RENO — A rare outbreak of hand, foot and mouth disease infected at least 30 children at a Reno day care center, Washoe County health officials reported Friday.
The Coxsackievirus A6 strain in Washoe County broke out beginning in February, said Dr. Randall Todd, director of epidemiology and public health preparedness at Washoe County Health District. Children who were infected started showing severe, painful sores that were distributed over many parts of their bodies, which is uncommon, and a fever.
The reason the outbreak went undetected for weeks was the result of state regulations that did not require doctors to report the condition, Todd said.
“This is a fairly new strain in the U.S.,” Todd said. “Part of the problem is that in most states, including Nevada, this is not a reportable disease.”
Another problem was the fact that this strain of hand, foot and mouth disease presents differently, causing numerous sores in areas throughout the body, a fever and the majority of the children who are infected don’t bother to get tested. The main difference with A6 strain, besides the prominence and severity of sores throughout the body, is the loss of nails after the strain is resolved.
The less-severe strain, called A16, typically presents later in the year. “”It’s different because of the severity of the rash, the distribution and the time of year,” Todd said.
The warmer winter weather may have had some effect on the the early onset.
“What we were concerned about is that they don’t usually occur in the wintertime, so that was unusual. I think because this is a different virus strain, it’s possibly seasonality,” Todd said. “The severity of the rash is going to be different.”
Fortunately, Todd said, the A6 strain is not a disease that is very frequently involved in mortality of a patient.
“Most of the time, it just makes you very miserable.”
Following the confirmation of the outbreak, the Washoe County Health District asked the day care, which the district declined to name, to clean the facility and bleach all areas and toys that children could access.
In all, 30 cases were identified in Nevada. In a few cases, parents contracted the condition.
“It made them miserable for a few days, too,” Todd said. “It can be spread fairly easily, but it is easy to prevent.”
Alabama identified 38 cases of the new strain, California reported seven cases and Connecticut identified one case.
According to the Centers for Disease Control and Prevention, hand, foot and mouth disease is a common viral illness with mild symptoms that present with a low fever, a rash or sores on the palms of the hands and soles of the feet, and sores or blisters inside the mouth.
Hand, foot and mouth disease is a highly contagious disease. It is typically transmitted through nasal or orally, through aerosolized droplets. The incubation period is usually three to six days.
According to the Washoe County Health District, the public should not be overly concerned about the rare strain of A6 cases. This strain is typically seen in Asia and Europe, Todd said, but it’s “finally made it to the U.S.”
At first, the health district tried to tell parents to keep children out of day care and away from other children until the fever subsided, but that didn’t work, Todd said. The child should not have any sores for two days before he or she should be in contact with other people to ensure the disease is not contagious, he said.
“We had some cleaning recommendations in the day care and a number od cases tapered off and went away,” Todd said. “As of now, no new cases in the day care for a couple of weeks. We are not seeing any clustering in other day cares.”