An outbreak of hand, foot and mouth disease in Bhubaneswar, Odisha.
OBJECTIVE
To describe the epidemiology and clinical features of cases in an outbreak of Hand, Foot and Mouth Disease (HFMD).


METHODS
Descriptive epidemiological study.


METHODS
Hospitals and community in urban areas of Bhubaneswar city, Odisha.


METHODS
Upon clinical suspicion of the first case as HFMD, local pediatricians and dermatologists were sensitized for case referral to Dermatology department of Institute of Medical Science and SUM hospital (IMS and SH) for evaluation and follow up. Community survey was undertaken by household visit by the team from Regional Medical Research Centre, Bhubaneswar in an outbreak area through hospital case tracing. Blood samples were tested for hematological counts and RT PCR assay done in a subset of samples for confirmation.


RESULTS
Seventy eight cases of HFMD were detected between September 7 and November 6, 2009. Mean age (SD) was 5.13  (4.94) years (range 4 mo-31 yrs) and both sexes were equally affected. Fever and rash were the most common presenting symptoms with the rash distributed mostly over buttocks (83.3%), knees (77.5%), both surfaces of hands and oral mucosa (78.2%). Lesions healed in Mean (SD) 8.6 (1.5) days (range 7-15 d). Recovery was complete with minimal supportive treatment but, nail shedding was noted in three children within 4-5 weeks. CA16 was confirmed as the viral agent.


CONCLUSIONS
Children (5-14 yrs) were majorly affected and complete recovery without neurological complications were noted. The characteristic clinical features described will be useful for early clinical diagnosis where laboratory confirmation is not feasible.
Department of Dermatology, Institute of Medical Science and SUM Hospital, Bhubaneswar, Odisha, India.
Bikash Ranjan
BR
Kar
Bhagirathi
B
Dwibedi
Shantanu Kumar
SK
Kar
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D029821:Enterovirus A, Human / Q000302:isolation & purification; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male