J Korean Med Sci.  2010 May;25(5):677-683. 10.3346/jkms.2010.25.5.677.

Transmission of Seasonal Outbreak of Childhood Enteroviral Aseptic Meningitis and Hand-foot-mouth Disease

• Park SK
• Park B
• Ki M
• Kim H
• Lee K
• Jung C
• Sohn YM
• Choi SM
• Kim DK
• Lee DS
• Ko JT
• Kim MK
• Cheong HK

• KMID: 1713949
• DOI: http://doi.org/10.3346/jkms.2010.25.5.677

Abstract

This study was conducted to evaluate the modes of transmission of aseptic meningitis (AM) and hand-foot-mouth disease (HFMD) using a case-control and a case-crossover design. We recruited 205 childhood AM and 116 HFMD cases and 170 non-enteroviral disease controls from three general hospitals in Gyeongju, Pohang, and Seoul between May and August in both 2002 and 2003. For the case-crossover design, we established the hazard and non-hazard periods as week one and week four before admission, respectively. In the case-control design, drinking water that had not been boiled, not using a water purifier, changes in water quality, and contact with AM patients were significantly associated with the risk of AM (odds ratio [OR]=2.8, 2.9, 4.6, and 10.9, respectively), while drinking water that had not been boiled, having a non-water closet toilet, changes in water quality, and contact with HFMD patients were associated with risk of HFMD (OR=3.3, 2.8, 6.9, and 5.0, respectively). In the case-crossover design, many life-style variables such as contact with AM or HFMD patients, visiting a hospital, changes in water quality, presence of a skin wound, eating out, and going shopping were significantly associated with the risk of AM (OR=18.0, 7.0, 8.0, 2.2, 22.3, and 3.0, respectively) and HFMD (OR=9.0, 37.0, 11.0, 12.0, 37.0, and 5.0, respectively). Our findings suggest that person-to-person contact and contaminated water could be the principal modes of transmission of AM and HFMD.

Keyword

Meningitis, Aseptic; Hand, Foot and Mouth Disease; Disease Transmission; Waterborne Infection; Enterovirus; Epidemiology

MeSH Terms

Adolescent
Child
Child, Preschool
Comorbidity
Disease Outbreaks/*statistics & numerical data
Enterovirus Infections/*epidemiology/*transmission
Female
Hand, Foot and Mouth Disease/*epidemiology/*transmission
Humans
Incidence
Male
Meningitis, Aseptic/*epidemiology
Risk Assessment
Risk Factors
*Seasons

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