Advanced SearchSearch Tips
Epidemiology and Clinical manifestations of Enterovirus in Pediatric Inpatient in Incheon
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
  • Journal title : Pediatric Infection and Vaccine
  • Volume 23, Issue 1,  2016, pp.46-53
  • Publisher : The Korean Society of Pediatric Infectious Diseases
  • DOI : 10.14776/piv.2016.23.1.46
 Title & Authors
Epidemiology and Clinical manifestations of Enterovirus in Pediatric Inpatient in Incheon
Cho, Byoung Wook; Kwon, Seong Eun; Kwon, Mun Ju; Hur, Myong Je; Kim, Kyung Seon; Hong, Young Jin; Kim, Soon Ki; Kwon, Young Se; Kim, Dong Hyun;
  PDF(new window)
Purpose: Enterovirus (EV) infection in children can manifest various diseases from asymptomatic infection to nonspecific febrile illness, hand-foot-mouth disease, and aseptic meningitis. This study was aimed to investigate epidemiology and clinical significance of various genotypes of EV infections in pediatric inpatient. Methods: We collected the stool samples from the admitted pediatric patients in Inha University Hospital from March 2014 to March 2015. EV detection and genotype identification were performed by real-time RT-PCR and semi-nested RT-PCR. Phylogenetic trees were constructed by neighbor joining method. Results: A total of 400 samples were collected during study period and 112 patients (28%) were diagnosed with EV infections. The mean age of EV positive patients was 2.66 years (0.1-14) and sex ratio was 1.73:1. Genetic sequences of EVs were identified; coxsackievirus B5 (17, 15.2%), coxsackievirus A16 (13, 11.6%), enterovirus 71 (10, 8.9%), and coxsackievirus A2 (9, 8.0%). Nonspecific febrile illness (96, 86%) was the most common clinical manifestation and the duration of fever was 0-11 days (mean 3.1 days). Rash (44, 39%) and meningitis (43, 38%) were followed. Patients who were attending daycare center or had siblings accounted for 82.1%. Phylogenetic relationship tree revealed 6 distinct genogroups among 56 types of EVs. Conclusions: This study is the report of epidemiology, serotype distribution and clinical manifestations of children with EV infection in Incheon. This data will be helpful for further study about the epidemiology of EV infection in Korea.
 Cited by
Abzug MJ. Nonpolio enteroviruses, In: Kliegman RM, Stanton BF, Schor NF, Geme III JWS, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier saunders, 2011:1088-94.

Park KS, Choi YJ, Park JS. Enterovirus infection in Korean children and antienteroviral potential candidate agent. Korean J Pediatr 2012;55:359-66.

Modlin JF. Enteroviruses and parechoviruses, In: Long SS, Pickering LK, Prober CG, editors. Principles and practice of pediatric infectious diseases. 4th ed. Philadelphia: Elsevier saunders, 2012:1172-9.

Jee YM, Cheon DS, Choi WY, Ahn JB, Kim KS, Chung YS, et al. Updates on enterovirus surveillance in Korea. Infect Chemother 2004;36:294-303.

Wu Y, Yeo A, Phoon MC, Tan EL, Poh CL, Quak SH, et al. The largest outbreak of hand; foot and mouth disease in Singapore in 2008: the role of enterovirus 71 and coxsackievirus A strains. Int J Infect Dis 2010;14:e1076-81. crossref(new window)

Yang F, Ren L, Xiong Z, Li J, Xiao Y, Zhao R, et al. Enterovirus 71 outbreak in the People's Republic of China in 2008. J Clin Microbiol 2009;47:2351-2. crossref(new window)

Fujimoto T, Iizuka S, Enomoto M, Abe K, Yamashita K, et al. Hand, foot, and mouth disease caused by coxsackievirus A6, Japan, 2011. Emerg Infect Dis 18:337-9.

Infectious Disease Surveillance Center. Virus isolation/detection from hand, foot and mouth disease cases, 2007-2011. Infectious Agents Surveillance Report. Available at: Assessed 24 September 2015.

Puenpa J, Mauleekoonphairoj J, Linsuwanon P, Suwannakarn K, Chieochansin T, Korkong S, et al. Prevalence and characterization of enterovirus infections among pediatric patients with hand foot mouth disease, herpangina and influenza like illness in Thailand, 2012. PLoS One 2014;9:e98888. crossref(new window)

Korea Centers for Disease Control and Prevention. National laboratory surveillance for enterovirus. Public Health Wkly Rep 2008;1:617-21.

Baek KA, Yeo SG, Lee BH, Park KS, Song JH, Yu JS, et al. Epidemics of enterovirus infection in Chungnam Korea, 2008 and 2009. Virology Journal 2011;8:297. crossref(new window)

Park KS, Lee BH, Baek KA, Cheon DS, Yeo SG, Park JS, et al. Enteroviruses isolated from herpangina and hand-foot-andmouth disease in Korean children. Virology Journal 2012;9:205. crossref(new window)

Park KS, Choi YJ, Park JS. Enterovirus infection in Korean children and antienteroviral potential candidate agent. Korean J Pediatr 2012;55:359-66.

Seo JH, Yeom JS, Youn HS, Han TH, Chung JY. Prevalence of human parechovirus and enterovirus in cerebrospinal fluid samples in children in Jinju, Korea. Korean J Pediatr 2015;58:102-7. crossref(new window)

Park IS, Lee HS, Choi SH, Kim HJ, Hwang SY, Cheon DS, et al. Epidemiology and clinical characteristics of enterovirus infections in children: a single center analysis from 2006 to 2010. Korean J Pediatr Infect Dis 2013;20:81-8. crossref(new window)

Baek DW, Kim JM, Kim KH, Ahn JG, Kim DS. Epidemiologic and clinical features of enteroviral infections in children, a single center study in Korea: 2009. Korean J Pediatr Infect Dis 2010;17:122-9. crossref(new window)

Pöyry T, Kinnunen L, Hyypiä T, Brown B, Horsnell C, Hovi T, et al. Genetic and phylogenetic clustering of enteroviruses. J Gen Virol 1996;77:1699-717. crossref(new window)

Ragonnet-Cronin M, Hodcroft E, Hué S, Fearnhill E, Delpech V, Brown AJ, et al. Automated analysis of phylogenetic clusters. BMC Bioinformatics 2013;14:317. crossref(new window)

Rosychuk RJ. Identifying geographic areas with high disease rates: when do confidence intervals for rates and a disease cluster detection method agree? Int J Health Geogr 2006;5:46. crossref(new window)

Li W, Zhang X, Chen X, Cheng YP, Wu YD, Shu Q, et al. Epidemiology of childhood enterovirus infections in Hangzhou, China. Virol J 2015;12:58. crossref(new window)

Jeon JS, Kim JK, Yu JS, Kim JW. Epidemic trends of enterovirus infections from pediatric patients in Cheonan, Korea. J Clin Lab Anal 2016;30:161-4. crossref(new window)

Cherry JD, Harrision GJ, Kaplan SL, Steinbach WJ, Hotez PJ. Enteroviruses, parechoviruses, and saffold viruses, In: Cherry JD, Krogstad P, editors. Feigin and Cherry's textbook of pediatric infectious diseases. 7th ed. Philadelphia: Elsevier saunders, 2014:2051-108.

Witso E, Cinek O, Aldrin M, Grinde B, Rasmussen T, Wetlesen T, et al. Predictors of sub-clinical enterovirus infections in infants: a prospective cohort study. Int J Epidemiol 2010;39:459-68. crossref(new window)

Saitou N, Nei M. The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol 1987;4:406-25.

Zhang S, Zhao J. Spatio-temporal epidemiology of hand, foot and mouth disease in Liaocheng City, North China. Exp Ther Med 2015;9:811-6. crossref(new window)