Monitoring the Influence of Hand, Foot, and Mouth Disease: New Guidelines on Patient Care during the 2011–2012 Multiwaves and Multivariant Outbreak in Hai Phong City, Vietnam
Nghia Ngu Duy,
Le Thi Thanh Huong,
Patrice Ravel,
Le Thi Song Huong,
Ankit Dwivedi,
Guilhem Kister,
Laurent Gavotte,
Christian A. Devaux,
Vu Dinh Thiem,
Nguyen Thi Hien Thanh,
Tran Nhu Duong,
Nguyen Tran Hien,
Emmanuel Cornillot,
Roger Frutos
Affiliations
Nghia Ngu Duy
National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi 100000, Vietnam
Le Thi Thanh Huong
National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi 100000, Vietnam
Patrice Ravel
Institut de Recherche en Cancérologie de Montpellier (U1194), IRCM, Université de Montpellier, Campus Val d’Aurelle, CEDEX 5, 34298 Montpellier, France
Le Thi Song Huong
Hai Phong Preventive Medicine Center, Hai Phong City 180000, Vietnam
Ankit Dwivedi
Institut de Recherche en Cancérologie de Montpellier (U1194), IRCM, Université de Montpellier, Campus Val d’Aurelle, CEDEX 5, 34298 Montpellier, France
Guilhem Kister
Faculty of Pharmacy, University of Montpellier, 15 av Charles Flahault, BP14491, CEDEX 5, 34093 Montpellier, France
Laurent Gavotte
Espace-DEV, Université de Montpellier, 500 Rue Jean François Breton, 34090 Montpellier, France
Christian A. Devaux
IHU Méditerranée-Infection, 19-21 Bd Jean Moulin, 13005 Marseille, France
Vu Dinh Thiem
National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi 100000, Vietnam
Nguyen Thi Hien Thanh
National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi 100000, Vietnam
Tran Nhu Duong
National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi 100000, Vietnam
Nguyen Tran Hien
National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi 100000, Vietnam
Emmanuel Cornillot
Institut de Recherche en Cancérologie de Montpellier (U1194), IRCM, Université de Montpellier, Campus Val d’Aurelle, CEDEX 5, 34298 Montpellier, France
Roger Frutos
CIRAD, UMR 17, Intertryp, TA-A17/G, Campus International de Baillarguet, CEDEX 5, 34398 Montpellier, France
From 2011 to 2012, Northern Vietnam suffered its first large-scale hand, foot, and mouth disease (HFMD) epidemic. Two sets of official guidelines were issued during the outbreak to handle the HFMD crisis. The city of Hai Phong was used as a model to analyze the impact of the released guidelines. A total of 9621 HFMD cases were reported in Hai Phong city from April 2011 to December 2012. Three distinct waves of HFMD occurred. Enterovirus A71 and Coxsackievirus A16 were successively associated with the epidemics. Two periods, before and after the guidelines’ release, could be distinguished and characterized by different patient patterns. The time to admission and severity changed notably. Guideline publications help the health system refocus on the 0.5–3 years age group with the highest incidence of the disease. The three waves showed different special distribution, but the main routes of infection were rivers and local secondary roads, most likely through local trade and occupational movements of people.
