Vietnam minister downplays seriousness of hand-foot-mouth outbreak

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Hand, foot and mouth disease (HFMD) in Vietnam is still under control, Health Minister Nguyen Thi Kim Tien said at a press conference Tuesday (October 25), despite the rising number of new HFMD cases.

The disease has killed 137 people, mostly children, out of 77,895 infections in 63 cities and provinces across the country this year.

A report by the Vietnam Administration of Preventive Medicine showed 2,900 new HFMD cases were recorded last week, up 400 cases from the previous week.

Nguyen Van Binh, chief of the administration, said the number of HFMD fatalities and infections would continue to rise.

Local media have repeatedly asked why the Health Ministry has not declared the HFMD an epidemic so that more money and effort can be poured into prevention of the disease.

Minister Tien reiterated a regulation Tuesday that the ministry can announce a national epidemic only after at least two provinces do so locally.

"In fact, HFMD is occurring in South Korea, Japan and China but none of those countries have declared a national epidemic either," she said.

"No announcement made does not mean we are neglecting of the lives of the children.

"We are trying our best to prevent the disease from spreading with the help of World Health Organization [WHO] experts in Vietnam."

Infection is typically mild and causes mouth sores and blisters on hands and feet. No vaccine or specific treatment exists, but most children typically recover quickly without problems.

According to WHO updates on October 11, Vietnam ranked third in the number of HFMD infections among seven countries and territories in the Western Pacific region, after China and Japan.

WHO said China, Japan, Macao (China) and South Korea were seeing a declining trend in the number of reported HFMD cases while Singapore continued to see low-level activity.

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China reported 1,217,768 HFMD cases, including 399 deaths, between January and September this year.

In Japan, 306,944 cases have been reported as of October 2. In Singapore, 14,146 cases have been reported as of October 1.

Big cities under pressure

Big cities are facing the danger of hand, foot and mouth disease (HFMD) outbreaks as more and more HFMD cases from other provinces rush to hospitals in big cities.

In Ho Chi Minh City, although the number of HFMD infections has not increased since peak months (May-August), the number of child patients at Children's Hospital 1 has also seen no decrease.

The hospital's Infectious Diseases Department is always overloaded, with an average 150 child patients a day, mostly from other provinces.

Dr. Truong Huu Khanh, chief of the Infectious Diseases Department, said there were days when more than 80 percent of child patients admitted to the hospital were from other provinces.

"The provinces with the most patients include Ben Tre, Tien Giang, Long An, Tay Ninh, Binh Phuoc, Binh Duong and Ba Ria-Vung Tau," he said.

At HCMC Children's Hospital 2, an estimated 110-130 HFMD cases are being reported a day, with 50-60 percent of patients coming from other provinces.

"The workload for doctors in big cities is so big that they can't make mistakes, which are sometimes paid for with the patients' lives," said a doctor who spoke on condition of anonymity.

According to doctors, HFMD patients rush to big cities because provincial hospitals do not have enough medical staff and equipment to treat serious cases.

Provincial hospitals also don't cover drug fees for HFMD patients under age six, while HCMC does.

Generally, gammaglobuline a kind of HFMD drug being used in Vietnam may cost VND15-20 million, or even VND40-50 million for serious cases.

According to Khanh, 10 percent of HFMD child patients at the Children's Hospital 1 must be treated with gammaglobuline.

Dr. Nguyen Dac Tho, deputy director of the HCMC Center for Preventive Medicine, warned that the rising number of HFMD patients from other provinces rushing to city-based hospitals could help spread the disease.

Dr. Tran Phu Manh Sieu, the center's director, said the risk of the disease spreading to new communities was very high.

 "HFMD child patients may spread the virus to other patients, and adults and children who share the hospitals' canteens and toilets may contract the virus.

"Families of child patients from other provinces who rush to HCMC may spread the viruses to their relatives too."

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