Hand, foot, mouth disease menaces Vietnam hub after infant death

By Nguyen Mi, Thanh Nien News

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Children suffering from hand-foot-and-mouth disease at a hospital in Ho Chi Minh City in September 2014. Photo: Nguyen Mi Children suffering from hand-foot-and-mouth disease at a hospital in Ho Chi Minh City in September 2014. Photo: Nguyen Mi

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Ho Chi Minh City health officials have announced the new threat of a deadly hand-foot-and-mouth disease (HFMD) outbreak after the fever-related death of an infant last month.
During a press briefing held Wednesday, Nguyen Tri Dung, director of the city's Preventive Health Department, said HFMD cases are rising as the disease enters its second peak of the year.
Dung said many districts have reported unusually high pediatric cases in the past four weeks.
An eight-month-old girl from Tan Phu District died at the Children’s Hospital No.2, one of the city's leading pediatric facilities, on September 20.
The death marked the first HFMD fatality in the city this year.
The toddler first came down with a fever on September 18, at which time doctors at a private clinic near her home diagnosed her with a sore throat.
The prescribed medicine failed to improve her symptoms, so the family brought her to the Children’s Hospital No.2 on September 20.
Doctors there failed to notice symptoms other than the fever and didn't challenge the initial diagnosis.
They sent her home and asked the family to keep an eye out for telltale HFMD symptoms – mouth sores and blisters that appear on the hands and feet.
None of those symptoms materialized, but her condition grew critical that afternoon.
Her temperature rose, her body turned pale and her arms and legs kept shaking.
By the time her family had admitted her to hospital, she had already fallen into a coma characterized by respiratory and cardiac decline.
She died around 15 minutes later.
Her blood tested negative for EV71--the deadliest strain of HFMD virus Entovirus and the most common in Vietnam--but doctors maintain she died of the illness.
The physicians said HFMD’s progression can be complicated and hard to detect in several cases.
The virus is named from its telltale symptoms, including rash, mouth sores and blisters on the hands and feet. It is spread by sneezing, coughing and contact with fluid from blisters or infected feces.
They said not all infections can be detected through blood tests, forcing them to base their diagnoses on physical symptoms.
Nearly 4,700 cases of the disease, which occurs mostly in children under 5, were hospitalized during the first eight months this year, up 19 percent year-on-year, according to the department.
New infections surged last year, when the highest rates of infection were reported in the outlying districts of Binh Chanh, Go Vap, Tan Binh and 6.
Dung said district health officials should beef up monitoring of hospitalized cases in their area, to prevent the disease from spiralling into a pandemic.
“The hospitalized cases are only signs. Medical staff should use them to track down more cases being treated at home in the area. That’s how we can hope to deal with the disease thoroughly,” he said.
“If we stop at treating the few cases that come through our doors, the chance of a pandemic in the final quarter runs very high.”
The disease is considered highly dangerous as it can quickly yield fatal complications like respiratory decline, meningitis and heart muscle inflammation.
Treatment requires the use of respirators and blood dialysis.
At present, there is no vaccine for the virus, which killed at least 41 out of more than 110,000 patients in 2012 and 169 the year before--out of roughly the same number of infections.
Dung also noted a rise in cases of the mosquito-borne dengue fever in recent months, especially in districts 10, Binh Chanh, Tan Binh and Thu Duc.
The disease has killed at least five people in the city so far this year.
Dung called for people to maintain good hygiene at home and in public areas as the disease is spread through contact with human waste and bodily fluids.

The Company for Vaccine and Biological Production No.1 (VABIOTECH) at the Ministry of Health has completed animal trials for an HFMD vaccine.

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