BACKGROUND: We experienced a @entity5825 ( @entity5825 ) outbreak in late year 2000 in Singapore. Between 14 September 2000 and 14 November 2000, a total of 3526 cases of @entity5825 were notified. There were 652 @entity1 clinically suspected to have @entity5825 , who were seen at the @entity1 's Emergency department of KK @entity1 's and @entity1 's Hospital of Singapore. OBJECTIVE OF THE STUDY: To study the clinical profile and virologic isolates of @entity1 admitted with @entity5825 during the outbreak. STUDY DESIGN: A prospective observational study. METHODS: Analysis of clinical features and virologic studies of 129 selected cases of @entity5825 and @entity5826 . RESULTS: The median age was 25 months with a range of between 4 months and 11 years. The majority were less than 5 years old (87%). The male-to-female ratio was 1.3:1. The median numbers of day of illness to presentation to the hospital was 3 days. Poor feeding and loss of appetite accounted for 76.7% of the admissions. Symptoms of @entity391 were present in 37.2% of the cases. @entity9645 were found in 96.1%, rashes over hands in 87.6%, over feet in 86.8% and over buttocks in 54.3%. Only 4.7% exhibited no rashes other than oral @entity1066 and were labelled as @entity5826 . The median duration of @entity221 was 3 days, ranging from 2 to 7 days. An intravenous drip was required in 68.2% due to poor feeding. @entity1800 were sent in 89.1% of @entity1 of whom 61.7% of @entity1 were positive for viruses. Of the positive cultures, types of viruses isolated were EV71 (enterovirus 71) in 59/71 (83%), Coxsackievirus (A16, A24, A2 B3, B4) in 6/71 (8.4%), EV Untypable in 4/71 (5.6%) and mixed [EV71, echo25, cytomegalovirus ( @entity2834 )] in 2/71 (2.8%). EV71 was isolated mostly from stool samples followed by vesicle fluid culture and throat swabs. Two siblings aged 14 months and 2.5 years died during this period at day 5 of illness, their post-mortem examinations showed @entity401 of the lungs. EV71 was isolated from the brain, heart, tonsils, intestines, throat and rectal swabs. A raised total white cell count of 14,000/L versus 12,000/L was significantly associated with complicated @entity5825 (P = 0.04). There was no difference in clinical characteristics of EV71 versus non-EV71 infections. Other viral illnesses, e.g. measles and @entity2834 , may be mistaken for @entity5825 in the outbreak setting. CONCLUSIONS: @entity5825 tends to occur in younger @entity1 less than 5 years old due to low herd immunity. Poor feeding due to mouth @entity1066 accounts for admission to hospital requiring intravenous drip. EV71 accounted for the majority (75%) of the positive isolations, followed by coxsackievirus and untypable EV, @entity325 of echovirus or @entity2834 . The yield of virus isolation was highest from stool, followed by vesicles and throat swabs. There is no difference in clinical characteristics of EV71 and non-EV71 virus infections. Enterovirus can cause mild symptoms to @entity204 . Two @entity1 died of @entity401 and @entity198 .

Clinical characteristics of an outbreak of XXXX in Singapore.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'Women', 'Children', 'infants'] @entity198 :: ('MESH:D004660', 'Disease') :: ['encephalitis'] @entity9645 :: ('MESH:D019226', 'Disease') :: ['Oral ulcers'] @entity5825 :: ('MESH:D006232', 'Disease') :: ['HFMD', 'hand, foot and mouth disease'] @entity391 :: ('MESH:D014839', 'Disease') :: ['vomiting'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcers'] @entity1800 :: ('MESH:D014777', 'Disease') :: ['Viral cultures'] @entity325 :: ('MESH:D060085', 'Disease') :: ['mixed infection'] @entity2834 :: ('12305', 'Species') :: ['CMV'] @entity401 :: ('MESH:D017563', 'Disease') :: ['interstitial pneumonitis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['fatal death'] @entity221 :: ('MESH:D005334', 'Disease') :: ['fever'] @entity5826 :: ('MESH:D006557', 'Disease') :: ['herpangina']
@entity5825 :: (MESH:D006232,Disease) :: ['hand, foot and mouth disease']
