China struggles to contain viral epidemic of HFMD

Channel NewsAsia 2 May 08;

BEIJING: Doctors in China struggled to contain the spread of an intestinal virus that has infected more than 3,300 children, killing 21 of them so far, state press reported Friday.

The latest death occurred in the city of Fuyang in Anhui province, the epicentre of the epidemic with 2,946 children infected there as of Friday, Xinhua news agency reported, citing local health officials.

The number of children in Anhui infected with the enterovirus 71, known as EV71, has risen by nearly 500 since Wednesday, the report said.

Up to 340 children have been infected in central Hubei province and five others are sick in the city of Hangzhou in eastern Zhejiang province, Xinhua reported.

Sixteen children have also fallen ill in Henan province, which borders Anhui.

EV71, which causes hand, foot and mouth disease, is highly contagious and is spread through direct contact with the mucus, saliva, or faeces of an infected person. Young children are most susceptible because of lower immune systems.

The disease begins with fever, blisters, mouth ulcers and rashes, and has spread in Anhui since early March, amid accusations by the Chinese media of a government-led cover-up of the epidemic.

Most of those stricken are under the age of six, with 879 children currently being treated in Fuyang hospitals, nine of whom are in critical condition, the report said. Forty others were in serious condition.

News of the epidemic only surfaced on Monday, when it was reported that 19 children had died.

State television showed video footage of parents from rural areas of Anhui bringing their toddlers to overcrowded hospitals in Fuyang.

Health officials warned that although older people may not show symptoms of the disease, they could be carriers of the virus and could possibly infect others, the report said.

"Fuyang city is strengthening medical emergency treatment and prevention and control measures in every way possible," Xinhua said, noting that treatment facilities would be expanded.

The World Health Organisation earlier this week expressed concern over the epidemic, which in serious cases can lead to brain, heart and lung damage.

It said in a statement Wednesday that while enteroviruses are found across the world, "the situation (in Anhui) is still of concern especially because of the current high reported case fatality rate compared to previous years."

China's health ministry has tried to calm fears, saying early discovery of the disease and better treatment has lowered the mortality rate, but has warned that the disease was likely to spread.

"We estimate that the hand, foot and mouth disease (caused by EV71) in Fuyang city will still continue for some time, the number of cases will continue to increase, and serious and fatal cases might still continue to happen," the ministry said Wednesday.

- AFP/ms

More HFMD cases in next few months
Close schools to check spread of virus that has killed 21 children: WHO
Straits Times 3 May 08;

BEIJING - CASES of hand, foot and mouth disease (HFMD) are likely to increase until next month or July, said the World Health Organisation (WHO) as China reported one more death from the disease.

The latest death occurred in the city of Fuyang in eastern Anhui province, which has been the epicentre of an outbreak that has infected nearly 3,000 and killed at least 21 children, reported state media.

They were infected by a potentially deadly strain of intestinal virus known as Enterovirus 71, or EV71.

EV71, said the WHO, spreads more easily in the summer and autumn months in temperate climates such as eastern China.

The fatality rate from the outbreak in China declined to 0.2 per cent in the April 17-29 period, from 11 per cent between March 10 and 31, the WHO said in its statement.

EV71 can cause ulcers on the tongue and gums, and blisters on the palms, soles and buttocks.

Most children recover within four to six days, according to the US Centres for Disease Control and Prevention (CDC) in Atlanta.

In severe cases, it can lead to fatal swelling of the brain, or encephalitis.

General hygiene measures such as hand-washing can help prevent the spread of the disease for which there is no vaccine.

'It may be advisable to close childcare facilities and schools to reduce the intensity of transmission,' the WHO said, adding that travel or trade restrictions are unnecessary.

Kindergartens in Anhui's Fuyang city closed two days early for the May 1 holiday in China.

Officials have said that almost all of those infected were children under the age of six and most were under two.

Some 738 children have recovered and 702 are still hospitalised, 36 of them in serious condition, Xinhua said. It said that 1,017 children were being treated as outpatients.

Some children have been diagnosed with brain, heart and lung damage, the report said.

China's Hubei province, which borders Anhui, yesterday reported 340 HFMD cases this year, of which at least five were caused by EV71. There were no casualties in Hubei.

Singapore, which is also experiencing an HFMD outbreak, has reported more than 9,000 cases and closed dozens of pre-schools and child-care centres.

EV71 is responsible for one in five of the HFMD cases in Singapore.

The most serious outbreak of HFMD from EV71 occurred in Taiwan in 1998 when 78 children died and 405 others had severe neurological complications, the CDC said.

Taiwan reported 39 cases of severe EV71 infection up to March 7, compared with three cases in the same period last year, according to Hong Kong's Sunday Morning Post.

Vietnam also has seen a sharp increase in EV71 but no details were available, said WHO Western Pacific spokesman Peter Cordingley.

'It is not a notifiable disease and it happens in large parts of Asia. Normally it goes under our radar, but the China outbreak caught our attention because at least 20 children had died,' he told the Post.

BLOOMBERG