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Cambodia + Philippines – It's Not Bird Flu or SARS. It's Enterovirus 71


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Enterovirus 71 behind 'mystery disease'

MANILA, Philippines – It's not bird flu or SARS. It's Enterovirus 71.

This virus is behind the “mystery illness” that killed 64 young children and hospitalized 66 in Cambodia, scientists in Phnom Penh said on Sunday, July 8.

The Pasteur Institute in Phnom Penh announced that it discovered Enterovirus Type 71 in about two-thirds of patients. The virus is the “perfect explanation” for the deaths, according to the institute’s virology unit head Philippe Buchy who was cited by Bloomberg.

“We can now focus on how to contain it,” Buchy said.

Enterovirus Type 71 is a strain of hand, foot and mouth disease (HFMD), which is widespread in Asia but rare in Cambodia.

HFMD, a human disease due to intestinal viruses, is not the same as foot-and-mouth disease, which only affects animals. Children affected by HFMD generally suffer high fever, rashes, respiratory and, sometimes, neurological problems.

It took longer for the experts to identify the virus since, in the 64 of the 66 deaths reported since April, the child’s health deteriorated faster than expected.

The Enterovirus 71 usually does not lead to such quick deaths.

Most of the 64 who died are between the ages of two and three, according to Swiss pediatrician Beat Richner of Kantha Bopha children's hospital in Phonm Penh where most of the patients were taken.

"All these children have encephalitis (inflammation of the brain) and in the later hours of their life they develop a severe pneumonia with a destruction of the alveoli in the lungs. That is the reason they die," he said. The alveoli, or air sacs, are pockets in the lungs where the exchange of oxygen and carbon dioxide takes place.

Children admitted to hospitals with symptoms including high fever, breathing difficulty and neurological problems had rapid deterioration of respiratory function, Joy Rivaca Caminade, a technical officer with WHO’s Regional Office for the Western Pacific in Manila, told Bloomberg on July 6.

"This information is valuable" in the investigation, according to Nima Asgari, the leader of the emerging diseases surveillance and response group at the World Health Organization (WHO) in Cambodia, which is working with the local health ministry since July 4.

So far, no cases have been reported outside of Cambodia. It also does not appear to be contagious, Al Jazeera said.

Nonetheless, the Philippines had tightened airport screening efforts in response to the "mystery illness."

The WHO has put neighboring countries on alert about the killer disease.

- Rappler.com and AFP

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-- (c) Copyright AFP 2012-07-08

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Virus Find Helps Mystery Disease Probe in Cambodia

The investigation of a mystery disease that has killed dozens of children in Cambodia is advancing after the discovery in patient samples of a virus that causes hand, foot and mouth disease.

The Institut Pasteur du Cambodge found enterovirus 71 in 15 of 24 patients sampled since mid-June, Philippe Buchy, head of the Phnom Penh-based institute’s virology unit, said today by phone. The virus is known to cause the symptoms seen in the deaths of more than 60 children across the country since April, he said.

“This information is valuable and will help the investigation tremendously,” said Nima Asgari, leader of the emerging diseases surveillance and response group at the World Health Organization in Cambodia, which is working with the local Ministry of Health to review the illness.

The investigation team is now reviewing cases in which the patients died before tests were done to ensure they “at least clinically and epidemiologically” fit the hand, foot and mouth disease profile, Asgari said in an e-mailed response to questions.

The country’s health ministry announced July 4 that it was working with the World Health Organization to actively investigate the cause of the deaths. Preliminary findings had identified 74 cases, the World Health Organization said in a July 6 statement, with the majority of the patients hospitalized in the Kantha Bopha Children’s Hospital in Phnom Penh.

“We have now to see what really is causing the deadly pulmonary complication and see if a toxic factor is playing a role too,” Beat Richner, head of the hospital, said today in an e-mailed statement.

More - Bloomberg Businessweek

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Officials make break in baffling disease killing Cambodian children

Phnom Penh, Cambodia (CNN) -- Health officials say they have made an important discovery in the mystery surrounding the deaths of 64 children in Cambodia.

The Institut Pasteur in Cambodia tested samples taken from 24 patients and found 15 had tested positive for Enterovirus Type 71 -- a common cause of hand, foot and mouth disease that can also cause severe neurologic complications, mainly in children.

"These results now give a good explanation to this outbreak," Dr. Philippe Buchy, head of the institute's virology unit, said in an e-mail. "We will get more results hopefully by next Tuesday or Wednesday."

But an official with the World Health Organization cautioned that the outbreak has not been fully solved, and more analysis is needed.

Outbreaks "occur periodically in the Asia-Pacific region," according to the Centers for Disease Control and Prevention. Brunei had its first major outbreak in 2006. China had an outbreak in 2008.

Though the detection of EV71 in Cambodia is significant, there may be other factors, said Dr. Beat Richner of Kantha Bopha hospitals.

More - CNN

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So far, no cases have been reported outside of Cambodia. It also does not appear to be contagious, Al Jazeera said.

It does not appear to be contagious, coming from a news agency?

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So far, no cases have been reported outside of Cambodia. It also does not appear to be contagious, Al Jazeera said.

It does not appear to be contagious, coming from a news agency?

At least 240 people, mainly children younger than 5 years old, have died from hand, foot and mouth disease (HFMD) from January to May as China enters a peak season of the epidemic, the Ministry of Health has said.

The peak will last until October but the infection commonly seen among toddlers can be easily prevented and treated with early detection and intervention, said Xiao Donglou, a division director of the ministry's disease prevention and control bureau.

http://www.thejakartapost.com/news/2012/07/05/hand-foot-mouth-disease-kills-240-china.html

In recent years outbreaks of severe hand, foot and mouth disease and EV-71 have hit other Asian countries—including Vietnam, where last year it killed 166 people, mostly children, the Associated Press reported. More than 240 people have died of the disease in China this year. It is considered more dangerous for children than adults because of their less-developed immune systems.

http://online.wsj.com/article/SB10001424052702303567704577515672007825712.html?mod=googlenews_wsj

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