An Outbreak of Hand Foot Mouth Disease and Herpangina caused by Coxsackies A16 in a Child Care Center, Workeaw Sub-district, Hangchat district, Lumpang province, Thailand, June – July 2014

Abstract

An outbreak investigation of Hand Foot and Mouth Disease (HFMD) in a child care center at Workeaw sub-district, Hangchat district, Lumpang province aimed to confirmed diagnosis and outbreak, to describe the epidemiological characteristics, to identify risk factor of HFMD outbreak and to implement control and prevention measures. We conducted descriptive and analytic studies in a child care center. Total 13 cases were met criteria of HFMD in the child care center. The most clinical presentations had lesions mouth (100%) followed by cough (61%), runny nose (61%), fever (46%), sore throat (46%) and hand/foot lesions (8%) respectively.
The laboratory investigation results revealed positive PCR of Coxsackies A16 virus for 9 out of 11 cases. The ratio of male : female was 1 : 1.6, median age was 2 year 8 months old range from 2 years 2 months to 3 years 8 months old. All cases had habitat in Workeaw sub-distrct and distributed to all 7 villages. The strongest risk factor in the outbreak was sleeping near the case (RR =3.59, p value = 0.04). The child care center which operated by the Workeaw municipality was voluntary closed for 7 days. The center’s staffs and health control team performed big cleaning in the center with sodium hypochlorite. After implementation of control measure, the center was reopening and followed up for 1 month without additional case reported.