Thursday, May 06, 2010

HFMD Rising In China




# 4551



Over the last few weeks newshounds on the Flu Forums have been watching an increase in the number of reports in the Chinese media of HFMD (Hand Foot Mouth Disease), particularly in southern China.   


HFMD is often confused by the public with Foot and Mouth Disease (FMD) that affects cattle, swine, and sheep.  Despite the similar name, the diseases are in no way related.


HFMD is a very common viral infection, mainly of children under the age of 10 (adults are vulnerable as well) caused by several of the non-polio enteroviruses.  


While this virus classification may be unfamiliar to a lot of people, the 60+ viruses that fall into this category 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 cause serious illness, and outbreaks are not uncommon in childcare facilities.


In most cases, the illness is mild and uncomplicated.


Over the past decade we've seen outbreaks, particularly in the Far East, caused by the more pathogenic EV-71 virus, and this version of the HFMD can occasionally be quite serious.


Viral meningitis, and less commonly, encephalitis may occur, although most of those infected recover without serious incident.


The more serious EV-71 virus remains mostly a problem in the far east, with outbreaks over the years in Malaysia and Singapore, Korea, Taiwan, sporadic cases reported in Hong Kong, and in 2008 large outbreaks were reported in China.


This report (hat tip Shiloh on FluTrackers) , from Bernama – the Official News agency of Malaysia – indicates that the number of cases of HFMD, and related deaths in China – are up sharply this year.


Hand, Foot And Mouth Disease Outbreak Claims 260 Lives In China

By Vincent Low

BEIJING, May 6 (Bernama) -- The hand, foot and mouth disease (HFMD) outbreak in China has claimed the lives of 260 children, between January and Tuesday.


The health ministry disclosed that a total of 427,278 HFMD cases were reported so far, a figure which was 40 per cent higher than that during the same period last year.


Of this, 5,454 have been found to be severe cases.


HFMD is a common viral illness affecting infants and children which is now at its peak in the Guangxi Zhuang Autonomous Region and Guangdong Province in southern China, Henan and Hebei Provinces in central China, and Shandong Province in eastern China.


Last year, the moderately contagious but typically mild disease caused more than 150 deaths in the country.


"The outbreak of HFMD in China became rampant at the end of last month and begining of this month," said Dr Xiao Donglou, Deputy Director of the Department of Disease Control and Prevention.


"Just within a month, the number of reported HFMD cases had doubled that of 190,000 accumulated cases, as of April 11," he said, adding that the HFMD epidemic might be more rampant in the coming month.


He said the spread of HFMD had currently moved southward to the province of Guangdong and the Guangxi Zhuang Autonomous Region from the north eastern province of Shandong and Hebei Province.




Given that the peak of the HFMD season in China isn’t usually reached until July or even August, authorities are justifiably concerned.


We are seeing a few scattered references in local Chinese media, and the dissident press, of unspecified `new features’ in the virus’s presentation this year, and even speculation that some sort of `mutation’ in the virus may have occurred.


FluTrackers has an ongoing thread with some of these reports.


It’s Possible, of course.  And certainly Interesting.


But news reports out of China aren’t necessarily reliable (okay, I’m being charitable), regardless of their source.  With unverified stories such as these, I always recommend an abundance of caution. 


Still, we’ll watch this story with interest.