Epidemic hand, foot and mouth disease caused by human enterovirus 71, Singapore.
Singapore experienced a large epidemic of hand, foot and mouth disease (HFMD) in 2000. After reviewing HFMD notifications from doctors and child-care centers, we found that the incidence of HFMD rose in September and declined at the end of October. During this period, 3,790 cases were reported. We performed enteroviral cultures on 311 and 157 specimens from 175 HFMD patients and 107 non-HFMD patients, respectively; human enterovirus 71 (HEV71) was the most frequently isolated virus from both groups. Most of the HFMD patients were </=4 years of age. Three HFMD and two non-HFMD patients died. Specimens from two HFMD and both non-HFMD patients were culture positive for HEV71; a third patient was possibly associated with the virus. Autopsies performed on all three HFMD and one of the non-HFMD case-patients showed encephalitis, interstitial pneumonitis, and myocarditis. A preparedness plan for severe HFMD outbreaks provided for the prompt, coordinated actions needed to control the epidemic.
Chan
Kwai Peng
KP
Virology Laboratory, Department of Pathology, Singapore General Hospital, Outram Road, Singapore. gptckp@sgh.com.sg
Goh
Kee Tai
KT
Chong
Chia Yin
CY
Teo
Eng Swee
ES
Lau
Gilbert
G
Ling
Ai Ee
AE
D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004770:Enterovirus / Q000145:classification / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012846:Singapore / Q000453:epidemiology