title: An outbreak of hand-foot-mouth disease: A report from the hills of northern India.
abstract: BACKGROUND
  Hand-foot-mouth disease (HFMD) is known to cause outbreaks around the world as well as in India. We report the clinical characteristics of an outbreak in Dehradun, Uttarakhand.
  
  
  METHODS
  The study was done in the Department of Paediatrics of a tertiary care referral teaching hospital in northern India. Children (<18 years of age) presenting with vesicular skin lesions distributed over the hand, foot and mouth were prospectively enrolled between August 2013 and October 2013. The diagnosis of HFMD was made clinically, and laboratory investigations were done for clinical care. Children were managed with supportive measures and followed for 6 weeks after discharge. No virological investigations were done to identify the offending agent.
  
  
  RESULTS
  Thirty-three children (18 boys, 54.5%; median [range] age 4 [1-17 years]) were enrolled. The majority of children were <5 years of age (75.8%), who presented with prodromal symptoms (93.9%), mostly milder (80.6%) in severity. The most common prodromal symptoms were fever (93.9%), cough (72.7%) and malaise (54.5%). All children had rash on their hands and feet whereas the majority (85%) had oral lesions as well. All children recovered completely and had no complications during 6 weeks of follow-up.
  
  
  CONCLUSIONS
  HFMD was milder and all children (mostly <5 years of age) recovered completely without complications.
authors.affiliation: Department of Paediatrics, Sri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India, drchhavi.nanda@gmail.com.
authors.forename: Chhavi
authors.initials: C
authors.lastname: Nanda
authors.affiliation: Department of Paediatrics, Sri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India.
authors.forename: Ragini
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Paediatrics, Sri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India.
authors.forename: Sudhir K
authors.initials: SK
authors.lastname: Rana
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D011446:Prospective Studies