Transmission of Seasonal Outbreak of Childhood Enteroviral Aseptic Meningitis and Hand-foot-mouth Disease

Abstract

This study was conducted to evaluate the modes of transmission of aseptic meningitis (AM) and hand-foot-mouth disease (HFMD) using a case-control and a case-crossover design. We recruited 205 childhood AM and 116 HFMD cases and 170 non-enteroviral disease controls from three general hospitals in Gyeongju, Pohang, and Seoul between May and August in both 2002 and 2003. For the case-crossover design, we established the hazard and non-hazard periods as week one and week four before admission, respectively. In the case-control design, drinking water that had not been boiled, not using a water purifier, changes in water quality, and contact with AM patients were significantly associated with the risk of AM (odds ratio [OR]=2.8, 2.9, 4.6, and 10.9, respectively), while drinking water that had not been boiled, having a non-water closet toilet, changes in water quality, and contact with HFMD patients were associated with risk of HFMD (OR=3.3, 2.8, 6.9, and 5.0, respectively). In the case-crossover design, many life-style variables such as contact with AM or HFMD patients, visiting a hospital, changes in water quality, presence of a skin wound, eating out, and going shopping were significantly associated with the risk of AM (OR=18.0, 7.0, 8.0, 2.2, 22.3, and 3.0, respectively) and HFMD (OR=9.0, 37.0, 11.0, 12.0, 37.0, and 5.0, respectively). Our findings suggest that person-to-person contact and contaminated water could be the principal modes of transmission of AM and HFMD.

Seasonality of Viral Encephalitis and Associated Environmental Risk Factors in Son La and Thai Binh Provinces in Vietnam from 2004 to 2013

“…37,38 In addition, seasonality of enteroviruses with peaks during summer has been described in Korea, Taiwan, and the United States. [39][40][41] The Taiwan study found that enterovirus infection was significantly associated with increasing temperature and humidity, which was consistent with our study.…”

“…40 Human enteroviruses are transmitted from person to person via direct contact with saliva, mucus, fluid from blisters, or stools of infected people. 41 To prevent the disease, it is very important to raise public awareness between June and November on good personal hygiene including frequent hand washing with soap. 42 At present, EV71 vaccine is available in some Asian countries, but it is not approved in Vietnam.…”

The efficacy of simulated solar disinfection (SODIS) against coxsackievirus, poliovirus and hepatitis A virus

“…Throughout many parts of the world, the lack of access to suitable drinking water is a major health concern as the consumption of drinking water contaminated with waterborne human pathogens including bacteria, protozoa and viruses is a major cause of morbidity and mortality (Park et al 2010;Baldursson & Karanis 2011;CDC 2011). Two recent studies from South Africa and Cambodia have demonstrated SODIS to be a highly effective tool for the reduction in diarrhoeal disease in compliant communities (Du Preez et al 2010;McGuigan et al 2011).…”

Coxsackievirus B5 associated with hand-foot-mouth disease in a healthy adult

“…Prodromal symptoms may consist of fever, malaise, abdominal pain, poor appetite, sore throat, and myalgias 1, 4. After a 3- to 7-day incubation period, painful oral ulcers are usually the first clinical signs of the disease, with skin manifestations occurring concurrently or shortly after 5 . Complete resolution of symptoms typically occurs by 7 to 10 days and treatment is mainly supportive.…”