Tuesday, July 17, 2012

The Emerging Threat Of EV71


Photo Credit University of Iowa

# 6439

Although only recently making headlines in the mainstream media, Enterovirus 71 has been known for decades, and has been responsible for a number of severe disease outbreaks in small children, particularly across southeast Asia.


For some earlier blogs on this virus and some of the outbreaks it has caused, you may wish to revisit:

China: A Recombinant EV-71
China Sounds Alert Over EV-71 Virus
China: EV71 Claims 28th Victim, Authorities Warn of Possible `Mass Outbreak'
HFMD Outbreak In China Spreads To 25,000 Children


But it has been the recent outbreak in Cambodia (see Updating The Cambodian EV71 Story) that has helped to propel this virus into the public’s consciousness, and we are now seeing reports in the media on practically a daily basis.

Today, several reports, including one from the Philippines where Assistant Health Secretary Eric Tayag ominously warns that even as the world seeks to eradicate polio from the last four countries, that the EV71 virus may soon become `the new polio’.


EV-71 is the 'new polio,' health experts warn

by Rappler.com

Updated 07/17/2012 7:33 PM

MANILA, Philippines - Two children in the Philippines have been tested positive for "human enterovirus," but the strain is not similar to the EV-71 that has killed kids in Cambodia, the Department of Health said Tuesday, July 17.

(Continue . . .)



A bit premature perhaps, given that the numbers of severe EV71 infections currently pale in comparison to the horrific spread of Polio during the first half of the 20th century.


But there are some valid comparisons between the two viruses.  Both are highly contagious, and both strike predominantly in young children and can cause serious – even fatal – neurological damage. 


From The Lancet, we’ve this 2008 report that makes a similar comparison.


Enterovirus 71 infection: a new threat to global public health?

The Asia-Pacific region has seen more frequent and widespread outbreaks of enterovirus 71 infections in the past decade. Clinicians and researchers are calling for a better understanding of the evolution of such epidemics and for more proactive international public health polices. Jane Qiu reports.

Enterovirus 71 (EV71), a single-stranded RNA virus that belongs to the same category as poliovirus, has made another comeback in many parts of Asia. The reported frequency of EV71 infections are rising on a weekly basis: in Hong Kong, the number of cases reached 79 by late August, the highest in a decade. In some cases, EV71 infections cause hand—foot—mouth disease (HFMD), a common, contagious disease that usually affects children and that is characterised by flu-like symptoms; rash on hands, feet, and buttocks; mouth ulcers; poor appetite; and vomiting and diarrhoea.


However, HFMD can be life threatening, particularly if the virus causes inflammation of the brain stem, which can progress to heart failure and pulmonary oedema.


(Continue . . .)



With no vaccine, and no specific antiviral treatments available, the focus is on stopping the spread of the virus through good hygiene, and when needed, school closures.


Today, from Thailand’s The Nation, we get this report indicating that a number of schools are being closed due to HFMD.



29 Bangkok schools suspend classes following HFMD outbreak

July 17, 2012 6:46 pm


At least 29 schools in Bangkok have suspended some of their classes or shut down their whole facilities in the wake of the hand, foot, and mouth disease or HFMD outbreak.


"In Bangkok, most patients are young children aged not over four years old," Dr Wongwat Liewlak said Tuesday as the head of Bangkok Metropolitan Administration (BMA) Communicable Diseases Control Division.

According to the Public Health Ministry, 12,581 people have come down with the HMFD in Thailand between January 1 and July 9 this year. There is no report of casualties.


Another report out of Thailand, carried by Xinhua News, indicates:


Top Bangkok primary school closes due to hand, foot and mouth disease

Updated: 2012-07-17 15:46:00

BANGKOK, July 17 (Xinhua) -- Bangkok's top-rated Chulalongkorn University Demonstration Elementary School suspended classes from Tuesday through Friday after a number of students were infected with hand, foot and mouth disease, Thai News Agency reported.


Chalermpol Daoruang, the school's deputy director, said that the temporary closure came after an unspecified number of Grade 1 and 2 students were diagnosed with hand, foot and mouth disease ( HFMD).

(Continue . . .)


And yet another report, out of Taiwan today, CDC reports six new enterovirus cases. The good news: all but one of these cases have already been released from the hospital.


Whether EV71 turns out to be 2012’s disease-du-jour, or ends up becoming a pervasive public health problem remains to be seen.


It has the potential, but it may not have the `legs’.


Encouragingly, there does appear to be work going on to create a vaccine against EV71.  In the meantime, like everyone else, we’ll continue to watch the virus for signs of spread, or changes in its behavior.

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