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. 2009;54(1):26-30.
doi: 10.4103/0019-5154.48982.

Epidemic of hand, foot and mouth disease in West Bengal, India in August, 2007: a multicentric study

Nilendu Sarma  1 , Abhijit Sarkar, Amlan Mukherjee, Apurba Ghosh, Sandipan Dhar, Rajib Malakar
Affiliations

Epidemic of hand, foot and mouth disease in West Bengal, India in August, 2007: a multicentric study

Nilendu Sarma et al. Indian J Dermatol. 2009.

Abstract

Background: Hand, foot, and mouth disease (HFMD) is caused mostly by Coxsackievirus A16 (CA16) and enterovirus 71 (EV71). Epidemic of HFMD has occurred in India only once in Kerala in 2003. We report here a recent outbreak of HFMD in three districts of West Bengal, India.

Materials and methods: A case detection system developed with 1) three private clinics in three districts; two at Howrah and one at Hooghly, 2) Pediatrics Department of two medical colleges in Kolkata, 3) 12 practioners of these three districts with 4) a central referral center at Department of Dermatology, NRS Medical College, Kolkata where all cases from this system were confirmed by a single observer. Pediatric Dermatology unit of the Institute of Child Health, Kolkata was another independent unit.

Results: A total of 38 cases of HFMD were reported till 08.10.07. Age group ranged from 12 months to 12 years (mean 40.76 months, SD 29.49). Males were slightly higher than females (M:F - 21:17). Disease was distributed mostly over buttocks, knees, hands, feet - both dorsum and palmar or the plantar surface and the oral mucosa. Highest severity noted over the buttocks and the knee. Healing time for skin lesions was 6-13 days (mean 9.13 days, SD 1.93). Oral lesions were found in 33 (86.8%) cases.

Conclusion: This outbreak far away from the initial one confirmed regular outsourcing of the virus with possibilities of future epidemics. Also the fact that EV71 induced epidemic is on rise in this part of globe is alarming for India. We hope this early report will be of help for strategic planning for a better management of the disease and prevention of dreaded neurological complications in India.

Keywords: Coxsackievirus A16; enterovirus 71; epidemic; hand foot and mouth disease.

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Conflict of interest statement

Conflict of Interest: Nil.

Figures

Figure 1
Figure 1
Date and district-wise incidence of cases
Figure 2
Figure 2
Contribution of different districts in the total cases of HFMD
Figure 3
Figure 3
A well formed vesicle with marked erythematous halo in a child in HFMD
Figure 4
Figure 4
Multiple papulo-vesicular eruptions over the knee and the hand
Figure 5
Figure 5
Erythematous papules without any vesicles over the margin of the foot
Figure 6
Figure 6
Severe involvement of the dorsum foot with multiple vesicles
Figure 7
Figure 7
Erythematous papules with mild vesiculation over thenar eminence and margin of the hand
Figure 8
Figure 8
Diffuse erythema over the lower gum, along with erosion from ruptured vesicle over the inner side of lip
See this image and copyright information in PMC

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