Enterovirus Epidemiology and Control in Sarawak, Malaysia

Dr. David Perera
Director 
Institute of Health & Community Medicine,
Universiti Malaysia Sarawak,
Malaysia

ABSTRACT

Hand, foot and mouth disease (HFMD) is endemic to Sarawak with outbreaks occurring annually in the state. The disease is primarily caused by Species A enteroviruses which includes enterovirus 71 (EV-A71) and other coxsackievirus A (CVA) serotypes. While the disease is generally presented as a mild childhood disease, it can also be associated with central nervous system involvement particularly when EV-A71 is present. In 1997, Sarawak recorded a large outbreak of HFMD associated with EV-A71 which saw a number of paediatric fatalities. Subsequently, over the next 2 decades, EV-A71-associated HFMD outbreaks have occurred in Sarawak approximately every three years. Major genotype shifts of the EV-A71 strain was recorded in each of the subsequent outbreaks in 2000 (B4) and 2003 (B5). However from 2003 onwards, a single EV-A71 genotype (B5) was recorded in outbreaks in 2006, 2008/9 and 2011/12. In Malaysia, the Ministry of Health has made HFMD a notifiable disease as a control measure.

The content is authorized by Dr. David Perera on October 29, 2017.

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