Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
권호 표지

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

2006-2010년 단일기관 소아에서의 엔테로바이러스 감염 역학 및 임상 양상에 관한 연구

  • Park, In-Soo (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Lee, Hae Sung (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Choi, Soo-Han (Department of Pediatrics, KEPCO Medical Foundation KEPCO Medical Center) ;
  • Kim, Hye Jin (Division of Vaccine Research, National Institute of Health, Korea Centers for Disease Control & Prevention) ;
  • Hwang, Seo Yeon (Division of Vaccine Research, National Institute of Health, Korea Centers for Disease Control & Prevention) ;
  • Cheon, Doo-Sung (Division of Vaccine Research, National Institute of Health, Korea Centers for Disease Control & Prevention) ;
  • Chang, Jin-Keun (Department of Pediatrics, Jecheon Myongji Hospital)
  • 박인수 (한전의료재단 한전병원 소아청소년과) ;
  • 이해성 (한전의료재단 한전병원 소아청소년과) ;
  • 최수한 (한전의료재단 한전병원 소아청소년과) ;
  • 김혜진 (질병관리본부 국립보건연구원 백신연구과) ;
  • 황서연 (질병관리본부 국립보건연구원 백신연구과) ;
  • 천두성 (질병관리본부 국립보건연구원 백신연구과) ;
  • 장진근 (제천명지병원 소아청소년과)
  • Received : 2013.03.11
  • Accepted : 2013.05.20
  • Published : 2013.08.25
Download PDF
⟨ Previous Next ⟩

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.

목 적 : 본 연구는 최근 5년간 엔테로바이러스의 분자유전학적 역학 및 임상 양상을 조사하고자 하였다. 방 법 : 2006년부터 2010년까지 한전병원에서 엔테로바이러스 감염이 의심되는 소아 환자의 검체를 질병관리본부로 의뢰하였고, 감염이 확진된 환자를 후향적으로 분석하였다. 결 과 : 277명 환자에서 386개의 검체가 분석되었고 그 중 적어도 한 개 이상의 검체에서 양성을 소견을 보인 환자는 총 98명(35.4%) 이었다. 98명의 환자로부터 100개의 엔테로바이러스가 확인되었고, echovirus 30형 28건(28%), enterovirus 71형 12건(12%), echovirus 25형 10건(10%), echovirus 9형 9건(9%), coxsackievirus A6형 8건(8%) 순이었다. 연도별 분포는 2006년과 2008년에 각각 echovirus 25형 및 echovirus 30형에 의한 무균성 뇌수막염이 각각 61.5% 및 69.2%로 대부분을 차지하였다. Enterovirus 71형에 의한 합병증을 동반한 환자는 없었다. 결 론 : 단일기관에서 최근 5년간 분리된 엔테로바이러스 감염 양상을 확인하였고 우리나라 소아에서의 최근 역학을 파악하는 데 도움이 될 것으로 사료된다.

Keywords

References

  1. Solomon T, Lewthwaite P, Perera D, Cardosa MJ, Mc- Minn P, Ooi MH. Virology, epidemiology, pathogenesis, and control of enterovirus 71. Lancet Infect Dis 2010;10:778-90. https://doi.org/10.1016/S1473-3099(10)70194-8
  2. Ooi MH, Wong SC, Lewthwaite P, Cardosa MJ, Solomon T. Clinical features, diagnosis, and management of enterovirus 71. Lancet Neurol 2010;9:1097-105. https://doi.org/10.1016/S1474-4422(10)70209-X
  3. Korea Centers for Disease Control and Prevention. National laboratory surveillance for enterovirus. Public Health Weekly Report 2008;1:617-21. Available at http: //www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuI ds=HOME001-MNU0004-MNU0036-MNU0037[accessed on 2 Mar 2013]
  4. Jee Y, Cheon D, Choi W, Ahn J, Kim K, Chung Y, et al. Updates on enterovirus surveillance in Korea. Infect Chemother 2004;36:294-303.
  5. Kim SJ, Kim JH, Kang JH, Kim DS, Kim KH, Kim KH, et al. Risk factors for neurologic complications of hand, foot and mouth disease in the Republic of Korea, 2009. J Korean Med Sci 2013;28:120-7.
  6. Korea Centers for Disease Control and Prevention. Laboratory- based surveillance of enterovirus associated diseases in Korea, 2010. Public Health Weekly Report 2011;4:935-9. Available at http://www.cdc.go.kr/CDC/ info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU0004-MNU0036-MNU0037 [accessed on 2 Mar 2013]
  7. Ryu WS, Kang B, Hong J, Hwang S, Kim A, Kim J, et al. Enterovirus 71 infection with central nervous system involvement, South Korea. Emerg Infect Dis 2010;16:1764-6. https://doi.org/10.3201/eid1611.100104
  8. Kim KH. Enterovirus 71 infection: An experience in Korea, 2009. Korean J Pediatr 2010;53:616-22. https://doi.org/10.3345/kjp.2010.53.5.616
  9. Cho HK, Lee NY, Lee H, Kim HS, Seo JW, Hong YM, et al. Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009. Korean J Pediatr 2010;53:639-43. https://doi.org/10.3345/kjp.2010.53.5.639
  10. Kim JH, Kim SJ, Cheon DS. Hand-foot-mouth disease related to enterovirus 71. J Korean Med Assoc 2009;52:886-94. https://doi.org/10.5124/jkma.2009.52.9.886
  11. Park KS, Choi YJ, Park JS. Enterovirus infection in Korean children and anti-enteroviral potential candidate agents. Korean J Pediatr 2012;55:359-66. https://doi.org/10.3345/kjp.2012.55.10.359
  12. Kim HJ, Kang B, Hwang S, Hong J, Kim K, Cheon DS. Epidemics of viral meningitis caused by echovirus 6 and 30 in Korea in 2008. Virol J 2012;9:38. https://doi.org/10.1186/1743-422X-9-38
  13. Baek K, Yeo S, Lee B, Park K, Song J, Yu J, et al. Epidemics of enterovirus infection in Chungnam Korea, 2008 and 2009. Virol J 2011;8:297. https://doi.org/10.1186/1743-422X-8-297
  14. Korea Centers for Disease Control and Prevention. Press release: Hand-foot-and mouth disease and enteroviral diseases are classfied as national notificable infectious diseases. [cited on 22 Jun 2009 and modified on 20 Sep 2012]. Availabe at http://www.cdc.go.kr/CDC/contents/ CdcKrContentLink.jsp?fid=21&cid=8983&ctype=1[accessed on 2 Mar 2013]
  15. Ooi MH, Solomon T, Podin Y, Mohan A, Akin W, Yusuf MA, et al. Evaluation of different clinical sample types in diagnosis of human enterovirus 71-associated hand-foot-and-mouth disease. J Clin Microbiol 2007;45:1858-66. https://doi.org/10.1128/JCM.01394-06
  16. Baek K, Park K, Jung E, Chung E, Park J, Choi H, et al. Molecular and epidemiological characterization of enteroviruses isolated in Chungnam, Korea from 2005 to 2006. J Microbiol Biotechnol 2009;19:1055-64. https://doi.org/10.4014/jmb.0810.584
  17. Ryu WS, Kang B, Hong J, Hwang S, Kim J, Cheon DS. Clinical and etiological characteristics of enterovirus 71-related diseases during a recent 2-year period in Korea. J Clin Microbiol 2010;48:2490-4. https://doi.org/10.1128/JCM.02369-09
  18. Choi YJ, Park KS, Baek KA, Jung EH, Nam HS, Kim YB, et al. Molecular characterization of echovirus 30-associated outbreak of aseptic meningitis in Korea in 2008. J Microbiol Biotechnol 2010;20:643-9.
  19. Cha SH. Recently prevalent infectious diseases among children: meningitis due to enteroviral infection. J Korean Med Assoc 2008;51:935-41. https://doi.org/10.5124/jkma.2008.51.10.935
  20. Park K, Lee B, Baek K, Cheon D, Yeo S, Park J, et al. Enteroviruses isolated from herpangina and handfoot- and-mouth disease in Korean children. Virol J 2012;9:205. https://doi.org/10.1186/1743-422X-9-205
  21. Choi CS, Choi YJ, Choi UY, Han JW, Jeong DC, Kim HH, et al. Clinical manifestations of CNS infections caused by enterovirus type 71. Korean J Pediatr 2011;54:11-6. https://doi.org/10.3345/kjp.2011.54.1.11
  22. 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