소아 수족구병 입원 환자에 있어서 유행 주기에 따른 역학 및 임상 양상의 최근 변화

Abstract

This study has done to know the recent clinical and epidemiological changes by epidemic cycle for hand, foot and mouth disease (HFMD). Methods: I collected the patient information of HFMD retrospectively who had been admitted and diagnosed clinically at the Department of Pediatrics, Yongin Severance Hospital, Yongin, Korea from January 2013 to December 2018. I divided them by epidemic cycle, investigated and compared their pidemiological and clinical features. Results: There were two cycles and the recent one was from 2016 to 2018 (group A, N=21) and the remote one from 2013 to 2015 (group B, N=47). Regarding to group A, their mean age and male to female ratio were 34.2±32.0 months old and 3.2:1. Their clinical manifestations except oral and skin involvements were fever (81.0%), poor oral intake (76.2%), cough (47.6%), rhinorrhea (42.9%). Serum total CO2 concentration was decreased in all cases (100%) and ketonuria (35.0%) was found. Serum alanine transaminase (ALT) concentration was elevated in 4 cases (19.0%). There were 4 pneumonia (19.0%), 1 febrile convulsion (4.8%), but no other neurological manifestation. The admission duration was 2.4±0.6 days . Compared to group B, group A showed different monthly occurrence peak pattern by duration and count (two months and 1 time for group A vs. one month and 2 times for group B), shorter admission duration (3.2±1.6 days for group B), higher platelet counts, more frequent cases with higher erythrocyte sedimentation rate (>20 mm/hr, 82.3% for group A vs. 50.0% for group B) and elevated ALT concentration (no case for group B, ). Conclusion: The cases are decreasing and their features have changed by epidemic cycle. Although it shows a favorable prognosis during both periods, the proportion of systemic involvement such as hepatitis and more severe inflammation is increasing.