Coxsackieviruses infection in northern Taiwan--epidemiology and clinical characteristics.
OBJECTIVE
The epidemiology of coxsackievirus has rarely been investigated in Taiwan. This study was performed to ascertain the epidemiological and clinical characteristics of coxsackievirus infections in Taiwan.


METHODS
457 patients treated at a medical center in northern Taiwan who were positive for coxsackievirus were enrolled in this retrospective study. Patients' medical charts were reviewed for clinical diagnosis, physical examination, laboratory findings, and clinical manifestations.


RESULTS
Three serotypes of coxsackievirus A (A9, 5.3%; A10, 7.2%; A16, 87.5%) were identified among 265 patients, 27.4% of whom were admitted to hospital. The mean (+/- standard deviation [SD]) duration of fever and hospital stay was 2.6 +/- 0.5 days and 4.0 +/- 2.1 days, respectively. Complications were noted in 14 patients (5.3%), all of which involved the central nervous system (CNS). All 6 serotypes of coxsackievirus B (B1, 2.6%; B2, 7.8%; B3, 55.7%; B4, 2.1%; B5, 12.5%; B6, 1.0%; non-typable, 18.2%) were identified in 192 patients, 45.3% of whom were admitted to hospital. The mean (+/- SD) duration of fever and hospital stay was 4.1 +/- 1.0 and 3.4 +/- 0.9 days, respectively. Thirty seven patients (19.3%) had complications, including 34 with CNS involvement. Patients with coxsackievirus B infection had higher hospital admission rates (p < 0.001), more CNS involvement (p < 0.001), and longer fever duration (p < 0.001) than those with coxsackievirus A infection. Patients with coxsackievirus A infection tended to have more skin manifestations (p < 0.001) and oral ulcers (p < 0.001).


CONCLUSIONS
The most common serotypes were coxsackieviruses A16 and B3. Patients with coxsackievirus B infection were more likely to be admitted to hospital, had longer fever duration, and more CNS involvement than patients with coxsackievirus A infection.
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Feng-Bin
FB
Yen
Luan-Yin
LY
Chang
Chuan-Liang
CL
Kao
Ping-Ing
PI
Lee
Chun-Min
CM
Chen
Chin-Yun
CY
Lee
Pei-Lan
PL
Shao
Shu-Chien
SC
Wang
Chun-Yi
CY
Lu
Li-Min
LM
Huang
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003384:Coxsackievirus Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D004770:Enterovirus / Q000145:classification / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012621:Seasons; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology