Human enterovirus 71 was the primary causative agent of the 2000 hand, foot and mouth disease epidemic in Singapore, isolated in 73.1% of virus-positive cases and associated with fatal complications.
Observational (n=282)
The 2000 HFMD epidemic in Singapore was primarily caused by HEV71, which can lead to fatal complications including encephalitis and myocarditis in young children.
Singapore experienced a large epidemic of hand, foot and mouth disease (HFMD) in 2000. After reviewing HFMD notifications from doctors and child-care centers, we found that the incidence of HFMD rose in September and declined at the end of October. During this period, 3,790 cases were reported. We performed enteroviral cultures on 311 and 157 specimens from 175 HFMD patients and 107 non-HFMD patients, respectively; human enterovirus 71 (HEV71) was the most frequently isolated virus from both groups. Most of the HFMD patients were </=4 years of age. Three HFMD and two non-HFMD patients died. Specimens from two HFMD and both non-HFMD patients were culture positive for HEV71; a third patient was possibly associated with the virus. Autopsies performed on all three HFMD and one of the non-HFMD case-patients showed encephalitis, interstitial pneumonitis, and myocarditis. A preparedness plan for severe HFMD outbreaks provided for the prompt, coordinated actions needed to control the epidemic.
Chan et al. (2003) conducted an observational in Hand, Foot and Mouth Disease (HFMD) (n=282). Human enterovirus 71 was the primary causative agent of the 2000 hand, foot and mouth disease epidemic in Singapore, isolated in 73.1% of virus-positive cases and associated with fatal complications.