title: Clinical features of severe cases of hand, foot and mouth disease with EV71 virus infection in China.
abstract: BACKGROUND
  Hand, foot and mouth disease (HFMD) caused by EV71 infection has become one of the major public health issues in China, which deeply affects children's health. The prevention and control of EV71 is a challenge currently because there is no safe and effective vaccine or antiviral medications available.
  
  
  METHODS
  A case control study was conducted in a designated hospital to compare severe and mild cases of patients infected with the EV71 virus. Demographic information along with clinical features of HFMD was collected through a standardized questionnaire. Multi-factorial logistic regression was used to analyze independent associations between potential risk factors and severe HFMD.
  
  
  RESULTS
  There were 120 cases (60 cases and 60 controls) collected. The male-to-female ratio was 1.3: 1 in the case group and 1.7: 1 in the control group. Multi-factorial logistic regression revealed that the main risk factors for severe cases were highest body temperature being ≥ 38.5°C (OR = 9.45, 95% CI: 2.07-43.11, p < 0.05), first visited a village level clinic (OR = 4.72, 95% CI: 1.15-19.45, p < 0.05), etc.
  
  
  CONCLUSIONS
  Close surveillance combined with laboratory testing should be in place during the epidemic period of HFMD. Grass root level medical facilities and training of clinical and laboratory staff should be reinforced so that the diagnostic and treatment capacity can be improved.
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention, Beijing, PR China ; Unit Infections Epidemiology, Robert Koch Institut, Berlin, Germany.
authors.forename: Weidong
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Jiyuan City Center for Disease Control and Prevention, Jiyuan, PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yan
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Shiwen
authors.initials: S
authors.lastname: Wang
authors.affiliation: Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Junling
authors.initials: J
authors.lastname: Sun
authors.affiliation: Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Chang
authors.affiliation: Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Zijun
authors.initials: Z
authors.lastname: Wang
keywords: EV71; foot and mouth disease; hand; risk factor
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