or HP patients for whom etiologic viruses had been verified in 2009. One hundred sixty-eight patients were examined for this investigation. Eighty patients were without complications while 88 were accompanied by complications, and 2 had expired. Enterovirus 71 subgenotype C4a was the most prevalent in number with 67 cases (54.9%). In the univariate analysis, the disease patterns of HFMD rather than HP, fever longer than 4 days, peak body temperature over 39℃, vomiting, headache, neurologic signs, serum glucose over 100 mg/dL, and having an enterovirus 71 as a causative virus were significant risk factors of the complications. After multiple logistic analysis, headache (Odds ratio [OR], 10.75; P < 0.001) and neurologic signs (OR, 42.76; P < 0.001) were found to be the most significant factors. Early detection and proper management of patients with aforementioned risk factors would be necessary in order to attain a better clinical outcome.     

新疆第八师石河子市2015~2018年手足口病原学特征及病流行病学分析

目的 探讨石河子市2015~2018年手足口病流行病学以及病原学特征,为石河子市手足口病的预防控制提供一定的科学依据和理论基础。方法 对2015年1月~2018年7月石河子市手足口病疫情资料进行描述性流行病学分析,并利用RT-PCR技术检测主要人肠道病毒病原体,包括EV71型、CoxA16型、CoxA6型、CoxA4型和CoxA10型,分析其分布特征。结果 2015~2018年石河子市实验室确诊手足口病373例,其中男性多于女性,男女性别比为1.94:1;发病呈典型的单峰分布,4~8月份为全年发病高峰期,占4年总发病人数的97.78%;城区和团场均有发病,其发病比例为0.97:1。2018年手足口病患者中CoxA6阳性率高于2016年和2017年;相较于2015~2017年,2018年石河子市手足口病患者EV71和CoxA16阳性率降低（P＜0.05）。结论 石河子市手足口病发病有明显的季节性,存在年龄、性别差异,并且CoxA6型感染者逐渐增多,今后应持续开展手足口病病原学监测,并加强手足口病疫苗的预防接种工作。     

东莞市一起CoxA16病毒引起的幼儿园手足口病爆发疫情调查

目的分析一起由CoxA16病毒引起的幼儿园手足口病爆发疫情的流行病学调查与处理结果,为有效预防控制幼儿园手足口病提供科学依据。方法对幼儿园发病儿童进行流行病学和临床特征的调查;并采集住院病例咽拭子、粪便标本。进行肠道病毒核酸RT-PCR检测。结果本次疫情发病8例,涉及3个班,罹患率为1．49％。所有患儿均小于5岁。与首发病例同楼层班级和其它楼层班级之间学童罹患率的差别有统计学意义（P〈0．05）。患儿主要的临床症状是口腔、手、足部的疱疹,其中2名患儿有发热。检测了3例住院患儿的粪便、咽拭子标本,COXA16核酸均为阳性,EV71核酸均为阴性。通过采取隔离传染源、切断传播途径和保护易感人群的控制措施21d后,确认疫情终止。结论CoxA16肠道病毒是导致本次幼儿园手足口病爆发的病原。年龄小于5岁、在同教室内与患儿密切接触可能是本次手足口病发病的危险因素。提高对手足口病的认识,严格执行晨午检筛查制度、消毒隔离制度及疫情报告制度可有效预防幼儿园手足口病。     

天津市滨海新区接种手足口病疫苗前后 流行病学特征对照分析

目的 对天津市滨海新区2017年接种手足口病疫苗前后各一年流行病学特征进行对照分析,为手足口病预防控制提供有力依据。方法 我院于2017年4月1日开始接种肠道病毒71型灭活疫苗,收集2016年4月1日~2018年4月1日我院门诊就诊的手足口病患者共1237例,其中接种疫苗前一年796例,接种疫苗后一年441例。采用描述性流行病学研究方法,对比接种手足口病疫苗前后各一年的流行病学特征。结果 我院接种手足口病疫苗后一年较前一年发生率下降,从年龄分布看出,接种疫苗前后各年龄组均有发病,发病均以5岁以下儿童为主,其中接种疫苗前一年占83.17%,接种疫苗后一年占81.18%,接种疫苗前一年均高于接种疫苗后一年。从职业分布看出,接种疫苗前后各职业组均有发病,发病均以幼托儿童为主,其中接种疫苗前一年占全年52.64%,接种疫苗后一年占全年46.26%,接种疫苗前一年均高于接种疫苗后一年。从时间分布看出,接种疫苗前一年与接种疫苗后一年手足口病发病时间均有明显的季节性特征,高峰期主要为7月份,其次为6月份。接种疫苗前一年6月份占29.52%,7月份占29.90%,接种疫苗后一年6月份占20.18%,7月份占23.81%,接种疫苗前一年均高于接种疫苗后一年。结论 接种手足口病疫苗是降低手足口病发生率最有效方法。     

Association of Interleukin-17F Gene Polymorphism with Enterovirus 71 Encephalitis in Patients with Hand, Foot, and Mouth Disease

Enterovirus 71 (EV71) is one of the common pathogenic agents of hand, foot, and mouth disease (HFMD) and is associated with severe complications including encephalitis. Interleukin (IL)-17F plays an important role in tissue inflammation by inducing release of proinflammatory cytokines and chemokines. We investigated the association between EV71 encephalitis and of IL-17F 7488T/C (rs763780) gene polymorphism, which is known to cause a His-to-Arg substitution at amino acid 161. The study was performed in 58 Chinese patients with EV71 encephalitis and 127 Chinese patients with EV71-related HFMD without complications. Genotyping was determined by the polymerase chain reaction–restriction fragment length polymorphism technique. The patients with EV71 encephalitis had a significantly lower frequency of the IL-17F 7488TC+CC genotypes (10.3 %) as compared to the patients with EV71-related HFMD without complications (27.6 %, p?=?0.008). The frequency of IL-17F 7488C alleles was also significantly lower among the patients with EV71 encephalitis (5.2 %) as compared to that of the patients with EV71-related HFMD without complications (15 %, OR?=?0.310, 95 % CI?=?0.127–0.756, p?=?0.006). Furthermore, homozygotes with the T allele had significantly higher levels of C-reactive protein, white blood cell count, and neutrophil count as compared to the patients with CC+CT genotypes (p?=?0.004, 0.001, and 0.000, respectively). These findings suggested that the IL-17F 7488C allele could be significantly associated with protection against encephalitis in Chinese patients with EV71-related HFMD.     

喜炎平联合单磷酸阿糖腺苷治疗小儿手足口病的 效果及安全性

目的 研究喜炎平联合单磷酸阿糖腺苷治疗小儿手足口病的临床效果及安全性。方法 抽取我院儿科2017年1月~2018年11月收治的117例手足口病患儿,按照随机数字表法分为对照组（58例）和观察组（59例）。对照组应用单磷酸阿糖腺苷治疗,观察组在此基础上联用喜炎平治疗,比较两组临床疗效,观察患儿口腔疱疹、溃疡愈合时间,血清免疫球蛋白水平及治疗期间不良反应发生情况。结果 观察组总有效率高于对照组（96.61% vs 86.21%）,差异有统计学意义（P＜0.05）;患儿口腔疱疹、溃疡愈合时间均较对照组短,差异有统计学意义（P＜0.05）;观察组患儿血清IgA及IgG水平高于对照组,IgM水平低于对照组,差异有统计学意义（P＜0.05）;观察组不良反应发生率为1.69%,低于对照组的8.62%,但差异无统计学意义（P＞0.05）。结论 喜炎平联合单磷酸阿糖腺苷治疗小儿手足口病临床效果显著,可有效缩短患儿口腔疱疹、溃疡愈合时间,提供患儿免疫力,安全性高。     

Isolation of Coxsackievirus A24 variant from patients with hemorrhagic conjunctivitis in Cuba, 2008-2009

Background

An outbreak of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009.

Objective

To determinate the etiological agent associated with the Cuban outbreaks of acute hemorrhagic conjunctivitis during 2008 and 2009.

Study design

Conjunctival swabs and/or faecal samples from 382 patients with clinical diagnosis suggestive of acute hemorrhagic conjunctivitis were subject to viral culture in HEp-2 human laryngeal epidermoid carcinoma cells. Positive samples were identified by a specific Coxsackievirus A24 variant PCR and the 3C protease region of 16 isolates was sequenced for phylogenetic analysis.

Results

Enterovirus cytopathic effect was observed in 138 cases (36%). A higher percent of CA24v was recovered from faecal samples, 19 out of 45 cases (42.2%), than from conjunctival swabs, 127 out of 355 samples (35.8%). All isolates were identified as Coxsackievirus A24 variant. Phylogenetic analysis revealed that 2008 and 2009 Cuban outbreaks were caused by the same virus strains and that isolates were closely related to those from Taiwan (2006-2007), China (2007-2008) and Singapore (2005) with a bootstrap value of 71%.

Conclusions

Outbreaks of acute hemorrhagic conjunctivitis occurred in Cuba in 2008 and 2009 were caused by Coxsackievirus A24 variant. The faecal-oral route is another mode of transmission of CA24v in the acute hemorrhagic conjunctivitis outbreaks. Phylogenetic analysis of Cuban CA24v strains involved in an acute hemorrhagic conjunctivitis outbreak in 2008 and 2009 confirms a new introduction of the CA24 variant into the Americas from South-east Asia.     

深圳市福田区2006-2012年医疗机构消毒效果监测分析

目的了解深圳市福田区医疗机构消毒效果。方法对2006-2012年146家医疗机构消毒效果监测数据进行分析。结果共采样12287份,合格11857份,合格率96.5%。2006-2012年合格率分别为96.7%、97.2%、95.2%、95.9%、95.2%、97.9%、97.2%,差异有统计学意义（χ2=39.465,P〈0.05）。室内空气、物体表面、医护人员手、使用中消毒液、污水合格率依次为97.3%、97.2%、90.9%、99.7%、98.9%、96.5%,差异有统计学意义（χ2=374.858,P〈0.05）。市级医院、区级医院、私营医院和个体诊所的消毒合格率分别为97.8%、97.9%、97.3%和94.1%,差异有统计学意义（χ2=104.470,P〈0.05）。结论采取措施加强对医疗机构消毒工作的管理,重点是个体诊所和手卫生方面。     

深圳市平湖地区2005—2008年HIV／AIDS流行病学分析

目的了解平湖地区2005—2008年HIV／AIDS的流行特征,分析其传染来源和流行趋势,为制订有效的预防控制措施提供科学依据。方法对2005—2008年平湖地区艾滋病监测资料及个案流行病学资料进行分析。结果2005—2008年共发现46例HIV／AIDS病例,男32例,女14例,主要感染途径为性接触（52．17％）和静脉吸毒（36．96％）,25％是通过HIV阳性配偶或性伴侣间感染,46例HIV／AIDS病例中外来流动人员占89．13％。结论HIV／AIDS在该地区的流行已进入快速增长期,艾滋病流行正由高危人群向一般人群扩散,预计今后HIV感染者将大幅度增长,需加大防制力度,防止进一步蔓延。     

Molecular characterization of Coxsackievirus A16 strains isolated from children with severe hand,foot, and mouth disease in Yunnan,Southwest China,during 2009-2015

Coxsackievirus A16 (CV-A16) commonly causes mild symptoms, but severe diseases, such as aseptic meningitis, encephalitis, and even fatal cases, have been reported. Thirteen CV-A16 strains were isolated from patients with severe hand, foot, and mouth disease in Yunnan, Southwest China, from 2009 to 2015. Subgenotype B1a and B1b of CV-A16 were predominantly circulating the region with B1b the predominant strain in recent years. The mean rate of nucleotide substitution based on the VP1 gene sequence was 4.545 × 10 ⁻³ substitution per site per year from 2009 to 2015. These results may help in understanding the genetic diversity of CV-A16 and develop a CV-A16 vaccine.     

Phylogenetic analysis of Bombyx mori nucleopolyhedrovirus polyhedrin and p10 genes in wild isolates from Guangxi Zhuang Autonomous Region, China

Bombyx mori nucleopolyhedrovirus (BmNPV) is a severe pathogen that seriously impacts the sericulture industry. In this study, 45 wild BmNPV isolates were collected from different silkworm-raising regions in China’s Guangxi Zhuang Autonomous Region. Two highly expressed very late genes from each isolate, polyhedrin and p10, were sequenced and subjected to phylogenetic analysis. The polyhedrin gene was found to be highly conserved, while the p10 gene was more variable frequently harboring point mutations and displaying variations in codon use without obvious codon bias. The BmNPV isolates from Guangxi were separated into three main clades, I, II, and III, according to the p10 gene phylogenetic tree. The geographical distribution of clade I isolates in Guangxi showed a concentrated pattern and that of clade II isolates showed a connected pattern. Clade III isolates were irregularly scattered throughout Guangxi. Local transmission of this pathogen clearly occurred in the silkworm-raising regions in Guangxi. This study may provide some data on BmNPV transmission in the silkworm-raising regions and be helpful in devising strategies for the prevention and control of BmNPV disease.     

Retracted: Prevalence and management of severe hand,foot, and mouth disease in Xiangyang,China from 2008-2013

The article, from Journal of Medical Virology, “Prevalence and management of severe hand, foot, and mouth disease in Xiangyang, China from 2008-2013” by Jian Liu and Jing Qi, published online on 16 June 2020 in Wiley Online Library ( wileyonlinelibrary.com ), has been withdrawn by agreement between the authors, the journal Editor Shou-Jiang Gao and John Wiley and Sons, Inc. The withdrawal has been agreed following a request by Jing Qi because the paper had been submitted without approval of both authors.     

Analysis of molecular variation of porcine reproductive and respiratory syndrome virus in Central China from 2006 to 2012

To analyze the epidemiology of PRRSV in Hubei Province of China, 668 serum samples collected from 14 pig-breeding farms were tested. We found that the PRRSV-positive rate was 5.24 % and that HP-PRRSV had become the dominant strain. To further investigate the genetic variation of PRRSV strains in this region, the complete gene sequences of nsp2, orf5, and orf7 from nine PRRSV strains collected during 2011-2012 were determined and compared with 33 known sequences. The results revealed that diverse HP-PRRSV strains are present in this region. An analysis of orf5 gene sequences showed that the strains collected during 2009-2010 formed a tightly clustered branch. When compared with the JXA1 strain, they had one mutation (V29 → A29) in a decoy epitope. Furthermore, we found that the number of potential N-glycosylation sites had apparently increased since 2006. These findings increase our knowledge of PRRSV epidemiology in Central China.