Enterovirus 71-associated hand, foot, and mouth disease, Southern Vietnam, 2011

Abstract

We prospectively studied 3,791 children hospitalized during 2011 during a large outbreak of enterovirus 71-associated hand, foot, and mouth disease in Vietnam. Formal assessment of public health interventions, use of intravenous immunoglobulin and other therapies, and factors predisposing for progression of disease is needed to improve clinical management.

Figure 1

Age distribution by 4-month interval of 3,667 children admitted to Children’s Hospital 1, Ho Chi Minh City, Vietnam, who had clinical diagnoses of hand, foot, and mouth disease, September 18–November 30, 2011. White bars indicate total number of cases; black bars indicate severe cases (grade 2b or worse). Severe cases are defined as grade 2b, 3, or 4 disease.

Figure 2

Phylogenetic tree of enterovirus 71 viral protein 1 constructed by MEGA4 (www.megasoftware.net) with neighbor-joining method showing the relationship of 18 local sequences from 2010 and 2011 (triangles). Sequence names consist of the following information: the hospital at which the sample was obtained (HTD, Hospital for Tropical Diseases; CH1, Children’s Hospital 1; CH2, Children’s Hospital 2 (all from Ho Chi Minh City, Vietnam]); number in chronologic order/VNM for Vietnam/date (month-year). Reference genotypic sequences used in tree construction were obtained from GenBank. Detailed information about these sequences is available in reference (1).