Thai Health Ministry: Number Of Hand, Foot And Mouth Disease Patients Rises To Over 12,000

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Health Ministry: Number of hand, foot and mouth disease patients rises to over 12,000

BANGKOK, July 14 - The number of hand, foot and mouth disease patients in Thailand has increased, including those infected by Enterovirus 71 D4, according to the Department of Disease Control.

Dr Pornthep Siriwanarangsan, director-general of the disease control department, said more than 12,000 persons were found to be infected by the hand, foot and mouth disease, increasing by 1,200 cases in one week from 10,800 recorded last week. The patients were reported in every province of Thailand but with higher numbers in the upper North and some northeastern provinces.

Dr Pornthep said the ministry of public health has instructed provincial health offices to immediately close affected schools where more than five patients were detected for at least one week, to stop the spread of the disease.

The problem is that some schools remained open, leading to a rise in the number of patients, according to the director-general.

Dr Pornthep stated he will inform the health minister of the matter next week and will propose the setup of a war room to monitor the disease and act as a disease control panel, authorised to order the immediate closure of any school with high numbers of cases.

Although no death from the hand, foot and mouth disease has been reported in the kingdom, Dr Pornthep said the severe Enterovirus 71 D4, which has killed dozens of Cambodian children, was also detected in one in every 100 Thai patients.

He said the number tended to rise and almost 200 persons have reportedly suffered from the more severe strain.

The health ministry earlier ordered public health offices in all provinces to keep watch for the disease, particularly in provinces along the Thai-Cambodian border.

Hand, foot and mouth disease is a highly contagious disease which spreads through direct contact with bodily fluids or faeces of infected persons. (MCOT online news)

-- TNA 2012-07-14

[Scott]

I thought that one of the reason for the high death toll in Cambodia was that they were treated with steroids which contributed to the organ failure.

[dcutman]

The only other story I have read was from July 10. 4 kids had it in Kanchanauri. Now there is 12,000?

I read the news every day, not sure how it went from 4 to 12,000 without another news piece somwhere. Or I missed some thing. Would this many cases in a week be considered a epidemic?

[dcutman]

I thought that one of the reason for the high death toll in Cambodia was that they were treated with steroids which contributed to the organ failure.

You are 100% correct on that, apparently. CNN News reporter and Doctor Sanja Gupata went to Cambodia last week to investigate, just confirmed that.

[Felt 35]

The only other story I have read was from July 10. 4 kids had it in Kanchanauri. Now there is 12,000?

I read the news every day, not sure how it went from 4 to 12,000 without another news piece somwhere. Or I missed some thing. Would this many cases in a week be considered a epidemic?

That was before WHO called and asked for accurate numbers

[Kilgore Trout]

I've worked at a few schools that had outbreaks of hand foot and mouth. Problem is, the Thai admins just wont close down the school unless forced to by authorities (or in the cases I've experience with, until the pressure from foreign staff and parents was strong enough, and then admin resented foreigners for forcing their school to close) to close.

It is just not important enough to them; full stop. Any amount of literature on the nature of this sickness or expert advice is just nonsense to them.

Part of the problem is parents too; particularly Thai parents and those of some othe asian ethnicities. They want their kids at school, no matter how sick or infectious they are. Thai admin are more than happy to oblige.

This is how this disease spreads. Schools must be closed and all places touched by little hands must be cleaned with bleach.

Its not rocket science; its Thai pride

[Scott]

It is not always as easy as it seems. I spoke with our principal about the situation at the school. I noticed that one of the classes had 23 students absent, another 15. I asked her if it was because of HFM and she said 'no'. She said that they had 3 confirmed cases, 1 each of the three buildings, and the rest were probably due to other illnesses or scared parents.

Her plan, unless otherwise instructed by the Ministry of Health is to close any class with 2 confirmed cases. If there are more than 5 cases in a building, then the entire building will be shut down. She hasn't decided about G. 1 yet, but the higher grades should have immunity from the disease.

Fortunately, she has a medical background, and she is pretty vigilant about things like this--had a doctor from the Ministry of Health come in when the Swine flu was a problem. All students with a fever were sent to a hospital and eventually the school was closed for 2 days and disinfected.

The owner, however, would much, much rather cover things up.

Schools are a perfect environment for the spread of disease.

[BigC]

what about treatment where do we go to get help if a child has suspected disease. i know the short answer is the hospital but out here simple things sometimes turn out to be complicated.

for example not all hospitals have anti snake venom.

If my kid has something i do not want to be running around from hospital to hospital looking for someone to treat my child.

Edited July 14, 2012 by Scott
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[Nisa]

what about treatment where do we go to get help if a child has suspected desease. i know the short answer is the hospital but out here simple things sometimes turn out to be coplicated.

for examplenot all hospitals have antie snake venim.

If my kid has something i do not want to be runnong around from hospital to hospital looking for someone to treat my child.

There is really no treatment for the HFM virus except for treating the symptoms and drinking plenty of water and getting rest. It is a common childhood ailment and usually goes away within a week. There are different strains that yield worse symptoms (like different flu strains) but in the end it is about treating the symptoms until the virus passes to avoid further complications.

[Thai at Heart]

Apparently a very good friend of ours daughter has just been diagnosed with kai wat nok, in hospital at the moment. Not sure how serious it is but no one seems to be panicking yet.

School has been informed, let's see what happens on Monday. She is in the other stream from my son

[geriatrickid]

The beastie tentatively identified in this outbreak is Enterovirus Type 71. An uncontrolled infection causes the brain to swell when fluids accumulate, resulting in paralysis and sometimes death. The presumed E71 also is linked to the distruction of the aleveola. If you remember your high school biology classes, these are the little sacs in the lungs that allow for the absorption of oxygen from the air. When theses sacs are damaged, respiratory collapse ensues.

There is a disagreement between the Pasteur Institute in Cambodia and the WHO. While WHO acknowledges the presence of the E71 in the dead Cambodians, WHO is asking for more tests. Pasteur is saying, no, we're certain. In the meantime, there is dithering on the treatment protocols. You can't treat unless you know what's causing the infection. Remember, antibiotics and standard treatments are ineffective against E71.

This epidemic was under control until last month and then it spiked. I believe that China has reported 248 deaths since January. A rule of thumb is that the numbers are always higher in SE Asia because epidemic deaths are under reported. Nothing sinister, its just that many of the sick do not receive medical care or the reporting methods are not precise.

BTW, there are now quarantine pre- alerts in place for the region. No one is being quarantined and there is no imminent threat of restricted travel, but health authorities are on the look out for people with symptoms. It's no secret either. The DOH in the Phillipines has the advisory posted publicly. Hong Kong, Taiwan, Japan already have a surveillance system in place for infectious diseases, so it's just another item added to the list for the officials at the border.

If this epidemic continues to spread over the next month I anticipate the closure of schools and related locations for at least 2 weeks. We'll know in another 2 weeks how serious the problem is. It's one of those wait and see situations. All one can do is to practice basic hygiene and carry on living.

[Falcon]

There is really no treatment for the HFM virus except for treating the symptoms and drinking plenty of water and getting rest. It is a common childhood ailment and usually goes away within a week. There are different strains that yield worse symptoms (like different flu strains) but in the end it is about treating the symptoms until the virus passes to avoid further complications.

this is not just a childhood ailment, my Son has had it 4 times when we lived in Bangkok (Minburi) and the last time my Wife also got it as it is passed on through contact and very contageous. Its very very painful for anyone with this HFM virus and its almost impossible for them to eat due to the mouth and throat ulcers. both my Son and Wife suffered through this for 5 days before they were able to do anything but sip water. I hope that the WHO are able to do something positive towards eradicating this nasty virus and soon,

[Reasonableman]

There is really no treatment for the HFM virus except for treating the symptoms and drinking plenty of water and getting rest. It is a common childhood ailment and usually goes away within a week. There are different strains that yield worse symptoms (like different flu strains) but in the end it is about treating the symptoms until the virus passes to avoid further complications.

this is not just a childhood ailment, my Son has had it 4 times when we lived in Bangkok (Minburi) and the last time my Wife also got it as it is passed on through contact and very contageous. Its very very painful for anyone with this HFM virus and its almost impossible for them to eat due to the mouth and throat ulcers. both my Son and Wife suffered through this for 5 days before they were able to do anything but sip water. I hope that the WHO are able to do something positive towards eradicating this nasty virus and soon,

I suspect eradication is impossible, but the authorities will do their best to limit the range and speed of its spread. Given that it has been a serious problem already in China and Cambodia, and its now hit Thailand, I'm not overly optimistic.

[Nisa]

There is really no treatment for the HFM virus except for treating the symptoms and drinking plenty of water and getting rest. It is a common childhood ailment and usually goes away within a week. There are different strains that yield worse symptoms (like different flu strains) but in the end it is about treating the symptoms until the virus passes to avoid further complications.

this is not just a childhood ailment, my Son has had it 4 times when we lived in Bangkok (Minburi) and the last time my Wife also got it as it is passed on through contact and very contageous. Its very very painful for anyone with this HFM virus and its almost impossible for them to eat due to the mouth and throat ulcers. both my Son and Wife suffered through this for 5 days before they were able to do anything but sip water. I hope that the WHO are able to do something positive towards eradicating this nasty virus and soon,

I suspect eradication is impossible, but the authorities will do their best to limit the range and speed of its spread. Given that it has been a serious problem already in China and Cambodia, and its now hit Thailand, I'm not overly optimistic.

It is also not like serious outbreaks of the HFM virus are uncommon in past years either ... http://en.wikipedia.org/wiki/Hand,_foot_and_mouth_disease#Notable_Outbreaks

Last year Vietnam had 112,000 reported people infected and 169 deaths from it. The first quarter of this year the rate of infected people was 7 times higher. http://english.vov.vn/Home/Handfootmouth-disease-spreading-quickly/20123/135589.vov

Edited July 14, 2012 by Nisa

[Reasonableman]

Quite so, but the concern this time is that the strain seems more virulent, and has caused hundreds of deaths.

[Thai at Heart]

Mucus, saliva and feces spread it.

Who hasn't been washing they're hands before eating then. Throw in communal eating, shared utensils, cups, a dash if cold water for washing and you can see why it hours around a school very very .

Till this day there are still water coolers with one cup sitting there in glorious isolation in just about every school in the country. Well it ever change?

Edited July 14, 2012 by Thai at Heart

[annabel]

There is really no treatment for the HFM virus except for treating the symptoms and drinking plenty of water and getting rest. It is a common childhood ailment and usually goes away within a week. There are different strains that yield worse symptoms (like different flu strains) but in the end it is about treating the symptoms until the virus passes to avoid further complications.

this is not just a childhood ailment, my Son has had it 4 times when we lived in Bangkok (Minburi) and the last time my Wife also got it as it is passed on through contact and very contageous. Its very very painful for anyone with this HFM virus and its almost impossible for them to eat due to the mouth and throat ulcers. both my Son and Wife suffered through this for 5 days before they were able to do anything but sip water. I hope that the WHO are able to do something positive towards eradicating this nasty virus and soon,

I suspect eradication is impossible, but the authorities will do their best to limit the range and speed of its spread. Given that it has been a serious problem already in China and Cambodia, and its now hit Thailand, I'm not overly optimistic.

Didn't Yingyucky just a few days ago say that no way this would hit Thailand and that was all under control/...???? Ouf!!

[jaltsc]

I thought that one of the reason for the high death toll in Cambodia was that they were treated with steroids which contributed to the organ failure.

The medical community assured that these types of deaths will never occur in Thailand. They use antibiotics to treat everything.

On the serious.side. I have had to stop eating and drinking at local community festivals since many of the people there return their cups and other utensils without washing them. Not that rinsing them in plain water would do much against spreading illnesses. Also, how many food vendors have you seen who do not wash their hands after going to the WC, or people who don't turn their heads away from the food and cover their mouths when sneezing or coughing? There is just a plain lack of awareness about the spreading of disease in many areas of the world including the west.

[ScouseTommy]

Over 25 confirmed cases at my school in BKK and we are still open!!

[gk10002000]

As for disease education and microbiology and bacteria, I recall a recent travel article I read. Lady food vendor said refrigerator or ice just keeps disease sleeping. Better to keep food warm all the time! Unfortunately their version of warm is like room temperature and the little bugs thrive.