Clinico-epidemiological profile and complications of hand foot mouth disease among cases attending tertiary care centre in Northern Kerala, India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20232376Keywords:
Complications, Clinico-epidemiological profile, Hand foot mouth diseaseAbstract
Background: Hand-Foot-Mouth Disease (HFMD), has suddenly become more prevalent than ever in Kerala and is reported in almost all districts. Earlier studies showed EnteroVirus-A71 to be the causative agent, but frequent outbreaks are also caused by coxsackievirus A6 and A16. In 2022 there was a surge in the HFMD cases being reported to the institution with few cases requiring hospital admission due to complications.
Methods: Study was a hospital based descriptive study in Government Medical College, Kannur, Kerala, India among Paediatric cases of HFMD, presented to the institution from April to July, 2022. Data was collected by direct interview using a semi structured questionnaire. It was coded and entered in MS Excel and analysed using SPSS 21.
Results: Of the total 50 cases studied, 60% of the cases were in the age group of 1-3 years. Majority (58%) were females, with maximum cases being reported in the month of May. 32% had contact history with 18% being family contacts. Fever (72%), lesions on the hand (86%), foot (92%) and oral cavity (68%) were the most common clinical presentation. Complications developed in 10% of the cases, requiring hospital admission. Most common complication being neurological complication- acute cerebellar ataxia and atypical febrile seizure. A major factor noted among the cases that developed complications was that all were having chronic malnutrition.
Conclusions: Even though majority of the cases had uncomplicated course, 10% cases showed complications. Therefore, awareness should be made regarding chances of complications and its risk factors. Assessment of nutritional status should be done in all cases.
References
CDC. Causes and Transmission of Hand, Foot, and Mouth disease. Centers for Disease Control and Prevention, 2022. Available at: https://www.cdc.gov/hand-foot-mouth/about/ transmission.html. Accessed 10 March 2023.
Ministry of health and family welfare (MOHFW), Hand Foot Mouth Disease (HFMD) Guidelines. Available at: https://www.moh.gov.my/moh/ resources/auto%20download%20images/589d71f714d23.pdf. Accessed 3 May 2023.
Guerra AM, Orille E, Waseem M. Hand Foot And Mouth Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
Lewis A, Josiowicz A, Hirmas Riade SM, Tous M, Palacios G, Cisterna DM. Introduction and differential diagnosis of monkeypox in Argentina, 2022. Emerg Infect Dis. 2022;28(10):2123-5.
Park B, Kwon H, Lee K, Kang M. Acute pancreatitis in hand, foot and mouth disease caused by Coxsackievirus A16: case report. Korean J Pediatr. 2017;60(10):333-6.
Ogilvie MM, Tearne CF. Spontaneous abortion after hand-foot-and-mouth disease caused by Coxsackie virus A16. Br Med J. 1980;281(6254):1527-8.
Kumar VS, Budur SV, Odappa GH, Bankolli SY, Rao AP. Clinical profile of hand, foot, and mouth disease and its associated complications among children in Shimoga City, southern Karnataka: A hospital-based study. Int J Sci Res. 2012;2(11):435–7.
Ang LW, Koh BK, Chan KP, Chua LT, James L, Goh KT. Epidemiology and control of hand, foot and mouth disease in Singapore, 2001-2007. Ann Acad Med Singapore. 2009;38(2):106–12.
Zhang D, Li Z, Zhang W, Guo P, Ma Z, Chen Q, et al. Hand-washing: the main strategy for avoiding hand, foot and mouth disease. Int J Environ Res Public Health. 2016;13(6):610.
Xu Z, Hu W, Jiao K, Ren C, Jiang B, Ma W. The effect of temperature on childhood hand, foot and mouth disease in Guangdong Province, China, 2010–2013: a multicity study. BMC Infect Dis. 2019;19(1):1-0.
Chen B, Yang Y, Xu X, Zhao H, Li Y, Yin S, et al. Epidemiological characteristics of hand, foot, and mouth disease in China: A meta-analysis. Medicine (Baltimore). 2021;100(20):e25930.
Kumar KB, Kiran AG, Kumar BU. Hand, foot and mouth disease in children: A clinico epidemiological study. Indian J Paediatr Dermatol. 2016;17(1):7.
Sharma A, Mahajan VK, Mehta KS, Chauhan PS, Manvi S, Chauhan A. Hand, foot and mouth disease: a single centre retrospective study of 403 new cases and brief review of relevant Indian literature to understand clinical, epidemiological, and virological attributes of a long-lasting Indian Epidemic. Indian Dermatol Online J. 2022;13(3):310–20.
Koh WM, Bogich T, Siegel K, Jin J, Chong EY, Tan CY, et al. The epidemiology of hand, foot and mouth disease in Asia: a systematic review and analysis. Pediatr Infect Dis J. 2016;35(10):e285-300.
