Sentinel surveillance for human enterovirus 71 in Sarawak, Malaysia: lessons from the first 7 years

Podin, Yuwana; Gias, Edna L. M.; Ong, Flora; Yee-Wei Leong; Siew-Fung Yee; Yusof, Mohd Apandi; Perera, David; Teo, Bibiana; Thian-Yew Wee; Sik-Chi Yao; Sik-King Yao; Kiyu, Andrew; Arif, Mohd Taha; Cardosa, Mary Jane
January 2006
BMC Public Health;2006, Vol. 6, p180
Academic Journal
Background: A major outbreak of human enterovirus 71-associated hand, foot and mouth disease in Sarawak in 1997 marked the beginning of a series of outbreaks in the Asia Pacific region. Some of these outbreaks had unusually high numbers of fatalities and this generated much fear and anxiety in the region. Methods: We established a sentinel surveillance programme for hand, foot and mouth disease in Sarawak, Malaysia, in March 1998, and the observations of the first 7 years are described here. Virus isolation, serotyping and genotyping were performed on throat, rectal, vesicle and other swabs. Results: During this period Sarawak had two outbreaks of human enterovirus 71, in 2000 and 2003. The predominant strains circulating in the outbreaks of 1997, 2000 and 2003 were all from genogroup B, but the strains isolated during each outbreak were genetically distinct from each other. Human enterovirus 71 outbreaks occurred in a cyclical pattern every three years and Coxsackievirus A16 co-circulated with human enterovirus 71. Although vesicles were most likely to yield an isolate, this sample was not generally available from most cases and obtaining throat swabs was thus found to be the most efficient way to obtain virological information. Conclusion: Knowledge of the epidemiology of human enterovirus 71 transmission will allow public health personnel to predict when outbreaks might occur and to plan interventions in an effective manner in order to reduce the burden of disease.


Related Articles

  • Treatment of Potentially Life-Threatening Enterovirus Infections with Pleconaril. Rotbart, Harley A.; Webster, A. David // Clinical Infectious Diseases;1/15/2001, Vol. 32 Issue 2, p228 

    Presents information on a study which evaluated the effectiveness of Pleconaril in treating enterovirus infections. Methodology; Results of the study; Discussion.

  • Epidemic Coxsackie Virus Infection with Mixed Clinical Manifestations. Artenstein, Malcolm S.; Cadigan Jr., Francis C.; Buescher, Edward L. // Annals of Internal Medicine;Feb64 Part 2, Vol. 60 Issue 2, p196 

    Describes another type of enterovirus, Coxsackie virus epidemic in which no common characteristic clinical picture occurred. Indications of pleurodynia with orchitis; Presence of abdominal pain, myocarditis and neonatal encephalomyocarditis in patients.

  • Türkiye’nin Van yöresinde Anti-HAV IgM pozitifliÄŸinin yaÅŸ ve aylara göre dağılımı. Parlak, Mehmet; Çıkman, Aytekin; Güdücüoğlu, Hüseyin; Berktaş, Mustafa // Dicle Medical Journal / Dicle Tip Dergisi;2012, Vol. 39 Issue 3, p398 

    Objectives: In this study we investigated the anti-HAV IgM positivity rates and their distribution according to age and season of a year in Van region of Turkey. Materials and methods: During five-year period between 2006-2010, the presence of anti-HAV IgM were determined in the serum samples...

  • Neutralizing Antibody Provided Protection against Enterovirus Type 71 Lethal Challenge in Neonatal Mice. Chun-Keung Yu, Steve R.; Chi-Chung Chen; Chi-Long Chen, Steve R.; Jen-Ren Wang; Ching-Chuan Liu; Jing-Jou Yan; Ih-Jen Su // Journal of Biomedical Science;2000, Vol. 7 Issue 6, p523 

    Experimental infection with enterovirus type 71 (EV71) induced death in neonatal mice in an age- and dose-dependent manner. The mortality rate was 100% following intraperitoneal inoculation 1-day-old ICR mice and this gradually decreased as the age at the time of inoculation increased (60% in...

  • Identification, phenotypic analysis, and full-length nucleotide sequence of a Dutch Coxsackievirus A20 isolate. Hein Boot; Vladimir Lukashov; Yvonne van Remmerden; Tjeerd Kimman // Virus Genes;Jan2007, Vol. 34 Issue 1, p75 

    Abstract??Recombination between (human) enteroviruses is a common event in nature. Recently, it has been recognised that this feature has a major impact on the use of the live-attenuated polio vaccine during the end stage of polio eradication. The constraints for successful recombination between...

  • An Epidemic of Enterovirus 71 Infection in Taiwan. Ho, Monto; Chen, Eng-Rin; Hsu, Kwo-Hsiung; Twu, Shiing-Jer; Chen, Kow-Tong; Tsai, Su-Fen; Wang, Jen-Ren; Shih, Shin-Ru // New England Journal of Medicine;09/23/99, Vol. 341 Issue 13, p929 

    Background: Enteroviruses can cause outbreaks of hand-foot-and-mouth disease (characterized by vesicular lesions on the hands, feet, and oral mucosa) or herpangina, usually without life-threatening manifestations. In 1998 an epidemic of enterovirus 71 infection caused hand-foot-and-mouth disease...

  • Nonpolio enterovirus surveillance--United States, 1993-1996.  // MMWR: Morbidity & Mortality Weekly Report;8/15/1997, Vol. 46 Issue 32, p748 

    Presents information on the number of reported cases of nonpolio enterovirus infections in the United States from 1993-1996. Background information on these infections; Causes of these infections; Indepth look at the results of a survey conducted on this issue.

  • ERRATUM.  // Clinical Infectious Diseases;11/1/2008, Vol. 47 Issue 9, p1244 

    A correction to the article "A novel mode of transmission for human enterovirus infection is swimming in contaminated seawater: implications in public health an in epidemiogical surveillance" that was published in the September 1, 2008 issue is presented.

  • Predictors of sub-clinical enterovirus infections in infants: a prospective cohort study. Witsø, Elisabet; Cinek, Ondrej; Aldrin, Magne; Grinde, Bjørn; Rasmussen, Trond; Wetlesen, Turid; Rønningen, Kjersti S. // International Journal of Epidemiology;Apr2010, Vol. 39 Issue 2, p459 

    Background Enterovirus infections are common, although most often sub-clinical. The present purpose was to assess the impact of breastfeeding and other factors on enterovirus infections in infancy.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics