Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)
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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.
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.
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.
The guidelines can provide systematic guidance on the diagnosis and management of HFMD.
KeywordsDiagnosis Guidelines HFMD Treatment
The Chinese version of this Guideline was published in the June issue of Chin J Infect Dis in 2018. We acknowledge the editing assistance of the English version of HFMD guidelines from Stephen Toovey, MD, PhD, and Jim Wu PhD, and also thank Mi Yao and Zhi-Jie Xu for translation support.
LXW, NX, QSY: contributed equally to this guideline. All the other authors confirmed the final version of the guideline.
The National Clinical Key Department of Infectious Diseases; The Key Medical Specialty Program of Sailing Plans organized by Beijing Municipal Administration of Hospitals (No. ZYLX201602)
Compliance with ethical standards
Conflict of interest
No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
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