Investigation of A Severe Enteroviral Encephalitis and Circulating Genotypes during Hand, Foot and Mouth Disease Surge in Nakhon Ratchasima Province, Thailand, August 2011
DOI:
https://doi.org/10.59096/osir.v7i1.263295Keywords:
encephalitis, HFMD, enterovirus, EV-71, coxsackie B5, Nakhon Ratchasima, ThailandAbstract
On 7 Aug 2011, a 1-month-old baby with encephalitis caused by unspecified enterovirus was reported during the period of widespread hand, foot and mouth disease (HFMD) outbreaks in Nakhon Ratchasima Province. An investigation was carried out to confirm the diagnosis, identify etiology of all severe enteroviral infection cases, determine magnitude of HFMD and enterovirus infection, including asymptomatic infections, and recommend prevention and control measures. A descriptive study was conducted by interviewing family members of the index case. Throat swab and stool specimens were collected to identify enterovirus. Survey on asymptomatic infection was done in schools attended by the index case’s siblings. Stool culture and isolation for enterovirus were also performed. Coxsackie B5 virus was isolated from fresh stool specimens of the index case. Among total 244 students screened for HFMD symptoms in four schools, only seven (3%) met the suspect case definition. During HFMD outbreaks caused by EV-71 B5, coxsackie A16 and coxsackie B5, proportion of asymptomatic infection among students was 22%. Risk factors such as no soap in toilets and misuse of alcohol gel to clean hands in schools were observed during the environmental survey.
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