An exanthematic disease epidemic associated with coxsackievirus B3 infection in a day care center

Moreira, Regina C.; Castrignano, Silvana B.; Carmona, Rita de C. C.; Gomes, Filumena M. S.; Saes, Sueli G.; Oliveira, Rosely S; Souza, Denise F. C.; Takimoto, Sueko; Costa, Marisa C. L.; Waldman, Eliseu Alves

doi:10.1590/S0036-46651995000300009

Abstracts

An epidemic of exanthematic illness in a day care center is described. Ten children aged 7 to 13 months were affected by the illness. The exanthem was characterized by nonconfluent macular or maculopapular lesions that appeared on the face, body and limbs. Fifty percent of the infected children had fever of up to 39ºC at the beginning of the disease. Coxsackievirus B3 (CB3) was isolated from the stool of one ill child. Paired serum samples were obtained from eight ill children and six of them presented seroconversion to CB3. Antibodies to CB3 were detected at titers higher than 16 in a single serum sample collected from the other two patients. Neutralizing antibodies to CB3 were detected in 71.0% of the contact children.

Enteroviruses; Epidemiology of enterovirus; Exanthematic disease

É descrita uma epidemia de doença exantemática em uma creche, acometendo 10 crianças de 7 a 13 meses de idade. O quadro exantemático caracterizou-se por lesões máculo ou maculopapulares não confluentes, que atingiam a face, tronco e pernas. 50% das crianças infectadas apresentaram febre de até 39ºC, no início da doença. Foi isolado das fezes de uma criança doente o coxsackievírus B3 (CB3). Foram examinados soros pareados de 8 das 10 crianças doentes e em 6 delas demonstrou-se soroconversão para CB3. Duas crianças que apresentaram sintomatologia e que tiveram amostras de sangue colhidas somente 7 meses após a epidemia, apresentaram anticorpos específicos contra o CB3, em títulos superiores a 16. Entre os contatos das crianças doentes, verificou-se que 71,0% do total apresentaram anticorpos neutralizantes específicos contra o CB3.

EPIDEMIOLOGY

An exanthematic disease epidemic associated with coxsackievirus B3 infection in a day care center

Epidemia de doença exantemática associada à infecção causada por coxsackievírus B3 em uma creche

Regina C. Moreira^I; Silvana B. Castrignano^II; Rita de C. C. Carmona^I; Filumena M. S. Gomes^II; Sueli G. Saes^I; Rosely S. Oliveira^II; Denise F. C. Souza^I; Sueko Takimoto^I; Marisa C. L. Costa^II; Eliseu Alves Waldman^III

^IInstituto Adolfo Lutz; Av. Dr. Arnaldo, 355, 01246-902, São Paulo, SP, Brasil

^IIHospital das Clínicas da FMUSP, São Paulo, SP, Brazil

^IIIFaculdade de Saúde Pública da USP, São Paulo, SP, Brazil

SUMMARY

An epidemic of exanthematic illness in a day care center is described. Ten children aged 7 to 13 months were affected by the illness. The exanthem was characterized by nonconfluent macular or maculopapular lesions that appeared on the face, body and limbs. Fifty percent of the infected children had fever of up to 39ºC at the beginning of the disease. Coxsackievirus B3 (CB3) was isolated from the stool of one ill child. Paired serum samples were obtained from eight ill children and six of them presented seroconversion to CB3. Antibodies to CB3 were detected at titers higher than 16 in a single serum sample collected from the other two patients. Neutralizing antibodies to CB3 were detected in 71.0% of the contact children.

Keywords: Enteroviruses; Epidemiology of enterovirus; Exanthematic disease.

RESUMO

É descrita uma epidemia de doença exantemática em uma creche, acometendo 10 crianças de 7 a 13 meses de idade. O quadro exantemático caracterizou-se por lesões máculo ou maculopapulares não confluentes, que atingiam a face, tronco e pernas. 50% das crianças infectadas apresentaram febre de até 39ºC, no início da doença. Foi isolado das fezes de uma criança doente o coxsackievírus B3 (CB3). Foram examinados soros pareados de 8 das 10 crianças doentes e em 6 delas demonstrou-se soroconversão para CB3. Duas crianças que apresentaram sintomatologia e que tiveram amostras de sangue colhidas somente 7 meses após a epidemia, apresentaram anticorpos específicos contra o CB3, em títulos superiores a 16. Entre os contatos das crianças doentes, verificou-se que 71,0% do total apresentaram anticorpos neutralizantes específicos contra o CB3.

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Recebido para publicação em 04/08/1994.

Aceito para publicação em 24/05/1995.

1. ARTENSTEIN, M.S.; CADIGAN, F.C. & BUESCHER, E.L. - Clinical and epidemiological features of Coxsackie group B virus infections. Ann. intern. Med., 63: 597-603, 1965.
2. BENENSON, A.S. - El control de las enfermedades transmisibles en el hombre. 15. ed. Washington, OPAS/OMS, 1992. p. 132-135.
3. CANBY, J.P. - Petechiae and fever: infection with coxsackievirus group B, type 3: case report. Clin. Pediat. (Phila.), 2: 187-188, 1963.
4. CHERRY, J.D. - Viral exanthems. Curr. Probl. Pediat., 13: 1-44, 1983.
5. CHERRY, J.D. - Enteroviruses: poliovirus (Poliomielitis), coxsackieviruses, echoviruses and enteroviruses. In: FEIGIN, R.D. & CHERRY, J.D., ed. Textbook of pediatric infectious diseases. Philadelphia, W. B. Saunders Company, 1987. v.2, p. 1729-1790.
6. GRANDIEN, M.; FORSGREN, M. & EHRNST, A. - Enteroviruses and reoviruses. In: SCHIMIDT, N.J. & EMMONS, R.W., ed. Diagnostic procedures for viral, rickettsial and chlamydial infections. 6. ed. Baltimore, APHA, 1989. p. 513-578.
7. MELNICK, J.L. - Importance and prospects for control of Coxsackievirus and Echovirus infections. In: INTERNATIONAL CONFERENCE ON VACCINES AGAINST VIRAL AND RICKETSIAL DISEASES IN MAN. 1., Washington, Pan American Health Organization, 1967. (Scient. Publ. 147).
8. MELNICK, J.L. - Enterovirus. In: EVANS, A. S., ed. Viral infections of humans - epidemiology and control. 3. ed. New York, Plenum, 1989. p. 191-263.
9. STRIKAS, R.A.; ANDERSON, L.J. & PARKER, R.A. - Temporal and geographic patterns of isolates of non polio enterovirus in the United States, 1970-1973. J. infect. Dis., 153: 346-351, 1986.
10. ZANATE, O.; COTOR, F.; AVRAM, G.; IVAN, A. & NASTASE, M. - Surveillance of enterovirus circulation in children communities. Rev. roum. Virol., 37: 61-66, 1986.

Publication Dates

Publication in this collection
21 Sept 2006
Date of issue
June 1995

History

Accepted
24 May 1995
Received
04 Aug 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARTENSTEIN, M.S.; CADIGAN, F.C. & BUESCHER, E.L. - Clinical and epidemiological features of Coxsackie group B virus infections. Ann. intern. Med., 63: 597-603, 1965.

[2] 2. BENENSON, A.S. - El control de las enfermedades transmisibles en el hombre. 15. ed. Washington, OPAS/OMS, 1992. p. 132-135.

[3] 3. CANBY, J.P. - Petechiae and fever: infection with coxsackievirus group B, type 3: case report. Clin. Pediat. (Phila.), 2: 187-188, 1963.

[4] 4. CHERRY, J.D. - Viral exanthems. Curr. Probl. Pediat., 13: 1-44, 1983.

[5] 5. CHERRY, J.D. - Enteroviruses: poliovirus (Poliomielitis), coxsackieviruses, echoviruses and enteroviruses. In: FEIGIN, R.D. & CHERRY, J.D., ed. Textbook of pediatric infectious diseases. Philadelphia, W. B. Saunders Company, 1987. v.2, p. 1729-1790.

[6] 6. GRANDIEN, M.; FORSGREN, M. & EHRNST, A. - Enteroviruses and reoviruses. In: SCHIMIDT, N.J. & EMMONS, R.W., ed. Diagnostic procedures for viral, rickettsial and chlamydial infections. 6. ed. Baltimore, APHA, 1989. p. 513-578.

[7] 7. MELNICK, J.L. - Importance and prospects for control of Coxsackievirus and Echovirus infections. In: INTERNATIONAL CONFERENCE ON VACCINES AGAINST VIRAL AND RICKETSIAL DISEASES IN MAN. 1., Washington, Pan American Health Organization, 1967. (Scient. Publ. 147).

[8] 8. MELNICK, J.L. - Enterovirus. In: EVANS, A. S., ed. Viral infections of humans - epidemiology and control. 3. ed. New York, Plenum, 1989. p. 191-263.

[9] 9. STRIKAS, R.A.; ANDERSON, L.J. & PARKER, R.A. - Temporal and geographic patterns of isolates of non polio enterovirus in the United States, 1970-1973. J. infect. Dis., 153: 346-351, 1986.

[10] 10. ZANATE, O.; COTOR, F.; AVRAM, G.; IVAN, A. & NASTASE, M. - Surveillance of enterovirus circulation in children communities. Rev. roum. Virol., 37: 61-66, 1986.