Epidemiology and Clinical Characteristics of Enterovirus Infections in Children: A Single Center Analysis from 2006 to 2010

In-Soo Park; Hae Sung Lee; Soo-Han Choi; Hye Jin Kim; Seo Yeon Hwang; Doo-Sung Cheon; Jin-Keun Chang

doi:10.14776/kjpid.2013.20.2.81

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Park, Lee, Choi, Kim, Hwang, Cheon, and Chang: Epidemiology and Clinical Characteristics of Enterovirus Infections in Children: A Single Center Analysis from 2006 to 2010

Original Article

Korean Journal of Pediatric Infectious Diseases 2013; 20(2): 81-88.

Published online: 20 August 2013

DOI: https://doi.org/10.14776/kjpid.2013.20.2.81

Epidemiology and Clinical Characteristics of Enterovirus Infections in Children: A Single Center Analysis from 2006 to 2010

In-Soo Park, M.D., Hae Sung Lee, M.D., Soo-Han Choi, M.D., Hye Jin Kim, M.S.^*, Seo Yeon Hwang, M.S.^*, Doo-Sung Cheon, Ph.D.^*, Jin-Keun Chang, M.D.^†

Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center, Seoul, Korea.

^*Division of Vaccine Research, National Institute of Health, Korea Centers for Disease Control & Prevention, Cheongwon-gun, Chungbuk, Korea.

^†Department of Pediatrics, Jecheon Myongji Hospital, Jecheon-si, Chungbuk, Korea.

Corresponding author (soohan.id@gmail.com)

Received 11 March 2013 Revised 7 May 2013 Accepted 20 May 2013

Abstract

Purpose

This study was performed to investigate the epidemiology of enterovirus (EV) infections in children at a secondary hospital during recent 5 years.

Methods

We collected the cerebrospinal fluid, stool and throat swab samples from the pediatric patients with suspected EV infections in KEPCO Medical Center, Seoul, Korea from July 2006 to September 2010. EV detection and genotype identification were performed by RT-PCR at Korea Centers for Disease Control and Prevention.

Results

A total of 386 samples were collected from 277 patients during study period. Ninety-eight patients (35.4%) were diagnosed with EV infections. The RT-PCR positive rate was the highest in throat swab samples (48.3%). The median age of patient was 4.7 years (range, 0.1-12.5 years). Aseptic meningitis (50, 51.0%) was the most common clinical manifestation; herpangina (22, 22.4%) and hand-foot-mouth disease (18, 18.4%). One hundred EVs were isolated from 98 patients and 20 genotypes of EV were identified; Echovirus 30 (28 cases, 28%), Enterovirus 71 (12 cases, 12%), Echovirus 25 (10 cases, 10%), Echovirus 9 (9 cases, 9%) and Coxsackievirus A6 (8 cases, 8%). Aseptic meningitis caused by Echovirus 30 was the most common manifestation in 2008. There was no complicated case caused by Enterovirus 71.

Conclusion

This study showed the epidemiology of confirmed EV infection in children from 2006 to 2010. There is a need for continuous surveillance of EV infections and its clinical manifestations.

Keywords: Enterovirus, Epidemiology, Child

Figures and Tables

Fig. 1

Distribution of Enterovirus-Positive Patients from 2006 to 2010. Positive rate in national laboratory surveillance: 24% in 2006; 18% in 2007; 55.6% in 2008; 30.3% in 2009; 29.6% in 2010 (Source from reference 3 and 6).

Table 1

Enterovirus RT-PCR Positive Rate

^*Nonspecific symptoms such as fever, vomiting, diarrhea or skin rash

Abbreviation: HFMD, hand-foot-mouth disease

Table 2

Characteristics of Patients with Enteroviral Infection

^*Nonspecific symptoms such as fever, vomiting, diarrhea or skin rash

Abbreviations: HFMD, hand-foot-mouth disease; E25, echovirus 25; E30, echovirus 30; CA6, coxsackievirus A6; EV71, enterovirus 71

Table 3

The Number of Enterovirus and Distribution of Serotype, 2006-2010

^*Two patients had two different serotypes of enterovirus simultaneously (coxsackievirus 16 and echovirus 25, echovirus 30 and echovirus 9).

Table 4

Characteristics of Patients with Enterovirus 71

^*Nonspecific symptoms such as fever, vomiting, diarrhea or skin rash

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