Cambodian Children’s Deaths Linked to Hand, Foot and Mouth Disease

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The mysterious illness that has killed dozens of Cambodian children may be a deadly strain of hand, foot and mouth disease, a common childhood illness. Lab tests have confirmed that a virulent strain of the disease called EV-71 was responsible for some of the 59 cases of illness reviewed in Cambodia since April, including 52 deaths, according to the World Health Organization (WHO) and Cambodian Health Ministry.

The numbers of cases and deaths have been scaled down since an initial report put the caseload at 62. Epidemiologists are now interviewing parents and still trying to determine a cause for all the cases; in many, relevant medical information may have been omitted and not all the children were tested before they died. “As far as I’m aware, EV-71 was not identified as a virus in Cambodia before,” Dr. Nima Asgari, who is leading the WHO investigation, told the Associated Press.

The Institut Pasteur in Cambodia tested samples taken from 24 patients and found that 15 came back positive for EV-71.

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EV-71 has been reported in other regions of Asia, including Vietnam and China. This strain of the disease can cause paralysis, brain swelling and death. In Cambodia, most affected children were under age 3, and many experienced severe respiratory symptoms that escalated quickly; some also developed neurological symptoms.

Hand, foot and mouth disease gets its name from a rash that appears on infected persons’ palms and soles (sometimes with blisters), along with painful, red, blister-like lesions on the tongue, gums and inside of the cheeks. Asgari told the AP that blistering was reported in only some of the Cambodian cases, but that steroids administered by doctors could have masked the symptom.

Early symptoms of hand, foot and mouth disease include fever, followed by sore throat and sometimes a poor appetite and malaise. One or two days after the fever begins, painful sores may develop in the mouth or throat, and rashes may then appear within one or two days after that. The usual incubation period — the time from infection to first symptoms — is about three to seven days.

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The disease, which is caused by enteroviruses — the same family as polio — is moderately contagious and is spread through sneezing, coughing and contact with blisters or infected fecal material. Although no vaccine or specific treatment exists, the disease is typically mild and most children recover in 7 to 10 days without medical treatment, according to the Centers for Disease Control and Prevention (CDC).

The CDC notes also that children with hand, foot and mouth disease are most contagious during the first week of illness, but can continue to spread the disease long after symptoms have disappeared because the viruses that cause it can remain in the feces for weeks. Also, infected people who show no symptoms of the disease can still spread the viruses to others.

Hand, foot and mouth disease should not be confused with foot-and-mouth disease which affects cattle, sheep and swine.

Although the U.S. is not experiencing a similar outbreak, hand, foot and mouth disease can be contracted by anyone. Between November 2011 and February 2012, the CDC received reports of 63 people with symptoms of hand, foot, and mouth disease in Alabama, California, Connecticut and Nevada.

To prevent the disease, the CDC recommends:

  • Washing your hands often, especially after changing diapers
  • Thoroughly cleaning objects and surfaces (toys, doorknobs, etc.) that may be contaminated with a virus that causes the disease
  • Avoiding close contact (like kissing and hugging) with people who are infected

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43 comments
stockbuy44
stockbuy44

The kids probably got of dose of Bill Gates new Eugenic depopulation vaccine. Seriously.

onLI
onLI

Pediatricians are doing us a diservice for not reporting this outbreak to the CDC. This isn't the normal coxsackie. It's a nastier strain than usual. It's in the NY metro area as well. For my family, it started as a 100-102 fever for 3 days with extreme malaise, diarhea, appetite loss, and headaches, and then progressed to 3-5 days of lesions in the mouth (and for me laryngitis), and an extremely bad cough.

onLI
onLI

Pediatricians are doing us a diservice for not reporting this outbreak to the CDC. This isn't the normal coxsackie. It's a nastier strain than usual. It's in the NY metro area as well. For my family, it started as a 100-102 fever for 3 days with extreme malaise, diarhea, appetite loss, and headaches, and then progressed to 3-5 days of lesions in the mouth (and for me laryngitis), and an extremely bad cough.

onLI
onLI

Pediatricians are doing us a diservice for not reporting this outbreak to the CDC.  This isn't the normal coxsackie.  It's a nastier strain than usual.  It's in the NY metro area as well.  For my family, it started as a 100-102 fever for 3 days with extreme malaise, diarhea, appetite loss, and headaches, and then progressed to 3-5 days of lesions in the mouth (and for me laryngitis), and an extremely bad cough.

onLI
onLI

It's in the NY metro area too.  My son caught it in pre-school and gave it to me and my husband.  100-102 fever for about 3 days, no appetite, malaise... then progressed to oral lesions, laryngitis (for me),  and coughing fits for days

onLI
onLI

It's also in the NY metro area.  My son caught it... then I did.  100-102 fever for days, appetite loss, malaise...  We had no blisters on the hands/feet, but DO have awful lesions in the throat (and some on my scalp).  I was stuck in bed for 5 days and still have laryngitis.  This is NOT the normal strain going around.  Much nastier.

Skegee
Skegee

So, why is this particular strain so deadly I wonder? Wow...scary. Do they have any proposals on how to treat the poor children that catch it?

Perni79
Perni79

I disagree with the article. There IS a current outbreak of HFM in Maryland.  My children contracted it from their school - which has reported a similar outbreak.  My husband also contracted it, and had a very severe reaction.  Apparently, he contracted a different more virulent strain. This disease MUST be elevated to the CDC.  

Perni79
Perni79

There is an outbreak of HFM currently here in Maryland.  The school at which my children attend have reported outbreaks. My children had a mild to moderate reaction, but my husband, who contracted it from the children, had a severe reaction. Apparently, my husband contracted a different strain. This disease MUST BE elevated to the CDC. 

IrishMomma
IrishMomma

There is a US epidemic.  Our son was covered in blisters from the shoulder to finger tips, hips to bottoms of feet and in and around his mouth.  Fever of 102 for days.  Also hands and feet peeled like he had been burnt.  Large patches of skin at a time.  This is really scarey to witness.  

cmeboxu
cmeboxu

Went to Mexico about 4 weeks ago with my kids 3 and 2. When we got back they were covered in lesions. Went to the doc and he said he didnt know what it was, but it resembled a severe case of hand, foot amp; mouth disease. They recovered within 7 to 10 days with the use of benedryl and calimine lotion. But now they have scars all over their body. Just glad they didn't die from it.

suefran
suefran

tickborne????  babesia form????  coinfection?????  don't just sit there research and find out what the baseline issue is derived from

suefran
suefran

tickborn?????  babesia???????   coinfection??????? 

Valeri Kastoff
Valeri Kastoff

Why do they show a Japanese child at the dentist in the photo. Very confused.

AgentUtah
AgentUtah

There IS currently an outbreak of HFMD though pediatricians do not report incidents to the CDC as they do not believe it necessary or too serious. This strain causes more blistering on hands, feet, mouth and also arms, legs, torso and face with high fever. I have not seen any nail loss as of yet but have read it is possible many weeks later. I have seen skin loss around fingers and toes weeks after illness... similar to blisters without any fluid (you can see the spots coming to surface days before they surface as, what I'd call "dry skin blisters"). San Francisco amp; Portland (OR)...