Published Date: 2011-06-04 23:52:03
Subject: PRO/EDR> Hand, foot & mouth disease - Viet Nam (02): (QN, HCM)
Archive Number: 20110604.1712
HAND, FOOT AND MOUTH DISEASE - VIET NAM (02): (QUANG NGAI, HO CHI MINH
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
In this posting:
 Quang Ngai
 Ho Chi Minh City
 Quang Ngai
Date: Tue 31 May 2011
Source: Thanh Nien News [edited]
Quang Ngai reports 2nd death from hand, foot and mouth disease
An infant died from hand, foot and mouth disease (HFMD) in the
central Vietnamese province of Quang Ngai last Sunday [29 May 2011],
the 2nd HFMD fatality in the province this month [May 2011]. The
20-month-old boy died just one day after being admitted to hospital
with serious complications.
On 15 May 2011 a 23-month-old boy became the 1st HFMD death in Quang
Ngai this year . He was admitted to hospital a day earlier with
high fever, trouble breathing and rash on his palms and legs. Doctors
said it was too late to save the boy because he developed fever at
home 2 days before being taken to hospital.
An estimated 200 HFMD cases have been reported in Quang Ngai since
early this month [May 2011]. The whole country has so far recorded
more than 2000 cases, 96 percent of which originated from the southern
 Ho Chi Minh City
Date: Thu 2 May 2011
Source: Viet Nam News [edited]
Hand, foot and mouth cases on the increase
More than 2100 children in Ho Chi Minh (HCM) City contracted hand,
foot and mouth disease [HFMD]] over the past 3 months, double the
number in the same period last year , according to the city's
Department of Health. Already 11 children have died. A total of 70
percent of the patients are under 3 years old.
The reason for the increase was the appearance of a new enterovirus
71 type B2, said Vice director of the department Le Truong Giang.
Hygiene levels in homes and schools were also an issue, he said.
Doctors at Paediatrics Hospital No 1 said that in the last week of
May, more than 100 children per day were being hospitalised with the
disease. In Paediatrics Hospital No 2, 5450 children were tested for
the disease last month [May 2011], and 795 of them were hospitalised,
double the number in April .
The municipal People's Committee on Tuesday [31 May 2011] sent an
urgent letter to health, education and training, information and
communication departments, and district people's committees, urging
them to take preventive measures. Doctors warned that residents should
wash children's hands regularly and clean children's toys and homes
with antiseptic solution once a week. If children show symptoms of a
high temperature, difficulty breathing and rashes on their feet, hands
and mouth, they should be taken to hospital immediately.
[The newswires report increased numbers of HFMD and deaths related to
HFMD in Ho Chi Minh City and the central province of Quang Ngai.
Enterovirus 71 type B2 was blamed for the increased number of cases
and deaths related to HFMD (see prior PRO/MBDS posting Hand, foot &
mouth disease - Viet Nam (03): Ho Chi Minh City 20110602.1690). There
is no information about the etiologic agent to the HFMD in Quang Ngai,
but the [fatal] cases make this moderator think that the EV 71 might
be also involved with the HFMD outbreak in that central province.
For a map of Viet Nam with provinces, see
For the interactive HealthMap/ProMED-mail map with direct links to
other outbreaks in Viet Nam and surrounding countries reported on
ProMED-mail and PRO/MBDS, see
http://healthmap.org/r/008O. - Mod.QCN]
[HFMD is characteristically self-limiting and usually resolves within
a week, particularly when due to its most common cause, human
coxsackievirus A-16. However, in those outbreaks due to human
enterovirus 71, the illness may be more severe, with complications
such as viral meningitis and encephalitis and paralytic disease. Most
cases of HFMD hospitalized for complications occur in children less
than 5 years old.
A great diversity of human enterovirus 71 strains circulate globally
and no particular genogroup has been specifically associated with
severe disease. According to a recent review (Lee, T.C. et al.,
Pediatr Infect Dis J. 2009 Oct;28(10):904-10. Diseases caused by
enterovirus 71 infection) different human enteroviruses co-circulate
in the community annually. The emergence in recent years of the human
enterovirus 71 epidemic in the Asia Pacific region has been associated
with the circulation of 5 genetic lineages (genotypes B3, B4, C1, C2,
C4) that appear to be undergoing rapid evolutionary changes. The virus
responsible for the current outbreak in Viet Nam, however, appears
uniquely to be a genotype B2 virus. - Mod.CP]