Laboratory Based Surveillance of Hand, Foot and Mouth Disease in Four Provinces of Northern Thailand (2012-2016)

Background: Hand, foot and mouth disease (HFMD) is a common childhood exanthema, characterized by a brief febrile illness, sore in the mouth and vesicular lesions on the hands, feet and mouth. HFMD is caused by enteroviruses, mainly enterovirus 71 (EV71) and Coxsackievirus A16 (CA16). An outbreak of HFMD was reported in Thailand in 2012 with incidence of 70.48 per 100,000 populations. Endemicity of these viruses across Thailand has been suspected.

Methodology: A total of 134 stool specimens of suspected HFMD patients from four Northern provinces; Chiangmai, Lampang, Lamphun and Mae Hong Son were analyzed from 2012 to 2016 using RT-PCR based detection method.

Results: Enteroviruses were detected in 74 specimens (55.2%), of which 27 were of CA16 (36.5%), 24 of EV71 (32.4%) and remaining 23 of other enteroviruses (31.1%). These results confirmed circulation of EV71 and CA16 in this region and causing HFMD. The young children below five years were predominant in the study group.

Conclusion: Laboratory based surveillance confirms the endemicity of enteroviruses in this defined geographical area and occurrence of such cases should be suspected and confirmation undertaken.