An outbreak of hand, foot, and mouth disease in Singapore

Epidemiological studies were carried out during an extensive outbreak of hand, foot and mouth disease caused by coxsackievirus A 16 in Singapore in 1981. Most of the cases were concentrated in densely populated public housing estates, and the morbidity rate was highest in children under 5 years of age. The mean secondary attack rate for children under 12 years of age was 76.7% compared with an overall rate of 31.3%. The incubation period ranged from 1 to 7 days. Factors favouring the transmission of infection within a household included sharing of household and personal articles with the index case. The disease was mild and self-limiting.