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. 2003 Jan;9(1):78-85.
doi: 10.3201/eid0901.020112.

Epidemic hand, foot and mouth disease caused by human enterovirus 71, Singapore

Kwai Peng Chan  1 , Kee Tai Goh, Chia Yin Chong, Eng Swee Teo, Gilbert Lau, Ai Ee Ling
Affiliations

Epidemic hand, foot and mouth disease caused by human enterovirus 71, Singapore

Kwai Peng Chan et al. Emerg Infect Dis. 2003 Jan.

Abstract

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.

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Figures

Figure 1
Figure 1
Number of cases of hand, foot and mouth disease reported to the Singapore Ministry of Environment as surveillance for the disease, July 2000–March 2001. Each epidemiologic week begins on Sunday. Mandatory reporting of the disease began on October 1, 2000.
Figure 2
Figure 2
Interstitial pneumonitis in the 14-month-old girl who died of human enterovirus 71 disease. Photomicrograph shows alveolar wall congestion, intra-alveolar hemorrhage, and interstitial lymphocytic infiltrate. (Hematoxylin and eosin stain, original magnification x 200).
Figure 3
Figure 3
Perivascular cuffing in the brain. (Hematoxylin and eosin stain, original magnification x 200).
Figure 4
Figure 4
Section of brain showing a focus of necrosis. (Hematoxylin and eosin stain, original magnification x 200).
Figure 5
Figure 5
Tissue section of heart showing lymphocytic infiltrate, interstitial edema, and myocardial necrosis. (Hematoxylin and eosin stain, original magnification x200).
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References

    1. Melnick JL. Enteroviruses: polioviruses, coxsackieviruses, echoviruses, and newer enteroviruses. In: Fields BN, Knipe DM, Howley PM, Chanlock RM, Melnick JL, Monath TP, et al., editors. Field’s virology. 3rd ed. Philadelphia: Lippincott-Raven Publishers; 1996. p. 655–712.
    1. Tunnessen WW Jr. Erythema infectiosum, roseola, and enteroviral exanthems. In: Gorbach SL, Bartlett JG, Blacklow NR, editors. Infectious diseases. Philadelphia: W. B. Saunders Company; 1992. p. 1120–5.
    1. Chan MCK, Wong HB. Hand-foot and mouth disease. J Singapore Paediatr Soc. 1973;15:31–4.
    1. Tay CH, Gaw CYN, Low T, Ong C, Chia KW, Yeo H, et al. Outbreak of hand, foot and mouth disease in Singapore. Singapore Med J. 1974;15:174–83.
    1. Goh KT, Doraisingham S, Tan JL, Lim GN, Chew SE. An outbreak of hand, foot and mouth disease in Singapore. Bull World Health Organ. 1982;60:965–9. - PMC - PubMed

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