Sunday, August 21, 2011

Vietnam’s HFMD Outbreak

 

 


# 5768

 

 

Photo Credit University of Iowa

HFMD (Hand Foot Mouth Disease) is a relatively common, and usually mild, viral illness seen mainly in children under the age of 10 (although adults are vulnerable as well) and may be caused by several of the non-polio enteroviruses.

 

The 60+ non-polio enteroviruses identified to date are among the most prevalent viral infections in the world, probably only second to the myriad and ubiquitous variants of Rhinovirus (`common cold’) that circulate every year.

 

The two most common causes of HFMD are the Coxsackie A16 virus, and the Enterovirus-71 (EV-71).

 

The disease caused by the Coxsackie A16 virus is generally the milder of the two, rarely causes serious illness, and outbreaks are not uncommon in childcare facilities. 

 

EV-71 HFMD is most commonly found in the Asia, with serious outbreaks recorded over the past dozen years in places like China, Malaysia, Hong Kong and most recently, Vietnam.

 

This version of the HFMD can sometimes be quite serious, with viral meningitis - and less commonly, encephalitis – complicating matters.

 

This summer Vietnam has seen an explosion of HFMD cases, and has recorded more than 80 deaths. Although the headline in the following story from Than Nien News uses the term `pandemic’, this outbreak would be better described as an `epidemic.

 

Hand, foot and mouth disease spreads to pandemic levels

Last updated: 8/19/2011

Official re-classifies the outbreak as death toll reaches 81

The Ministry of Health is considering declaring hand, foot and mouth disease (HFMD) a pandemic, as more than 32,000 cases of the illness have killed 81 across the country so far this year.

 

According to the ministry, the disease has hit 52 of 62 cities and provinces, mostly in the southern and central regions. Some 96 percent of the fatalities have been children under the age of five.

(Continue . . . )

 

According to a recent VOA Vietnamese news report, about 1/3rd of the cases reported in Vietnam have been due to the more serious virus; EV-71.

 

For more on HFMD, we turn to the CDC’s webpage, which offers advice on prevention, and treatment, focusing primarily on the mild version more likely to be encountered outside of Asia.

 

 

Hand, Foot, and Mouth Disease

 

Hand, foot, and mouth disease is a contagious viral illness that commonly affects infants and children. While there is no vaccine to prevent the disease, there are simple steps you and your family can take to reduce the risk of getting sick.

 

Hand, foot, and mouth disease (HFMD) is a contagious viral illness that commonly affects infants and children in the U.S. and abroad. In the U.S. and other countries with temperate climates, HFMD occurs most often in summer and early autumn. While there is no vaccine to prevent the disease, there are simple steps you and your family can take to reduce the risk of getting sick.

HFMD

  • Usually causes fever, sores in the mouth, and a rash with blisters.
  • Is moderately contagious.
  • Mostly affects children younger than 10 years of age, but people of any age can be infected.
  • Has no specific treatment.
  • Infection risk can be reduced by practicing good hygiene, such as washing hands frequently.
  • Is not the same as foot-and-mouth disease.

(Continue . . . )

 

The CDC also offers a short (4 minute) audio podcast on HFMD, which may be listened to HERE.

image

 

 

Two major genotypes of EV-71, EV-71 B and EV-71 C, have been identified as being responsible for a number of severe outbreaks in Australia, Japan, China, Malaysia, and Taiwan since 1997.

 

Last year, the Virology Journal, published an analysis of an EV-71 HFMD virus that caused a major disease outbreak in Fuyang City, China in 2008 that showed it was due to an emerging recombinant virus (see China: A Recombinant EV-71).

 

Viruses are always changing.

 

Normally mild viral diseases like HFMD can sometimes mutate or pick up genetic material from other viruses and become more virulent or more transmissible as a result.

 

While serious cases are uncommon in Europe or the United States at this time, there is no reason to believe we are immune to an importation of a more severe version of HFMD.

 

More than enough reason to pay close attention to what is happening in Asia today.