Volume 25, Number 4—April 2019
Dispatch
Enterovirus A71 Phenotypes Causing Hand, Foot and Mouth Disease, Vietnam
, Nguyen To Anh, Nguyen Thi Thu Hong, Le Nguyen Truc Nhu, Lam Anh Nguyet, Tran Tan Thanh, Nguyen Thi Han Ny, Vu Thi Ty Hang, Truong Huu Khanh, Ho Lu Viet, Do Chau Viet, Ha Manh Tuan, Nguyen Thanh Hung, Du Tuan Quy, Do Quang Ha, Phan Tu Qui, Le Nguyen Thanh Nhan, Guy Thwaites, Nguyen Van Vinh Chau, Louise Thwaites, H. Rogier van Doorn, and Le Van Tan
Table 1
Demographics and clinical severities of enterovirus A71 in patients with hand, foot and mouth disease, Vietnam, July 2013–July 2015*
| Characteristic | Total EV-A71 cases enrolled, n = 379 | EV-A71 cases included for phylogenetic analysis, n = 146 | Subgenogroup C4 cases, n = 10 | Subgenogroup B5 cases, n = 136 |
|---|---|---|---|---|
| Sex | ||||
| M | 213 (56.2) | 89 (61) | 8 (80) | 81 (59.6) |
| F |
166 (43.8) |
57 (39) |
2 (20) |
55 (40.4) |
| Median age, mo (range) |
21.9 (14.3–32.1) |
19.4 (13.2–30.8) |
13.9 (15.5–23.5) |
19.6 (13–31.2) |
| Discharge grade† | ||||
| 1 | 168 (44.3) | 78 (53.4) | 0 | 78 (57.4) |
| 2a | 120 (31.7) | 42 (28.8) | 3 (30) | 39 (28.7) |
| 2b1 | 30 (7.9) | 13 (8.9) | 4 (40) | 9 (6.6) |
| 2b2 | 16 (4.2) | 10 (6.8) | 2 (20) | 8 (5.9) |
| 3 | 43 (11.3) | 3 (2.1) | 1 (10) | 2 (1.5) |
| 4 |
2 (0.5) |
0 |
0 |
0 |
| Death | 0 | 0 | 0 | 0 |
*Values are no. (%) except as indicated. EV-A71, enterovirus A71.
†Grade 1, mouth ulcers or vesicles or papules on hands, feet, or buttocks, with or without mild fever (temperature <39°C). Grade 2a, central nervous system involvement, (myoclonus reported by parents or caregivers only, temperature >39°C or ataxia). Grade 2b1, myoclonus observed by medical staff or history of myoclonus and lethargy or pulse >130 bpm. Grade 2b2, ataxia, nystagmus, limb weakness, cranial nerve palsies, persistent high fever, or pulse >150 bpm. Grade 3, autonomic dysfunction with sweating, hypertension, tachycardia, and tachypnea. Grade 4, additional cardiopulmonary compromise with pulmonary edema or shock syndrome.