HFMD claims 56 lives; health ministry issues new guidelines

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 Children infected with Hand, Foot and Mouth Disease (HFMD) being treated in a hospital in Ho Chi Minh City. According to the HCMC Preventive Health Center, the city has reported nearly 5,000 HFMD cases and 21 related deaths.

The Ministry of Health issued new guidelines, on July 19, for the diagnosis and treatment of Hand, Foot and Mouth Disease (HFMD). The information was released following the recent spate of dire infections"”56 people have succumbed to the disease so far this year.

The 2011 guideline details four stages of the disease.

In the first stage, symptoms such as oral ulcers and/or skin lesions appear "” during this phase, children should be treated as outpatients for 8-10 days. Those who have fever should be admitted to hospital within two days of the appearance of fever.

When the disease develops to the second stage, patients suffer high fever, breathing difficulties, sweating, vomiting, fatigue, and sleeping troubles; children must hospitalized during this stage.

They can also suffer higher fever, despite taking medication. These fevers may lead to paralyzed limbs and must be treated with specific drugs under the guidance of a physician.

In the third stage, patients suffer from sweating and severe breathing difficulties and must be supported by oxygen devices.

The disease reaches its worst stage when patients' lungs swell and their breathing becomes halted. In many cases their bodies turn purple. They must be treated with artificial resuscitation methods.

According to the Ministry of Health, the number of HMFD cases in Vietnam this year has hit a record: around 20,000 cases with 56 fatalities. Most of the cases (and fatalities) come from southern region and several central provinces.

Between 2008 and 2010, Vietnam recorded more than 10,000 HFMD cases, each year.

Since there is no specific treatment for the disease, the ministry said, the best way to prevent an outbreak is to quarantine sick children from kindergartens and schools within 10-14 days of incubation.

Doctors have also recommended that parents and teachers protect their children by washing their hands regularly with soap, sterilizing floors, furniture and children's toys.

According to the Ho Chi Minh City Preventive Health Center, the city has reported around 5,000 HFMD cases and 21 related deaths.

The center predicted that the endemic would peak between September and November.

Several HCMC-based kindergartens were shut down following the HFMD outbreaks.

Dr Tran Thi Thuy of the HCMC Children's Hospital 2 said the number of children over the age of five that have been hospitalized for HFMD, this year, was higher than in previous years.

Even children aged 10 and above can get sick. One 13-year-old died from the disease, she noted.

Authorities act

On July 20, a team from the General Department of Preventive Medicine arrived in Quang Ngai Province the locality with the most HFMD cases and fatalities in the central region.

The department also asked HCMC, Dong Nai, Quang Ngai and Da Nang authorities to take voluntary measures to prevent outbreaks, and distributed 13,000 kilograms of antiseptics to health authorities in these locations.

"So far, most of the HFMD cases have been caused by Enterovirus 71, which can quickly spread in an unsanitary environment," said department chief Nguyen Van Binh.

Four department task forces will be sent to 12 localities throughout the country. They will remain in the field until August, to provide advisory and logistical support for the prevention and treatment of HFMD cases.

The Health Ministry issued a warning that the epidemic may expand in the coming months, especially in kindergartens, nurseries and amusement parks.

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