Contagious Virus Linked to Child Deaths

Health officials say Hand Foot and Mouth Disease is behind mysterious deaths in Cambodia.
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Minister of Health Mam Bunheng, Oct. 25, 2011.
Minister of Health Mam Bunheng, Oct. 25, 2011.

A mysterious illness that has already killed dozens of children in Cambodia is believed linked to a virus which causes an infectious childhood disease relatively common in Asia, according to the Cambodian government and the World Health Organization.

In a joint statement issued on Monday, Cambodia’s Ministry of Health and the WHO said that a significant proportion of the 59 hospitalized cases sampled between April and July 5 tested positive for Enterovirus 71 (EV-71).

“Based on the latest laboratory results, a significant proportion of the samples tested positive for EV-71, which causes hand foot and mouth disease (HFMD),” the statement said.

“The EV-71 has been known to generally cause severe complications among some patients.”

The Associated Press reported that of 24 samples tested, 15 came back positive for EV-71.

According to the statement, 59 children were hospitalized between April and July 5, of which 52 died after experiencing fever and respiratory problems that led to rapid shutdown and sometimes neurological symptoms.

Patients ranged in age from three months to 11 years old, but the majority of patients were under the age of three years. The group included a ratio of 1.3:1 females to males.

Lab samples were not available for the majority of cases, as they died before appropriate samples could be taken, the statement said.

A number of other pathogens, including dengue, a mosquito-borne disease that affects the blood, and Streptococcus suis, an infection which can be transmitted to humans from pigs, were identified in some of the samples. The samples were negative for the H5N1 and other influenza viruses, SARS and Nipah.

Cambodian Health Minister Mam Bunheng confirmed that the virus is EV-71, which he said affects the skin, mouth, hands, and feet.

“Further investigation is ongoing and this includes the matching of the laboratory and epidemiological information,” he said.

“We hope to be able to conclude our investigation in the coming days.”

The AP quoted Nima Asgari, who is leading the WHO investigation, as saying that EV-71 had not been identified as a virus in Cambodia before.

Common disease

The joint statement identified HFMD as a “common infectious disease of infants and children” and said that symptoms generally include fever, painful sores in the mouth, and a rash with blisters on the hands, feet, and buttocks.

It said that while the disease is most commonly caused by coxsackievirus A16, infection by enteroviruses, including EV-71, can lead to a more serious form of HFMD which can cause death.

The disease mainly occurs in children under 10 years of age, but more commonly in those younger than five years. Younger children generally suffer from worse symptoms.

The usual period from infection to the onset of symptoms is three to seven days, and the most common symptom of HFMD is fever lasting 24-48 hours.

The statement said that the disease usually begins with a fever, poor appetite, malaise, and frequently with a sore throat.

It said that one or two days after fever onset, sores develop in the mouth, beginning as small red spots that blister and become ulcers, usually located on the tongue, gums, and inside of the cheeks.

In one to two days, a non-itchy skin rash occurs on the palms of the hands, soles of the feet, and buttocks or genitalia.

The joint statement said that the HFMD virus is contagious and spread from person to person by direct contact with most bodily fluids. Infected persons are most contagious during the first week of illness, but the period of communicability can last for several weeks. Animals cannot transmit the disease to humans.

There is no specific treatment available for HFMD, but illness is typically mild and most children recover quickly. The statement advised patients to drink plenty of water or other fluids.

The disease has spread through the Asian region recently, sickening more than 110,000 and killing 166 in neighboring Vietnam last year and killing more than 240 in China this year.

Reported by RFA’s Khmer service. Translated by Samean Yun. Written in English by Joshua Lipes.





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