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Basic reproduction number of coxsackievirus type A6 and A16 and enterovirus 71: estimates from outbreaks of hand, foot and mouth disease in Singapore, a tropical city-state.
Epidemiol Infect. 2016 Apr; 144(5):1028-34.EI

Abstract

Coxsackievirus A6 (CV-A6), coxsackievirus A16 (CV-A16) and enterovirus 71 (EV-A71) were the major enteroviruses causing nationwide hand, foot and mouth disease (HFMD) epidemics in Singapore in the last decade. We estimated the basic reproduction number (R 0) of these enteroviruses to obtain a better understanding of their transmission dynamics. We merged records of cases from HFMD outbreaks reported between 2007 and 2012 with laboratory results from virological surveillance. R 0 was estimated based on the cumulative number of reported cases in the initial growth phase of each outbreak associated with the particular enterovirus type. A total of 33 HFMD outbreaks were selected based on the inclusion criteria specified for our study, of which five were associated with CV-A6, 13 with CV-A16, and 15 with EV-A71. The median R 0 was estimated to be 5·04 [interquartile range (IQR) 3·57-5·16] for CV-A6, 2·42 (IQR 1·85-3·36) for CV-A16, and 3·50 (IQR 2·36-4·53) for EV-A71. R 0 was not significantly associated with number of infected children (P = 0·86), number of exposed children (P = 0·94), and duration of the outbreak (P = 0·05). These enterovirus-specific R 0 estimates will be helpful in providing insights into the potential growth of future HFMD epidemics and outbreaks for timely implementation of disease control measures, together with disease dynamics such as severity of the cases.

Authors+Show Affiliations

Epidemiology and Disease Control Division,Ministry of Health,Singapore.Epidemiology and Disease Control Division,Ministry of Health,Singapore.Epidemiology and Disease Control Division,Ministry of Health,Singapore.Epidemiology and Disease Control Division,Ministry of Health,Singapore.Epidemiology and Disease Control Division,Ministry of Health,Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26374168

Citation

Lim, C T K., et al. "Basic Reproduction Number of Coxsackievirus Type A6 and A16 and Enterovirus 71: Estimates From Outbreaks of Hand, Foot and Mouth Disease in Singapore, a Tropical City-state." Epidemiology and Infection, vol. 144, no. 5, 2016, pp. 1028-34.
Lim CT, Jiang L, Ma S, et al. Basic reproduction number of coxsackievirus type A6 and A16 and enterovirus 71: estimates from outbreaks of hand, foot and mouth disease in Singapore, a tropical city-state. Epidemiol Infect. 2016;144(5):1028-34.
Lim, C. T., Jiang, L., Ma, S., James, L., & Ang, L. W. (2016). Basic reproduction number of coxsackievirus type A6 and A16 and enterovirus 71: estimates from outbreaks of hand, foot and mouth disease in Singapore, a tropical city-state. Epidemiology and Infection, 144(5), 1028-34. https://doi.org/10.1017/S0950268815002137
Lim CT, et al. Basic Reproduction Number of Coxsackievirus Type A6 and A16 and Enterovirus 71: Estimates From Outbreaks of Hand, Foot and Mouth Disease in Singapore, a Tropical City-state. Epidemiol Infect. 2016;144(5):1028-34. PubMed PMID: 26374168.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Basic reproduction number of coxsackievirus type A6 and A16 and enterovirus 71: estimates from outbreaks of hand, foot and mouth disease in Singapore, a tropical city-state. AU - Lim,C T K, AU - Jiang,L, AU - Ma,S, AU - James,L, AU - Ang,L W, Y1 - 2015/09/16/ PY - 2015/9/17/entrez PY - 2015/9/17/pubmed PY - 2016/7/9/medline KW - Enterovirus KW - mathematical modelling SP - 1028 EP - 34 JF - Epidemiology and infection JO - Epidemiol Infect VL - 144 IS - 5 N2 - Coxsackievirus A6 (CV-A6), coxsackievirus A16 (CV-A16) and enterovirus 71 (EV-A71) were the major enteroviruses causing nationwide hand, foot and mouth disease (HFMD) epidemics in Singapore in the last decade. We estimated the basic reproduction number (R 0) of these enteroviruses to obtain a better understanding of their transmission dynamics. We merged records of cases from HFMD outbreaks reported between 2007 and 2012 with laboratory results from virological surveillance. R 0 was estimated based on the cumulative number of reported cases in the initial growth phase of each outbreak associated with the particular enterovirus type. A total of 33 HFMD outbreaks were selected based on the inclusion criteria specified for our study, of which five were associated with CV-A6, 13 with CV-A16, and 15 with EV-A71. The median R 0 was estimated to be 5·04 [interquartile range (IQR) 3·57-5·16] for CV-A6, 2·42 (IQR 1·85-3·36) for CV-A16, and 3·50 (IQR 2·36-4·53) for EV-A71. R 0 was not significantly associated with number of infected children (P = 0·86), number of exposed children (P = 0·94), and duration of the outbreak (P = 0·05). These enterovirus-specific R 0 estimates will be helpful in providing insights into the potential growth of future HFMD epidemics and outbreaks for timely implementation of disease control measures, together with disease dynamics such as severity of the cases. SN - 1469-4409 UR - https://www.unboundmedicine.com/medline/citation/26374168/Basic_reproduction_number_of_coxsackievirus_type_A6_and_A16_and_enterovirus_71:_estimates_from_outbreaks_of_hand_foot_and_mouth_disease_in_Singapore_a_tropical_city_state_ L2 - https://www.cambridge.org/core/product/identifier/S0950268815002137/type/journal_article DB - PRIME DP - Unbound Medicine ER -