Published Date: 1998-08-08 23:50:00
Subject: PRO> HFMD-related deaths, role of EV71 - Malaysia: revised
Archive Number: 19980808.1545
HFMD-RELATED DEATHS, ROLE OF EV71 - MALAYSIA: REVISED
*****************************************************
A ProMED-mail post
<http://www.healthnet.org/programs/promed.html>
See Also
HFMD-related deaths, role of EV71 - Malaysia 980718094233Date: Wed, 5 Aug 1998 09:28:35 +1000
From: Nobuhiko Okabe, MD, PhD <okabenob@crick.nih.go.jp>
Reference is made on the ProMED-mail post:
HFMD-RELATED DEATHS; ROLE OF EV71 - MALAYSIA.
Dr.C.L.Wong quoted our articles on HFMD-related death experienced in
Sarawak, Malaysia, in 1997, published in Japanese in Infectious Agents
Surveillance Reports (IASR), Japan, translated into English by Kaede I.
<kaedesyrup@yahoo.com>, visiting Japanese medical student in Sarawak.
I appreciate his(her) voluntary translation, however, I would request you
to insert the following report which was revised by Dr. N. Okabe, the
author of that article, to clear and correct some errata.
A full report on Malaysian issue related HFMD and sudden death would be
expected to be published on the appropriate international journal by
Malaysian [authors.
--
Nobuhiko Okabe, MD, PhD
Infectious Disease Surveillance Center
National Institute of Infectious Diseases
e-mail: okabenob@crick.nih.go.jp
and
Hiroshi Shimizu, PhD, Hiroshi Yoshida, PhD
Viral Division 2
National Institute of Infectious Diseases,
Tokyo Japan
--------------------------
[The first 4 paragraphs were essentially unchanged. The revised version of
the remainder is given below - Mod.JW
"Among the 27 patients that showed HFMD rashes, the cell count in the
cerebrospinal fluid was high in 6 out of 8 cases. Pediatric cardiologists
quoted that Echo cardiogram examination was identical with myocardial
disorder in some fatal or serious cases (Pediatrics/Sarawak General
Hospital, Pediatrics, Sibu Hospital).
"Out of 30 registered fatalities, Sarawak General Hospital and the CDC team
investigated 7 heart tissues obtained by biopsy from fatal cases and 4
total autopsies. Some of these were examined in the NIID also. None of the
pathologically investigated cases showed any evidence of myocardial
inflammation. Of the 4 with total autopsies, 3 showed slight edema and
infection in the central nervous system and one had brainstem encephalitis.
"At the Department of Virology, IMR, and the NIID, EV71, Coxsackie A16
(CA16) and other enteroviruses such as the Echovirus [sic - there at least
30 types - Mod.JW were isolated from HFMD and other related cases. The
serological studies from some patients revealed Coxsackie B virus infection
also. These virological examinations showed that various types of
enterovirus existed [together in this epidemic. EV71 was also isolated
from throat swab and fecal specimens obtained from some fatal cases. CDC
also identified EV71 infection in the fatal cases.
Although not finally concluded, the following have been revealed: there may
be sudden deaths in the course of HFMD, autopsy detected acute neurological
involvement such as brainstem encephalitis, and EV71 may have served as one
of the etiological viral agents. Careful monitoring of the incidence in
children seems to be very important."
--
ProMED-mail
e-mail: promed@usa.healthnet.org
[Note this disclaimer to the effect that a viral cause of the deaths in
Malaysia has not yet been definitely established - Mod.JW
.............................jw/es
--
*##########################################################*
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################