Abstract:
Hand-foot-and-mouth disease (HFMD) is a viral illness commonly seen in young children under 5 years of age, characterized by typical manifestations such as oral herpes and rashes on the hands and feet. These symptoms typically resolve spontaneously within a few days without complications. Over the past two decades, our understanding of HFMD has greatly improved and it has received significant attention. A variety of research studies, including epidemiological, animal, and in vitro studies, suggest that the disease may be associated with potentially fatal neurological complications. These findings reveal clinical, epidemiological, pathological, and etiological characteristics that are quite different from initial understandings of the illness. It is important to note that HFMD has been linked to severe cardiopulmonary complications, as well as severe neurological sequelae that can be observed during follow-up. At present, there is no specific pharmaceutical intervention for HFMD. An inactivated Enterovirus A71 (EV-A71) vaccine that has been approved by the China Food and Drug Administration (CFDA) has been shown to provide a high level of protection against EV-A71-related HFMD. However, the simultaneous circulation of multiple pathogens and the evolution of the molecular epidemiology of infectious agents make interventions based solely on a single agent comparatively inadequate. Enteroviruses are highly contagious and have a predilection for the nervous system, particularly in child populations, which contributes to the ongoing outbreak. Given the substantial impact of HFMD around the world, this Review synthesizes the current knowledge of the virology, epidemiology, pathogenesis, therapy, sequelae, and vaccine development of HFMD to improve clinical practices and public health efforts.
摘要:
手足口病(HFMD)是一种病毒性疾病,常见于5岁以下的幼儿,其特征是典型的表现,如手和脚上的口腔疱疹和皮疹。这些症状通常在几天内自发缓解而没有并发症。在过去的二十年里,我们对手足口病的认识有了很大的提高,并受到了极大的关注。各种各样的研究,包括流行病学,动物,和体外研究,提示该疾病可能与潜在的致命神经系统并发症有关。这些发现揭示了临床,流行病学,病态,和病因学特征与最初对疾病的理解有很大不同。值得注意的是,手足口病与严重的心肺并发症有关,以及在随访期间可以观察到的严重神经系统后遗症。目前,手足口病没有具体的药物干预措施。已被中国食品药品监督管理局(CFDA)批准的灭活肠道病毒A71(EV-A71)疫苗已被证明可提供针对EV-A71相关HFMD的高水平保护。然而,多种病原体的同时循环和传染性病原体分子流行病学的演变使得仅基于单一病原体的干预措施相对不足。肠病毒具有高度传染性,对神经系统有好感,特别是在儿童群体中,这有助于持续的爆发。鉴于手足口病在世界各地的巨大影响,这篇综述综合了当前的病毒学知识,流行病学,发病机制,治疗,后遗症,以及手足口病的疫苗开发,以改善临床实践和公共卫生工作。