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February 23, 2011The Pediatric Infectious Disease Journal69 citations

Estimation of the Basic Reproduction Number of Enterovirus 71 and Coxsackievirus A16 in Hand, Foot, and Mouth Disease Outbreaks

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EMEdmond MaCFConnie FungSYSteven H. L. Yip

Key Result

The basic reproductive number (R0) for enterovirus 71 was significantly higher than that of coxsackievirus A16 (median 5.48 vs 2.50; P=0.002) in pediatric hand, foot, and mouth disease outbreaks.

Study Design

Type

Observational (n=34)

Multicenter

Yes

Structured PICO

P
Population
34 laboratory-confirmed hand, foot, and mouth disease (HFMD) outbreaks (27 caused by Cox A16 and 7 caused by EV71) reported to the Department of Health from 2004 to 2009
O
Outcome
Basic reproductive number (R0)

The basic reproduction number for EV71 is significantly higher than that of Cox A16 in HFMD outbreaks, indicating higher transmissibility.

Main Result

Absolute Event Rate: 5.48% vs 2.5%

p-value: p=0.002

Abstract

BACKGROUND: Coxsackievirus A16 (Cox A16) and enterovirus 71 (EV71) are common pathogens causing hand, foot, and mouth disease (HFMD) in pediatric population. Little is known about the basic reproductive number (R0) for these enteroviruses. METHODS: We estimated the R0 of EV71 and of Cox A16 from laboratory-confirmed HFMD outbreaks reported to the Department of Health, from 2004 to 2009. We derived a mathematical model and calculated R₀ based on the cumulative number of cases at the initial growth phase of the outbreaks, as determined by the epidemic curves. We tested the association of R₀ with settings and sizes of the institution and total number of persons affected. RESULTS: We analyzed 34 outbreaks, 27 caused by Cox A16 and 7 caused by EV71. Assuming the incubation period to be 5 days, the median R₀ of EV71 was 5.48 with an interquartile range of 4.20 to 6.51, whereas the median R₀ of Cox A16 was 2.50 with an interquartile range of 1.96 to 3.67. The R₀ of EV71 was significantly higher than that of CoxA16, P = 0.002; and sensitivity analysis showed the same results. The R₀ was not associated with outbreak settings, sizes of the institutions, or number of persons affected. CONCLUSIONS: The R₀ for EV71 and for Cox A16 was determined using a model which showed that the R₀ for EV71 was higher than that of Cox A16. This finding helps better understand the transmission dynamics of HFMD outbreaks and formulate public health measures for controlling the disease.

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Cite This Study

Ma et al. (2011) conducted an observational in Hand, foot, and mouth disease (HFMD) (n=34). Enterovirus 71 (EV71) vs. Coxsackievirus A16 (Cox A16) was evaluated on Basic reproductive number (R0) (p=0.002). The basic reproductive number (R0) for enterovirus 71 was significantly higher than that of coxsackievirus A16 (median 5.48 vs 2.50; P=0.002) in pediatric hand, foot, and mouth disease outbreaks.

synapsesocial.com/papers/6a1c5d19d54006be995feee8https://doi.org/10.1097/inf.0b013e3182116e95
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