A Cluster of Severe Enterovirus 71 infections among Children at Saithong Watthana District, Kamphaengphet, July 2014

Abstract

Background: On 11 July 2014 the Preventive Medicine Department, Kampheangphet Hospital received notifying of cluster of suspected severe Enterovirus infection. Two cases were referred from a same community hospital. The surveillance and rapid response teams started outbreak investigation with aimed to confirm diagnosis and outbreak, to describe the magnitude of problem and to identify the etiologic agent of the disease and to implement control and prevention measures during 11 – 14 July 2014.
Methods: Descriptive study was done. Reviewed medical records and interviewed the attending pediatricians and parents of the cases. We conducted active case finding in the two communities of the severe cases live. We send the specimens from all severe cases and closed contact of the cases including the case in the community to test EV71 by RT-PCR at Thai National Institute of Health. Environmental survey in the home, village and community was done.
Results: Total 2 cases of severe Enterovirus 71 infection with encephalitis were identified at Kampheangphet hospital, one was confirmed and one was probable. All severe cases were not presenting with HFMD and received IVIG in very early stage. The outcome of treatment was improved without complication. We found the positive EV71 in a family member of probable case. Overall 24 symptomatic cases in the communities were found. There were 3 HFMD, 2 Herpangina (HA) and 19 URI and diarrhea cases. But the laboratory results revealed negative for EV71 among 5 HFMD/HA cases. The outbreak was propagated source in the community. After follow up for 2 weeks after implement control there was no additional case of HFMD and Herpangina.
Conclusions: Confirmed outbreak of severe Enterovirus 71 infection without HFMD/Herpangina at Saithong Watthana district, Kampheangphet. All severe cases early received IVIG and were improved without complication. The transmission might be from the community due to identified symptomatic cases of HFMD and Herpangina.