Hand, Foot, and Mouth disease (virus) strongly associated with low vitamin D – May 2017

Clinical Significance and Prognostic Effect of Serum 25-hydroxyvitamin D Concentrations in Critical and Severe Hand, Foot and Mouth Disease.

Nutrients. 2017 May 10;9(5). pii: E478. doi: 10.3390/nu9050478.
Dang HX1,2,3, Liu CJ4,5,6, Li J7,8,9, Chen SJ10,11,12, Xu F13,14,15.

VitaminDWiki

This viral disease has been prevelant in Asia and increasing perhaps 10X in a decade
Apparently started in the US around 2010 - but is not tracked (No ID code?)
HFMD is associated with Low Vitamin D
The more severe the HFMD, the lower the vitamin D level
Children dying of HFMD have the lowest levels of vitamin D

Severe hand, foot, and mouth virus is 2.9 X more likely if poor Vitamin D receptor – Oct 2018
Based on 10,000+ Vitamin D studies, VitaminDWiki
suspects that a good level of Vitamin D would prevent HFMD
And that an OK level of vitamin D would reduce the severity/duration of HFMD
Intervention - Vitamin D category listing has 821 items along with related searches
Virus category listing has 1395 items along with related searches
Meta-analysis of Vitamin D

The Epidemiology of Hand, Foot and Mouth Disease in Asia: A Systematic Review and Analysis - 2017 Download the PDF from VitaminDWiki__ the word VITAMIN does not occur once

Epidemiological Characteristics and Spatial-Temporal Distribution of Hand, Foot, and Mouth Disease in Chongqing, China, 2009–2016
Download the PDF from VitaminDWiki
Perhaps 10X increase in HFMD in a decade in Thailand

Hand-foot-and-mouth disease in adults Clinical Advisor 2017 " Statistics are maintained in China, and approximately 1,900,000 cases and four deaths were reported in 2015."

Download the PDF from VitaminDWiki

OBJECTIVE:
To examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with critical and severe hand, foot and mouth disease (HFMD) and assess the clinical significance and prognostic effect of 25(OH)D concentrations in children with HFMD.

METHODS:
This is a prospective observational study. The 138 children with HFMD were divided into common (49 cases), severe (52 cases), and critical (37 cases) HFMD groups. Another 59 healthy children undergoing outpatient medical examinations during the same period were chosen as the control group. Serum 25(OH)D concentrations were measured in all the subjects, and each group was subdivided by serum 25(OH)D concentration into 25(OH)D normal (≥30 ng/mL); insufficiency (20-29.9 ng/mL), and deficiency (<20 ng/mL) groups. The pediatric critical illness score (PCIS) was recorded for the critical and severe HFMD group upon admission to the pediatric intensive care unit (PICU). Children with critical and severe HFMD were also monitored for blood lactate (LAC), serum calcium ions (Ca++), D-dimer (DD), lactate dehydrogenase (LDH), and creatine kinase-MB (CK-MB) levels; the incidences of brainstem encephalitis, neurogenic pulmonary edema, and circulatory failure; and the 14-day mortality rate.

RESULTS:
Serum 25(OH)D concentrations were generally low in all groups. The critical HFMD group showed a significantly lower serum 25(OH)D mean concentration (20.0 ± 8.4 ng/mL) and a higher proportion of deficiency (18%) compared with the control group (28.1 ± 6.6 ng/mL, 8%), common (29.5 ± 8.1 ng/mL, 10%) and severe (31.9 ± 9.7 ng/mL, 8%) HFMD groups (p < 0.05). In the critical and severe HFMD groups, the 25(OH)D deficiency group had lower PCISs than the 25(OH)D normal and insufficiency groups (p < 0.05); and had higher values than the latter two groups for LAC, LDH, CK-MB and DD; and the incidences of brainstem encephalitis, neurogenic pulmonary edema, circulatory failure, and mortality (p < 0.05). The death group showed significantly lower serum 25(OH)D concentrations and PCISs than the survival group (p < 0.05) and had higher LAC, LDH, CK-MB and DD levels and higher incidences of brainstem encephalitis, neurogenic pulmonary edema, and circulatory failure (p < 0.05). Logistic regression analysis revealed that the serum 25(OH)D concentration was an independent factor that influenced mortality in children with critical and severe HFMD.

CONCLUSIONS:
In this study, we find the serum 25(OH)D concentrations are substantially reduced in children with critical and severe HFMD and are associated with the severity of HFMD. The serum 25(OH)D concentrations may have clinical value for determining the progression of critical HFMD and predicting the risk of death. Further evidence is needed before it can be stated that 25(OH)D concentrations have clinical value in HMFD diagnosis.

PMID: 28489032 PMCID: PMC5452208 DOI: 10.3390/nu9050478