title: Risk factors for critical disease and death from hand, foot and mouth disease.
abstract: BACKGROUND
  There has been a high mortality and morbidity rate of critical and fatal patients from hand, foot and mouth disease (HFMD) in China in recent. Causes for development of critical and fatal disease remain unclear.
  
  
  METHODS
  We performed a case-control study to assess the association between use of drugs and development of critical disease and death from HFMD.
  
  
  RESULTS
  We found that glucocorticoids treatment was associated with a greater incidence of severe HFMD, whereas andrographolides treatment was associated with a protective effect when they are used for treatment within 48 hours after onset or before being diagnosed as critical.
  
  
  CONCLUSIONS
  We recommend that glucocorticoids should not be used for mild HFMD and andrographolides should undergo clinical trials for treatment of enterovirus 71 infections.
authors.affiliation: From the *Taizhou Center for Disease Control and Prevention, Jiangsu Province, Taizhou; †Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China; ‡U.S. Centers for Disease Control and Prevention, Atlanta, GA; and §Chongqing Center for Disease Control and Prevention, Chongqing, China.
authors.forename: Yilin
authors.initials: Y
authors.lastname: He
authors.forename: Jianguo
authors.initials: J
authors.lastname: Yang
authors.forename: Guang
authors.initials: G
authors.lastname: Zeng
authors.forename: Tao
authors.initials: T
authors.lastname: Shen
authors.forename: Robert E
authors.initials: RE
authors.lastname: Fontaine
authors.forename: Lijie
authors.initials: L
authors.lastname: Zhang
authors.forename: Guoqing
authors.initials: G
authors.lastname: Shi
authors.forename: Yulin
authors.initials: Y
authors.lastname: Wang
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.forename: Jiang
authors.initials: J
authors.lastname: Long
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016638:Critical Illness; D004224:Diterpenes / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006232:Hand, Foot and Mouth Disease / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000998:Antiviral Agents; D004224:Diterpenes; D005938:Glucocorticoids; C030419:andrographolide