An Outbreak of Hand, Foot and Mouth Disease in Bhubaneswar, Odisha.

Objective: To describe the epidemiology and clinical features of cases in an outbreak of Hand, Foot and Mouth Disease (HFMD). Design: Descriptive epidemiological study. Setting: Hospitals and community in urban areas of Bhubaneswar city, Odisha. Methods: Upon clinical suspicion of the first case as HFMD, local pediatricians and dermatologists were sensitized for case referral to Dermatology department of Institute of Medical Science and SUM hospital (IMS&SH) for evaluation and follow up. Community survey was undertaken by household visit by the team from Regional Medical Research Centre, Bhubaneswar in an outbreak area through hospital case tracing. Blood samples were tested for hematological counts and RT PCR assay done in a subset of samples for confirmation. Results: Seventy eight cases of HFMD were detected between September 7 and November 6, 2009. Mean age (SD) was 5.13 (4.94) years (range 4 mo-31 yrs) and both sexes were equally affected. Fever and rash were the most common presenting symptoms with the rash distributed mostly over buttocks (83.3%), knees (77.5%), both surfaces of hands and oral mucosa (78.2%). Lesions healed in Mean (SD) 8.6 (1.5) days (range 7-15 d). Recovery was complete with minimal supportive treatment but, nail shedding was noted in three children within 4-5 weeks. CA16 was confirmed as the viral agent. Conclusion: Children (5-14 yrs) were majorly affected and complete recovery without neurological complications were noted. The characteristic clinical features described will be useful for early clinical diagnosis where laboratory confirmation is not feasible. [ABSTRACT FROM AUTHOR]