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Outbreak of herpangina associated with Coxsackievirus B3 infection
1Department of Pediatrics, Keio University, School of Medicine, Tokyo, Japan.
Abstract:
An outbreak of acute febrile illness was observed in summer, 1987, in a welfare home in which 31 healthy infants were accommodated. Within a 5-day period 25 infants (81%) acquired a febrile illness. Coxsackievirus B3 was isolated from 16 (64%) of 25 throat swabs. In the patients in whom viral culture was negative or not performed, 6 were serologically identified as having a coxsackievirus B3 infection. Among 22 patients identified as having a coxsackievirus B3 infection 7 had typical herpangina and the others had pharyngitis with or without a few small vesicles. Serum alpha-interferon was detected in all but 2 cases (one with proved infection and another with indefinite infection). Herpangina can be associated with coxsackievirus B3 as well as with the more frequently associated coxsackievirus Group A; this explosive type of outbreak might be transmitted by a small particle aerosol.
Insights
An outbreak of acute febrile illness in infants was caused by Coxsackievirus B3. This highly contagious virus spread rapidly, leading to herpangina and pharyngitis in a welfare home setting.
Area of Science:
- Pediatrics
- Virology
- Infectious Diseases
Background:
- An outbreak of acute febrile illness occurred in a welfare home housing 31 infants during the summer of 1987.
- Within a five-day period, 25 infants (81%) contracted the illness.
Purpose of the Study:
- To identify the causative agent of the acute febrile illness outbreak in infants.
- To understand the clinical manifestations and transmission dynamics of the outbreak.
Main Methods:
- Viral isolation from throat swabs of affected infants.
- Serological testing to confirm Coxsackievirus B3 infection.
- Clinical observation for symptoms such as herpangina and pharyngitis.
Main Results:
- Coxsackievirus B3 was isolated from 64% of throat swabs and confirmed serologically in additional cases.
- Seven patients presented with herpangina, while others had pharyngitis with or without vesicles.
- Serum alpha-interferon was detected in most infected infants.
Conclusions:
- Coxsackievirus B3 was identified as the primary cause of the infant febrile illness outbreak.
- Herpangina and pharyngitis are clinical presentations associated with Coxsackievirus B3 infection in this outbreak.
- The rapid, explosive nature of the outbreak suggests transmission via small particle aerosols.