Objective To identify the etiological characteristics and diagnostic significance of hand, foot and mouth disease (HFMD) in Baoshan District of Shanghai by data collected from 2009 to 2011.
Methods Specimens of throat swabs, anal swabs or faeces and herpes fluids of patients with HFMD were collected from March 2009 to December 2011 to detect nucleic acid of enterovirus 71 (EV71), coxsackievirus A16 (CoxA16) and other enterovirus.
Results From 2009 to 2011, the total positive enterovirus rates of all samples were 59.00%, 72.44% and 79.00% respectively. The positive rate of EV71 in the severe or fatal cases was 90.91%, significantly higher than those of the general cases (χ2=45.97, P < 0.001) and the clustered cases (χ2=56.85, P < 0.001). The positive rates of enterovirus in throat swabs, anal swabs or faeces, herpes fluids and pharyngeal aspirates were 68.02%, 86.67%, 71.43%, and 25.00% respectively. The coincidence rate of throat swabs and anal swabs or faeces was 83.53%; and that of throat swabs and herpes was 100.00%. There was a significant difference in the positive rates of nucleic acid between specimens collected 0-4 days and 5-10 days after onset (79.73% versus 45.61%, χ2=30.91, P < 0.001).
Conclusion The main pathogens that caused HFMD in Baoshan District from 2009-2011 were EV71 and CoxA16. The detection rates increased year by year with varied dominant pathogens for each year. Severe or fatal HFMD cases were mainly caused by EV71 in this area. Throat swabs, anal swabs or faeces, and herpes fluids show a high diagnostic value on HFMD monitoring. Collecting HFMD specimens within 4 days after onset is proposed for HFMD diagnosis.
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