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Article

Molecular Epidemiological Study of Hand, Foot, and Mouth Disease in a Kindergarten-Based Setting in Bangkok, Thailand

1
Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
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Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
*
Author to whom correspondence should be addressed.
Academic Editor: Robert Yung Liang Wang
Pathogens 2021, 10(5), 576; https://doi.org/10.3390/pathogens10050576
Received: 29 April 2021 / Revised: 6 May 2021 / Accepted: 7 May 2021 / Published: 10 May 2021
Hand, foot, and mouth disease (HFMD) is a contagious childhood illness and annually affects millions of children aged less than 5 years across the Asia–Pacific region. HFMD transmission mainly occurs through direct contact (person-to-person) and indirect contact with contaminated surfaces and objects. Therefore, public health measures to reduce the spread of HFMD in kindergartens and daycare centers are essential. Based on the guidelines by the Department of Disease Control, a school closure policy for HFMD outbreaks wherein every school in Thailand must close when several HFMD classrooms (more than two cases in each classroom) are encountered within a week, was implemented, although without strong supporting evidence. We therefore conducted a prospective cohort study of children attending five kindergartens during 2019 and 2020. We used molecular genetic techniques to investigate the characteristics of the spreading patterns of HFMD in a school-based setting in Bangkok, Thailand. These analyses identified 22 index cases of HFMD (symptomatic infections) and 25 cases of enterovirus-positive asymptomatic contacts (24 students and one teacher). Enterovirus (EV) A71 was the most common enterovirus detected, and most of the infected persons (8/12) developed symptoms. Other enteroviruses included coxsackieviruses (CVs) A4, CV-A6, CV-A9, and CV-A10 as well as echovirus. The pattern of the spread of HFMD showed that 45% of the subsequent enteroviruses detected in each outbreak possessed the same serotype as the first index case. Moreover, we found a phylogenetic relationship among enteroviruses detected among contact and index cases in the same kindergarten. These findings confirm the benefit of molecular genetic assays to acquire accurate data to support school closure policies designed to control HFMD infections. View Full-Text
Keywords: HFMD; molecular epidemiology; kindergarten; Thailand HFMD; molecular epidemiology; kindergarten; Thailand
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MDPI and ACS Style

Thammasonthijarern, N.; Kosoltanapiwat, N.; Nuprasert, W.; Sittikul, P.; Sriburin, P.; Pan-ngum, W.; Maneekan, P.; Hataiyusuk, S.; Hattasingh, W.; Thaipadungpanit, J.; Chatchen, S. Molecular Epidemiological Study of Hand, Foot, and Mouth Disease in a Kindergarten-Based Setting in Bangkok, Thailand. Pathogens 2021, 10, 576. https://doi.org/10.3390/pathogens10050576

AMA Style

Thammasonthijarern N, Kosoltanapiwat N, Nuprasert W, Sittikul P, Sriburin P, Pan-ngum W, Maneekan P, Hataiyusuk S, Hattasingh W, Thaipadungpanit J, Chatchen S. Molecular Epidemiological Study of Hand, Foot, and Mouth Disease in a Kindergarten-Based Setting in Bangkok, Thailand. Pathogens. 2021; 10(5):576. https://doi.org/10.3390/pathogens10050576

Chicago/Turabian Style

Thammasonthijarern, Nipa, Nathamon Kosoltanapiwat, Warisa Nuprasert, Pichamon Sittikul, Pimolpachr Sriburin, Wirichada Pan-ngum, Pannamas Maneekan, Somboon Hataiyusuk, Weerawan Hattasingh, Janjira Thaipadungpanit, and Supawat Chatchen. 2021. "Molecular Epidemiological Study of Hand, Foot, and Mouth Disease in a Kindergarten-Based Setting in Bangkok, Thailand" Pathogens 10, no. 5: 576. https://doi.org/10.3390/pathogens10050576

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