Risk factors for severe hand foot mouth disease in Singapore: a case control study

Risk factors for severe hand foot mouth disease in Singapore: a case control study

2015 BMC Infect Dis

Chew, S. P. | Chong, S. L. | Barbier, S. | Matthew, A. | Lee, J. H. | Chan, Y. H. | Volume: 15, Issue: , Pages: 486, Case-Control Studies, Central Nervous System Diseases/etiology/virology, Child, Child, Preschool, Enterovirus/pathogenicity, Enterovirus Infections/complications/epidemiology, Female, Hand, Foot and Mouth Disease/complications/*epidemiology/*virology, Heart Diseases/etiology/virology, Hospitalization, Humans, Infant, Logistic Models, Male, Risk Factors, Singapore/epidemiology, Survival Rate,

BACKGROUND: Hand foot mouth disease (HFMD) is a common childhood infection that can potentially lead to serious complications. The aim of this study is to identify risk factors of acquiring severe HFMD in our population. METHODS: We performed a case control study using patients admitted to our hospital from August 2004 to July 2014. Cases were patients with severe HFMD disease while controls were age-matched patients obtained from the same year, in a 2:1 ratio. Data comprising demographic characteristics, clinical symptoms and signs, and lab findings were collected. Conditional univariable logistic regression was performed to determine risk factors for severe disease. RESULTS: A total of 24 cases of severe HFMD were identified and matched with 48 controls. Seventeen (70.8%) cases had central nervous system complications. Seven (29.2%) had cardiovascular complications without evidence of myocarditis. One patient died of encephalitis. The overall mortality of severe disease is 4%. Evidence of hypoperfusion, seizure, altered mentation, meningeal irritation, tachycardia, tachypnea, raised absolute neutrophil count and EV-A71 (Enterovirus A71) positivity were significantly associated with a severe course of HFMD. CONCLUSION: In managing children with HFMD, physicians should consider these factors to help identify patients at risk for severe disease.

https://www.doi.org/10.1186/s12879-015-1195-2