Four Thai Children Develop Symptoms Like Hand, Foot And Mouth Disease: Kanchanaburi

[webfact]

Four Thai children develop symptoms like hand, foot and mouth disease

KANCHANABURI, July 10 – Four two-year-old children in a childcare centre in Kanchanaburi have developed symptoms similar to those of hand, foot and mouth disease and tests are being conducted to determine the virus strain.

After the cases were detected, the childcare centre at Chaichumponchanasongkram Temple in Kanchanaburi’s provincial seat, which accommodates 155 children, was closed for a week to investigate the source of the disease, Deputy Public Health Minister Surawit Khonsomboon said on Tuesday.

Five children have been separated from other children and taken to hospital to have their body fluids tested in further diagnosis.

Initially, four children developed symptoms of apparent hand foot and mouth disease with ulcers in their mouths and on their tongues, while some have a rash with small blisters on their hands and feet. The other child with fever is being closely monitored.

The deputy minister said the ministry ordered public health offices in all provinces to keep watch for the disease, particularly in the provinces along the Thai-Cambodian border after 52 children out of 59 previously undiagnosed cases have died since mid-April.

Recent laboratory results showed "a significant proportion of the samples tested positive for Enterovirus 71 (EV-71)", which causes a lethal strain of hand, foot and mouth disease, Agence France Presse news agency reporting the joint statement of the World Health Organisation and Cambodian public health ministry.

Cambodia is working with the World Health Organisation to investigate the spread of the virus and to contain the disease.

Hand, foot and mouth disease symptoms were also found in children under the age of five in Thailand with full recovery in one week. The virus strain detected in Thailand is not as severe as the lethal strain detected in Cambodia, the minister said.

Hand, foot and mouth disease is contagious and spreads through direct contact with the bodily fluids or faeces of an infected person. (MCOT online news)

-- TNA 2012-07-10

[Redr0m]

Never heard of it to be lethal, my daughter just had it along with 5 other students of her nursery, i wrote my doctor back home and looked it up on the internet myself, both answers were similar a common children virus that starts with fever and then develops blisters nothing dangerous and very common. Both advised to stay home until the blisters dries out, only to get medical assistance if the blisters in the mouth gets too painful and get something to sooth the pain so she can eat again. Don't understand why its always such a big issue in Thailand, as its very common and most children will have it once in their life.

[GentlemanJim]

Never heard of it to be lethal, my daughter just had it along with 5 other students of her nursery, i wrote my doctor back home and looked it up on the internet myself, both answers were similar a common children virus that starts with fever and then develops blisters nothing dangerous and very common. Both adviced to stay home untill the blisters dries out, only to get medical asstistance if the blisters in the mouth gets to painfull and get something to sooth the pain so she can eat again. Dont understand why its always such a big issue in Thailand, as its very common and most children will have it once in their life.

Really? I have not known any child to have it in either my own or my extended family.

[Yunla]

Wishing them a speedy recovery to full health.

Edited July 10, 2012 by Yunla

[Reasonableman]

Cambodian Deaths Tied to Hand, Foot and Mouth Disease

A deadly form of a common childhood illness has been linked to the mysterious child deaths in Cambodia that sparked alarm after a cause could not immediately be determined, health officials said Monday. Lab tests have confirmed that a virulent strain of hand, foot and mouth disease known as EV-71 is to blame for some of the 59 cases reviewed since April, including 52 deaths, according to a joint statement from the World Health Organization and Cambodian Health Ministry. The numbers were lowered from the initial report of 62 cases.

Read more: http://healthland.time.com/2012/07/09/cambodian-deaths-tied-to-hand-foot-and-mouth-disease/#ixzz20COtVmzm

[webfact]

HAND, FOOT AND MOUTH

Disease warning for schools

The Nation

BANGKOK: -- The Public Health Ministry on Tueday instructed schools and nurseries nationwide to close if they find that students in five classes or more have contracted hand, foot and mouth disease.

The move follows reports that at least 64 children in Cambodia died after being infected with enterovirus 71, know to cause the disease, since April this year.

In Thailand, about 10,813 children are believed to have caught the disease during the most recent outbreak but there were no reports of any fatalities.

Disease Control Department director general Dr Pornthep Siriwanarangsan said the strain of hand, foot and mouth disease currently spreading in the country is not a virulent one.

It is recommended that children with fever, blister-like lesions on the tongue, gums and inside of the cheeks, and a pimple-like rash on the hands and feet be taken to a clinic for treatment.

About 20,000 nurseries have been told to suspend classes if they find that two or more children have been infected with the virus. School who find infected students in five classes have been told to close.

-- The Nation 2012-07-10

[Thai at Heart]

Never heard of it to be lethal, my daughter just had it along with 5 other students of her nursery, i wrote my doctor back home and looked it up on the internet myself, both answers were similar a common children virus that starts with fever and then develops blisters nothing dangerous and very common. Both adviced to stay home untill the blisters dries out, only to get medical asstistance if the blisters in the mouth gets to painfull and get something to sooth the pain so she can eat again. Dont understand why its always such a big issue in Thailand, as its very common and most children will have it once in their life.

Well considering that Cambodia had possibly something similar that is fatal, and the ministry only a couple of days ago said that there was no risk, I would suggest that this may be quite serious.

Beyond that, if it gets into the livestock population, well, what a mess that will make.

[Redr0m]

Well i agree after reading more that it may acctual be serious, however im pretty sure this a very rare kind of the virus, cause when googleing it none of the first many hits says anything about it being dangerous or contacting doctors. So this must be a rather new string and way more dangerous virus that people is not yet aware of. Pretty sure that leading health sites run by doctors would tell people to imidiately seek medical assistance if it was known to be lethal.

[bluegum]

Thai health and education authorities need to be on this like bloodhounds, especially in areas bordering Cambodia. Youngsters in tropical countries like Thailand are extremely vulnerable to Hand-Foot-Mouth. Up to now its been a blessing that it rarely brings anything more than discomfort for the child and follows a well understood lifecycle. The strain found in Cambodia has proven lethal however - what happened there was a genuine tragedy.

I get the shivers thinking about what damage it may do in Thailand, not just in the near term, but longer term. The 'kind' strain is endemic throughout SE Asia and would seem impossible to eradicate. The twice annual HFM outbreaks across Thai kindergartens could become horror stories if the lethal strain becomes established here.

[geriatrickid]

The Cambodian situation has been in the alert memos for a month now. It is spreading as was predicted. I don't envy the health officials that will have to contain this. Once it gets into the population it will take months to contain and control. Vietnam has been struggling for quite some time to deal with it. Brace yourself for some inconvenient quarantines.

[MEL1]

52 OUT OF 59 'UNDIAGNOSED' died before being assessed, or diagnosed.

How many did they come into contact with, before diagnosis?

Others, treated at a Wat? .... were moved to hospital,,,, and the others presumably have not so far been diagnosed also?

This seems, based upon info, to be a new sub-group, or particularly bad new strain of the disease, does it not?

Possibilities here of a serious epidemic of monstrous proportions..... a killer at bay, if you like.

I sure hope not, but this could become a biggie here, as initial diagnosis in the lesser parts of townships, and hence passed to cities, is virtually unsighted.

The quote actually said, "like or similar to those of known FHM disease" (like or similar being very 'operative' words!)

Be careful, esp Kinder and Primary/Elementary teachers all over....... this might be a sweepstake!

-mel.

[ripstanley]

Tonight on Austrlaian network 1930 news the Cambodian children deaths was a news item. One doctor (who was European)said that there were now 64 deaths. He also said that their respiratory system eventually fails

Edited July 10, 2012 by ripstanley

[GentlemanJim]

As people are claiming Hand foot and mouth is common for children out here, is there a vaccine for it?

[elektrified]

Never heard of it to be lethal, my daughter just had it along with 5 other students of her nursery, i wrote my doctor back home and looked it up on the internet myself, both answers were similar a common children virus that starts with fever and then develops blisters nothing dangerous and very common. Both adviced to stay home untill the blisters dries out, only to get medical asstistance if the blisters in the mouth gets to painfull and get something to sooth the pain so she can eat again. Dont understand why its always such a big issue in Thailand, as its very common and most children will have it once in their life.

Really? I have not known any child to have it in either my own or my extended family.

My son had it one week ago. Had a very high fever followed by the blisters on the feet, hands and mouth. He was sick 3-4 days. Just 2 or 3 days before he got sick we got the notice from the Health Department which was sent home with all the students. Otherwise we would have really been worried. We were able to identify the symptoms immediately. More than a week later now, he still has the dried out blisters on his hands.

[elektrified]

As people are claiming Hand foot and mouth is common for children out here, is there a vaccine for it?

No vaccine according to the info sent home with my child.

[IsaanUSA]

Never heard of it to be lethal, my daughter just had it along with 5 other students of her nursery, i wrote my doctor back home and looked it up on the internet myself, both answers were similar a common children virus that starts with fever and then develops blisters nothing dangerous and very common. Both advised to stay home until the blisters dries out, only to get medical assistance if the blisters in the mouth gets too painful and get something to sooth the pain so she can eat again. Don't understand why its always such a big issue in Thailand, as its very common and most children will have it once in their life.

The "official" thread is over in the SE Asia sub-forum. So if you don't browse there, you might have missed it in the news.

[DanRRW]

My wife and I have a small nursery in Chiang Mai and HF&M is a hot topic at the moment. Last year one child got it and we followed official advice and closed the school for cleaning. It never went any further than that one child and we were none the wiser.

We then decided that we would only consider closing the school if two or more children caught the disease at the same time.

Two or three of the children at our school have caught HF&M over the past 5 weeks or so and the symptoms have been mild, albeit different from one child to the next. Our policy is to announce the the news at the second reported case, whether it occurs around the same time or within a couple of weeks.

Maintaining high standards of cleanliness (especially during the rainy season when the disease is most prevalent), and making sure the children wash their hands after using the bathroom are the best courses of action for any childcare setting. A policy of openness also goes a long way with the majority of parents.

The Thai authorities seem to promote school closure immediately, but in other places I have read that their advice is to close if children from 5 classes become infected.

From a school owner's perspective some clear, practical and sensible guidance from the government is required.

[waza]

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.

According to official statistics the infection claimed more than 240 lives on the mainland in the first five months of the year.

The epidemic appeared to hit harder this year in terms of scale and severity, Xiao said.

From January to June last year, 132 deaths were reported.

An official tally showed China reported nearly 1.62 million HFMD cases in 2011, including 509 deaths

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

[Reasonableman]

"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."

A bit confusing, since once detected it is already too late to be prevented. What can be done is limit the spread of further infection to others. Treatment is largely symptomatic treatment, not curative, afaik. While the words above are reassuring, prevention is not all that easy. Schools/daycare centers can be closed and children sent home and the infected can be isolated, but there are plenty of potential areas of failure, such as infection of siblings at home. It is a nasty infection, and the kids can suffer great discomfort (to their parents' consternation) even with a lesser strain on infection. Hospitalisation, due to inability to take food and fluids (very sore mouth, throat) is not uncommon.

Edited July 10, 2012 by Reasonableman

[webfact]

Health ministry boosts prevention measures against hand, foot and mouth disease

BANGKOK, July 11 – Thailand’s Public Health Ministry on Wednesday is meeting local health officials nationwide via video conferencing to improve surveillance measures following the spread of hand, foot and mouth disease in Cambodia.

Permanent Secretary for Public Health Paijit Warachit said the virus strain causing hand, foot and mouth disease in Thailand is Enterovirus 71 B5 and Coxsackievirus, which are not as severe as Enterovirus 71 D4, detected in the neighbouring country of Cambodia.

It is normal to have patients, contracting hand, foot and mouth disease from Cambodia, crossing the border to seek medical treatment in Thailand, he added.

The public should not panic as the disease can be prevented through good hygiene – such as washing hands and using serving spoons. Teachers and parents are advised to pay attention to children’s hygiene.

Regarding four children who developed symptoms similar to hand, foot and mouth disease in Kanchanaburi, the lab test results reporting the virus strain will be known within a week. (MCOT online news)

-- TNA 2012-07-11

[webfact]

Public Health Ministry orders nationwide emergency surveillance of Hand-Foot-Mouth outbreak

BANGKOK, 11 July 2012 (NNT) – The Public Health Ministry has instructed health offices nationwide to watch out for the possible outbreak of the Hand-Foot-an-Mouth disease outbreak.

Permanent Secretary for Public Health, Dr. Paijit Warachit, said that the Ministry, on Tuesday, sent out emergency letters to all provincial health offices, ordering nationwide surveillance of the outbreak of the Hand-Foot-Mouth disease among young children.

Dr. Paijit stated that even though Thailand remains safe, the Public Health Ministry will not lower its guard and is urging all healthcare offices, particularly pediatricians along the Thai-Cambodian border to thoroughly check their patients, in accordance with standard medical practices, to prevent the spread of the disease.

According to the Public Health Ministry Permanent Secretary, the severity of the Hand-Foot-Mouth disease findings in Thailand has been low, with 10,813 children infected with the virus this year and no death reported.

During the past 3 months, 62 young Cambodians have been killed by a severe strain of Hand-Foot-Mouth virus.

In addition, Dr. Paijit has instructed provincial health officers to child care centers and kindergartens to give advice on how to effectively sterilize their utensils and facilities and to educate young children about hand sanitation, in a bid to prevent the Hand-Foot-Mouth disease.

-- NNT 2012-07-11

[softgeorge]

Never heard of it to be lethal, my daughter just had it along with 5 other students of her nursery, i wrote my doctor back home and looked it up on the internet myself, both answers were similar a common children virus that starts with fever and then develops blisters nothing dangerous and very common. Both adviced to stay home untill the blisters dries out, only to get medical asstistance if the blisters in the mouth gets to painfull and get something to sooth the pain so she can eat again. Dont understand why its always such a big issue in Thailand, as its very common and most children will have it once in their life.

Really? I have not known any child to have it in either my own or my extended family.

Dito I have not heard of it either. Never heard of a child in Australia having it even through my days in nurseries and schools. I thought it was just a 3rd world country thing.

[Nigel1500]

Wow, I'd never even heard of this.

[mrtoad]

Not uncommon, they even have outbreaks of it from time to time in the U.K, however here in Thailand it seems much more frequent. not pleasant for the children concerned.

[brianP]

Those first 7 years of a child are vulnerable times. US and European strains are different as well as our immune systems to Asian viruses and those are constantly mutating stronger. And with international travel spreading germs everywhere. Wash up and then do it again!

[meatboy]

how sad to see all these children suffering as 6.30am today 64deaths in cambodia,but what i saw yesterday on the front page of a newspaper i was so appalled by it i sometimes wonder,an outbreak of sickness among children hospitals overwelmed so much that treatment centers had to be set up,but the paper front page showed beds with children on drips but also crowds of reporters and camera men taking photo's and allowed to roam around the treatment area,no masks and no compassion for these poor chidren.

[nikster]

Well the spots on hand, foot, and mouth are just the symptoms, and they can be caused by a variety of viruses.

Those in the west are all considered harmless; this strain that was found in Cambodia clearly isnt.

[Norcan]

Some useful information (and technology) to combat this disease here