Sarma Nilendu, Sarkar Abhijit, Mukherjee Amlan, Ghosh Apurba, Dhar Sandipan, Malakar Rajib
Department of Dermatology, NRS Medical College, Kolkata-700014, West Bengal, India.
Indian J Dermatol. 2009;54(1):26-30. doi: 10.4103/0019-5154.48982.
Hand, foot, and mouth disease (HFMD) is caused mostly by Coxsackievirus A16 (CA16) and enterovirus 71 (EV71). Epidemic of HFMD has occurred in India only once in Kerala in 2003. We report here a recent outbreak of HFMD in three districts of West Bengal, India.
A case detection system developed with 1) three private clinics in three districts; two at Howrah and one at Hooghly, 2) Pediatrics Department of two medical colleges in Kolkata, 3) 12 practioners of these three districts with 4) a central referral center at Department of Dermatology, NRS Medical College, Kolkata where all cases from this system were confirmed by a single observer. Pediatric Dermatology unit of the Institute of Child Health, Kolkata was another independent unit.
A total of 38 cases of HFMD were reported till 08.10.07. Age group ranged from 12 months to 12 years (mean 40.76 months, SD 29.49). Males were slightly higher than females (M:F - 21:17). Disease was distributed mostly over buttocks, knees, hands, feet - both dorsum and palmar or the plantar surface and the oral mucosa. Highest severity noted over the buttocks and the knee. Healing time for skin lesions was 6-13 days (mean 9.13 days, SD 1.93). Oral lesions were found in 33 (86.8%) cases.
This outbreak far away from the initial one confirmed regular outsourcing of the virus with possibilities of future epidemics. Also the fact that EV71 induced epidemic is on rise in this part of globe is alarming for India. We hope this early report will be of help for strategic planning for a better management of the disease and prevention of dreaded neurological complications in India.
手足口病（HFMD）主要由A16型柯萨奇病毒（CA16）和肠道病毒71型（EV71）引起。印度仅在2003年于喀拉拉邦发生过一次手足口病疫情。我们在此报告印度西孟加拉邦三个地区近期爆发的手足口病疫情。
通过以下方式建立病例检测系统：1）三个地区的三家私人诊所，其中豪拉有两家，胡格利有一家；2）加尔各答两所医学院的儿科；3）这三个地区的12名从业者；4）加尔各答NRS医学院皮肤科的一个中央转诊中心，该系统的所有病例均由一名观察者确诊。加尔各答儿童健康研究所的儿科皮肤科单元是另一个独立单元。
截至2007年10月8日，共报告了38例手足口病病例。年龄范围为12个月至12岁（平均40.76个月，标准差29.49）。男性略多于女性（男：女 = 21:17）。疾病主要分布在臀部、膝盖、手部、足部——包括背部和手掌或足底以及口腔黏膜。臀部和膝盖的病情最为严重。皮肤病变的愈合时间为6 - 13天（平均9.13天，标准差1.93）。33例（86.8%）病例出现口腔病变。
此次疫情远离最初确诊的地区，证实病毒存在常规传播，未来有可能再次爆发疫情。此外，在全球这一地区，EV71引发的疫情呈上升趋势，这对印度来说令人担忧。我们希望这份早期报告将有助于印度制定战略规划，以便更好地管理该疾病并预防可怕的神经系统并发症。
