Epidemiological survey of three outbreaks of CoxA16-induced hand, foot and mouth disease in kindergartens

The investigation was to evaluate the epidemiological characteristics of the three outbreaks of hand, foot and mouth disease that occurred in three kindergartens in Minhang district, Shanghai from May to July in 2009, which involved a total of 46 cases with the overall attack rate of 5.51% and the male to female ratio of 2.07 ∶ 1. The attack rate in male patients was significantly higher than that in female, and the attack rate of children younger than three years old was noticeably higher than others. The average prevalent duration was 11.5 d with remarkable onset peaks, the first one of which was observed on Day 5. On average, two or three classes in the kindergartens were affected in these outbreaks, resulting in relatively concentrated patients in the class where the primarily onset case was found, in the absence of widespread involvement. Laboratory tests suggested that the enterovirus, CoxA16, had caused the three outbreaks. Therefore, importance should be attached to the disease surveillance and reporting system during the prevalent period for the purpose of early detection, early report, early quarantine and early management.