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. 2019 Nov 5;19(1):933.
doi: 10.1186/s12879-019-4583-1.

Transmission and serotype features of hand foot mouth disease in household contacts in Dong Thap, Vietnam

Cuong Quoc Hoang  1 , Thao Thanh Thi Nguyen  2 , Nguyen Xuan Ho  2 , Hai Duc Nguyen  2 , An Binh Nguyen  3 , Tham Hong Thi Nguyen  3 , Hung Cong Phan  2 , Lan Trong Phan  2
Affiliations

Transmission and serotype features of hand foot mouth disease in household contacts in Dong Thap, Vietnam

Cuong Quoc Hoang et al. BMC Infect Dis. .

Abstract

Background: Hand, foot and mouth disease (HFMD) has emerged as a major public health issue in Vietnam since 2003. We aimed to investigate the household transmission of HFMD and its causative viruses from 150 households in a high incidence province in Vietnam.

Methods: A longitudinal study was conducted in patients presenting to the provincial hospital with a HFMD-like syndrome, along with their household members between April and August 2014 in Dong Thap Province. Each participant was followed up for 2 weeks. We enrolled 150 patients aged under 15 who were clinically diagnosed with HFMD in Dong Thap Hospital, 600 household members, and 581/600 household members completed the study. All participants were interviewed using a standard questionnaire. Throat swabs and blood samples were taken for molecular detection of viruses and assessment of neutralizing antibodies, respectively. Index cases were defined using a clinical case definition, household contact cases were defined using a similar definition applied to the 2 weeks before admission and 2 weeks after discharge of the index case. Characteristics of index cases, household contacts, the attack rate, serotype features and related factors of HFMD were reported.

Result: Among 150 index cases, 113 were laboratory confirmed: 90/150 were RT-PCR-positive, 101/142 had a ≥ 4-fold increase of neutralizing antibody against Enterovirus A71 (EV-A71), Coxsackievirus (CV) A6 or CV-A16 across the two samples collected. 80/150 (53%) were males, and 45/150 (30%) were under the age of 1. The predominant serotype was CV-A6, identified in 57/87 (65.5%) of the specimens. No deaths were reported. Among 581 household contacts, 148 were laboratory confirmed: 12/581 were RT-PCR-positive, 142/545 had a ≥ 4-fold increase of neutralizing antibodies against EV-A71, CV-A6 or CV-A16; 4 cases experienced HFMD in the past 4 weeks. Attack rate among household contacts was 148/581 (25.5%). In 7/12 (58%) instances, the index and secondary cases were infected with the same serotype. Having a relationship to index case was significantly associated with EV infection.

Conclusion: The attack rate among household contacts was relatively high (25.5%) in this study and it seems justified to also consider the household setting as an additional target for intervention programs.

Keywords: Hand foot and mouth disease; Serotype features; Transmission; Vietnam.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cao Lanh City and Cao Lanh District, Dong Thap in Vietnamese mainland
Fig. 2
Fig. 2
Flowchart of Enrollment and Identified of Enterovirus Infection
See this image and copyright information in PMC

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