Sentinel surveillance for human enterovirus 71 in Sarawak, Malaysia: lessons from the first 7 years
Background: A major outbreak of human enterovirus 71-associated hand, foot and mouth disease in Sarawak in 1997 marked the beginning of a series of outbreaks in the Asia Pacific region. Some of these outbreaks had unusually high numbers of fatalities and this generated much fear and anxiety in th...
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| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Podin et al; licensee BioMed Central Ltd.
2006
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/13420/1/yuwana.pdf http://ir.unimas.my/id/eprint/13420/ http://www.biomedcentral.com/1471-2458/6/180 |
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| Institution: | Universiti Malaysia Sarawak |
| Language: | English |
| Summary: | Background: A major outbreak of human enterovirus 71-associated hand, foot and mouth disease
in Sarawak in 1997 marked the beginning of a series of outbreaks in the Asia Pacific region. Some
of these outbreaks had unusually high numbers of fatalities and this generated much fear and anxiety
in the region.
Methods: We established a sentinel surveillance programme for hand, foot and mouth disease in
Sarawak, Malaysia, in March 1998, and the observations of the first 7 years are described here. Virus
isolation, serotyping and genotyping were performed on throat, rectal, vesicle and other swabs.
Results: During this period Sarawak had two outbreaks of human enterovirus 71, in 2000 and
2003. The predominant strains circulating in the outbreaks of 1997, 2000 and 2003 were all from
genogroup B, but the strains isolated during each outbreak were genetically distinct from each
other. Human enterovirus 71 outbreaks occurred in a cyclical pattern every three years and
Coxsackievirus A16 co-circulated with human enterovirus 71. Although vesicles were most likely
to yield an isolate, this sample was not generally available from most cases and obtaining throat
swabs was thus found to be the most efficient way to obtain virological information.
Conclusion: Knowledge of the epidemiology of human enterovirus 71 transmission will allow
public health personnel to predict when outbreaks might occur and to plan interventions in an
effective manner in order to reduce the burden of disease. |
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