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Open Access Research

Excretion of enterovirus 71 in persons infected with hand, foot and mouth disease

Jie Li, Changying Lin, Mei Qu, Xinyu Li, Zhiyong Gao, Xin Zhang, Yuan Liu, Ying Huang, Xiaoli Wang, Lei Jia, Xitai Li, Guirong Liu, Hanqiu Yan, Lijuan Chen and Quanyi Wang*

Author Affiliations

Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, No.16, Hepingli middle Road, Beijing, 100013, People’s Republic of China

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Virology Journal 2013, 10:31  doi:10.1186/1743-422X-10-31

Published: 23 January 2013

Abstract

Background

Hand, foot and mouth disease (HFMD) is a common illness in young children. It also can be seen in adults occasionally. Enterovirus 71 (EV71), a pathogen that causes not only HFMD but also neurological complications and even death, has caused many HFMD outbreaks in China. However, till now the data about the duration of EV71 shedding is very limited.

Results

A total of 136 throat swabs and fecal samples were collected from 27 children and 3 adults, which includs 7 close contacts, 9 mild cases and 14 severe cases,. The participants were divided into three groups namely, severe case group, mild case group and close contact group. All the samples were assayed with real-time polymerase chain reaction (PCR). Kruskal-Wallis Test was employed to compare the difference in duration of viral RNA shedding among three groups. The results showed that significant difference in duration of EV71 shedding was found among three groups (P < 0.01). The longest duration of EV71 shedding in fecal samples is 54 days and 30 days in throat swabs.

Conclusions

HFMD is characterized by extended excretion of EV71. Our results suggest that the duration of EV71 shedding is correlated with the severity of the disease. EV71 shedding through feces can persist more than 54 days. Prolonged virus shedding is a potential risk factor of proliferating HFMD epidemic.

Keywords:
Hand, foot and mouth disease; Enterovirus 71; Virus excretion