Wednesday, 17 September 2014

Southeast Asia

Asia's Health Workers Scramble to Contain HFMD Outbreak

Reports of outbreaks of the virus that causes hand, foot, and mouth disease (HFMD) have cropped up in countries across Asia in recent months.

 Thai teachers check the mouth of the students for hand, foot and mouth disease, before they get inside the school in Bangkok, July 25, 2012. Thai teachers check the mouth of the students for hand, foot and mouth disease, before they get inside the school in Bangkok, July 25, 2012.
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 Thai teachers check the mouth of the students for hand, foot and mouth disease, before they get inside the school in Bangkok, July 25, 2012.
Thai teachers check the mouth of the students for hand, foot and mouth disease, before they get inside the school in Bangkok, July 25, 2012.
Ron CorbenVOA
BANGKOK —  Doctors across Southeast Asia are on alert for outbreaks of a strain of the virus that causes hand, foot and mouth disease, responsible for killing scores of children across Asia in recent months. Medical authorities say the peak of the outbreak still has not been reached.

Reports of outbreaks of the virus that causes hand, foot, and mouth disease (HFMD) have cropped up in countries across Asia in recent months, mainly affecting young children. 

The hardest hit has been China with more than 1.2 million cases and over 350 deaths.

Medical authorities in Japan, Hong Kong, South Korea, Malaysia, Singapore, Thailand, Taiwan and Vietnam have all reported cases largely among children under the age of 10 years.

In Vietnam, the case load has reached 63,000 with over 30 children perishing while in Singapore 26,000 cases of children with the virus have been reported.

The HFMD disease is quite common and can pass easily among children, but researchers are still trying to understand why there have been higher infection rates this year.

“We are seeing slightly high number of cases this year than has been the average in the past [in Thailand]," said Dr. Brent Burkholder, the World Health Organization's acting country representative in Thailand. "But we’re also seeing that in other countries in Southeast Asia. Singapore, Vietnam, and others have also reported that they are seeing more cases a bit higher than previously. So it’s not quite clear yet exactly why this might be. Sometimes it’s just increased reporting and sometimes it’s the cyclical nature of the viruses.”

Attention focused on Cambodia earlier this month when authorities reported up to 60 children dying from a ‘mysterious’ disease. Cambodia’s Ministry of Public Health and the WHO later issued a joint statement confirming hand, foot, and mouth disease claimed the lives of 54 children.

Doctors have blamed some of the higher death rates on clinics using steroids to treat the symptoms of fever, vomiting, rashes and blisters. Steroids undermine the body’s natural immune systems to fight the virus.

But researchers believe that poor treatment is not the only reason for the virus’ increased lethality.

“These are viruses that pretty much circulate. These are viruses primarily. Kids pick them up," said Vit Suwanvanichkij, a research associate with the John Hopkins Bloomberg School of Public Health. "Most of the time its really non-specific viral illness with a fever, may be some diarrhea, gastrointestinal bug and it goes away. [But] this year might have more attention to it because probably it’s more severe - it’s more concerning. ”

Thailand’s Ministry of Public Health has reported over 13,160 cases this year, the highest rate in over five years. In 2011, there were 18,000 cases for the whole year and six deaths. Vit said improved surveillance and awareness in the region may also have led to higher reporting rates.

On Tuesday. Thai health officials confirmed the country’s first fatality this year - a two-and-a-half-year-old child. Authorities say some 60 schools across the country have reported outbreaks and tens of schools have been closed to halt the spread.

Eric John-Abo, a public health expert with the Asian Disaster Preparedness Center in Thailand, says the country’s health system is well prepared to deal with such health emergencies following the outbreak of bird flu and other threatened pandemics in recent years.

“Thailand, because of the experience of Avian influenza and planning previously in the pandemic influenza, the structure, the public health structure is already there," he said. "The surveillance is there so they can easily detect cases around the country. And the management of the public health systems is there.”

Medical authorities expect the virus will remain active at least for another several weeks before the latest outbreaks across the region subside.
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