Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)

doi:10.1007/s12519-018-0189-8

Review

. 2018 Oct;14(5):437-447.

doi: 10.1007/s12519-018-0189-8. Epub 2018 Oct 3.

Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)

Xing-Wang Li¹, Xin Ni², Su-Yun Qian³, Quan Wang³, Rong-Meng Jiang¹, Wen-Bo Xu⁴, Yu-Cai Zhang⁵, Guang-Jun Yu⁶, Qiang Chen⁷, Yun-Xiao Shang⁸, Cheng-Song Zhao⁹, Hui Yu¹⁰, Ting Zhang¹¹, Gang Liu⁹, Hui-Ling Deng¹², Jie Gao¹³, Xian-Gui Ran¹⁴, Qiao-Zhi Yang¹⁵, Bian-Li Xu¹⁶, Xue-Yong Huang¹⁶, Xing-Dong Wu¹⁷, Yi-Xiao Bao¹⁸, Yi-Ping Chen¹⁹, Zhi-Hai Chen¹, Qing-Quan Liu²⁰, Guo-Ping Lu²¹, Chun-Feng Liu²², Rong-Bing Wang²³, Guo-Liang Zhang²⁴, Fang Gu²⁵, Hong-Mei Xu²⁶, Ying Li²⁷, Tao Yang²⁸

Affiliations

¹ Infectious Disease Diagnosis and Treatment Center, Beijing Ditan Hospital Capital Medical University, Beijing, China.
² Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China. nixin@bch.com.cn.
³ Prediatric Intensive Care Unit, Beijing Children's Hospital of Capital Medical University, Beijing, China.
⁴ National Institute For Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
⁵ Pediatric Intensive Care Unit, Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
⁶ Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
⁷ Pneumology department, Jiangxi Provincial Children's Hospital, Nanchang, China.
⁸ Department of Pediatric Pneumology, Shengjing Hospital of China Medical University, Shenyang, China.
⁹ Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China.
¹⁰ Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
¹¹ Digestive Department, Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
¹² Department of Infectious Diseases, The Children's Hospital of Xi 'an, Xi'an, China.
¹³ Infection Control Office, Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
¹⁴ Department of Respiratory Medicine, People's Hospital of Fuyang City, Fuyang, China.
¹⁵ Department of Pediatrics, People's Hospital of Liaocheng City, Liaocheng, China.
¹⁶ Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China.
¹⁷ Department of Pediatrics, Xiamen Maternal and Child Health Care Hospital, Xiamen, China.
¹⁸ Pneumology Department, Shanghai Children's Medical Center of Shanghai Jiaotong University Medical School, Shanghai, China.
¹⁹ Department of Pediatrics Infectious Diseases, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
²⁰ Beijing Hospital of Traditional Chinese Medicine, Beijing, China.
²¹ Prediatric Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, China.
²² Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, China.
²³ Department of Integrated Traditional Chinese and Western Medicine, Beijing Ditan Hospital Capital Medical University, Beijing, China.
²⁴ Department of Infectious Diseases, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China.
²⁵ Pneumology Department, Baoding Hospital of Beijing Children's Hospital, Baoding, China.
²⁶ Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China.
²⁷ Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China.
²⁸ Department of Pediatrics, Yan'an Hospital of Kunming City, Kunming, China.

PMID: 30280313
DOI: 10.1007/s12519-018-0189-8

Review

Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)

Xing-Wang Li et al. World J Pediatr. 2018 Oct.

. 2018 Oct;14(5):437-447.

doi: 10.1007/s12519-018-0189-8. Epub 2018 Oct 3.

Authors

Affiliations

¹ Infectious Disease Diagnosis and Treatment Center, Beijing Ditan Hospital Capital Medical University, Beijing, China.
² Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China. nixin@bch.com.cn.
³ Prediatric Intensive Care Unit, Beijing Children's Hospital of Capital Medical University, Beijing, China.
⁴ National Institute For Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
⁵ Pediatric Intensive Care Unit, Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
⁶ Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
⁷ Pneumology department, Jiangxi Provincial Children's Hospital, Nanchang, China.
⁸ Department of Pediatric Pneumology, Shengjing Hospital of China Medical University, Shenyang, China.
⁹ Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China.
¹⁰ Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
¹¹ Digestive Department, Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
¹² Department of Infectious Diseases, The Children's Hospital of Xi 'an, Xi'an, China.
¹³ Infection Control Office, Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
¹⁴ Department of Respiratory Medicine, People's Hospital of Fuyang City, Fuyang, China.
¹⁵ Department of Pediatrics, People's Hospital of Liaocheng City, Liaocheng, China.
¹⁶ Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China.
¹⁷ Department of Pediatrics, Xiamen Maternal and Child Health Care Hospital, Xiamen, China.
¹⁸ Pneumology Department, Shanghai Children's Medical Center of Shanghai Jiaotong University Medical School, Shanghai, China.
¹⁹ Department of Pediatrics Infectious Diseases, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
²⁰ Beijing Hospital of Traditional Chinese Medicine, Beijing, China.
²¹ Prediatric Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, China.
²² Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, China.
²³ Department of Integrated Traditional Chinese and Western Medicine, Beijing Ditan Hospital Capital Medical University, Beijing, China.
²⁴ Department of Infectious Diseases, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China.
²⁵ Pneumology Department, Baoding Hospital of Beijing Children's Hospital, Baoding, China.
²⁶ Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China.
²⁷ Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China.
²⁸ Department of Pediatrics, Yan'an Hospital of Kunming City, Kunming, China.

PMID: 30280313
DOI: 10.1007/s12519-018-0189-8

Abstract

Background: Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed.

Methods: National Health Commission of China assembled an expert committee for a revision of the guidelines. The committee included 33 members who are specialized in diagnosis and treatment of HFMD.

Results: Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases.

Conclusion: The guidelines can provide systematic guidance on the diagnosis and management of HFMD.

Keywords: Diagnosis; Guidelines; HFMD; Treatment.

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ZYLX201602/The Key Medical Specialty Program of Sailing Plans organized by Beijing Municipal Administration of Hospitals

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[1] PLoS Negl Trop Dis. 2013 Dec 19;7(12):e2599 - PubMed

[2] PLoS Negl Trop Dis. 2013 Dec 19;7(12):e2599 - PubMed

[3] Lancet Infect Dis. 2010 Nov;10(11):778-90 - PubMed

[4] Lancet Infect Dis. 2010 Nov;10(11):778-90 - PubMed

[5] Mol Psychiatry. 2008 Mar;13(3):293-301 - PubMed

[6] Mol Psychiatry. 2008 Mar;13(3):293-301 - PubMed

[7] Zhongguo Dang Dai Er Ke Za Zhi. 2008 Feb;10(1):38-41 - PubMed

[8] Zhongguo Dang Dai Er Ke Za Zhi. 2008 Feb;10(1):38-41 - PubMed

[9] BMC Infect Dis. 2016 Nov 21;16(1):691 - PubMed

[10] BMC Infect Dis. 2016 Nov 21;16(1):691 - PubMed

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Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)

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Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)

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