SALON

Thursday, Jul 12, 2012 8:48 AM UTC

Common childhood illness rages across Asia

By

Topics: From the Wires,

Common childhood illness rages across AsiaFILE- In this Monday, July 9, 2012, file photo, Mean Thida, 4, affected with mystery disease, sleeps beside her mother as she receives treatment via a bottle of serum, not in photo, at their home near a dump site at Sambour village, on the outskirts of Phnom Penh, Cambodia. The enterovirus 71 strain, or EV-71, raised fears earlier this week after it was detected in some lab samples taken after 52 of 59 Cambodian children died suddenly from a mystery illness that sparked international alarm. Health officials are still investigating, but say the virus is likely to blame. (AP Photo/Heng Sinith, File)(Credit: AP)

HANOI, Vietnam (AP) — Tran Minh Giang has spent more than a third of his young life in a Hanoi hospital, and it could be many months more before he can go home. All for a disease that in Asia is as common as chicken pox, and usually about as severe.

The 20-month-old boy fell victim to a particularly menacing form of hand, foot and mouth disease that has killed hundreds of young children across the region. They sometimes suffer high fever, brain swelling, paralysis and respiratory shutdown, even though they may have been infected by people with few or no symptoms.

When the strain hit Cambodia recently, doctors there had no idea what it was, and even now experts don’t fully understand why it can be so devastating. Seven months after becoming sick, Giang still breathes using a ventilator connected to a hole in his tiny throat.

“It may take time, maybe years, before he can recover. When he sleeps, his lungs don’t work,” his father, Tran Nam Trung, said Thursday while fanning the baby. “When he first got a high fever, I didn’t think that he would be in a situation like this.”

The enterovirus 71 strain, or EV-71, raised fears earlier this week when it was detected in some lab samples taken after 52 of 59 Cambodian children died suddenly from a mystery illness that sparked international alarm. Health officials are still investigating, but say the virus is likely to blame for a significant number of cases.

The World Health Organization said it’s the first time EV-71 had been identified in the country, but it’s a well-known pathogen in many other parts of the region. In the first half of this year alone, 356 people in China and 33 in Vietnam have died from it.

The scale of the disease was clear last week on the crowded ground floor of a hospital in China’s hard-hit central Hunan province. Dozens of crying children were packed into two small rooms, sitting or lying on chairs with IV drips hooked to them. Hunan reported 33 hand, foot and mouth disease deaths in May, a quarter of the country’s total that month.

The disease has exploded across the region since 1997, when the first major outbreak was reported in Malaysia. Since then, Japan, South Korea, Singapore, Mongolia, Taiwan and Australia have all wrangled with it.

EV-71 is one of a group of viruses that cause the disease, but it has become a more dominant strain over the past decade in Asia. Still, only a small percentage of children infected experience severe symptoms, and experts aren’t exactly sure why. There is no vaccine or specific treatment to cure it, but severe cases are given supportive care and blood proteins are also sometimes administered intraveneously.

“There’s a buildup of that susceptible population, like many viruses, and this happens to be the children who have not been exposed to different types of enteroviruses before,” said Dr. Zarifah Hussain Reed, co-author of a WHO report on hand, foot and mouth disease and medical director at a Malaysia-based biotech company researching a vaccine for it. “Then this buildup somehow explodes in a way that suddenly you get severe cases of EV-71.”

She said it’s unclear why it remains largely confined to certain parts of Asia — India and Indonesia, for instance, have not reported large outbreaks — and it’s not understood if EV-71 is more infectious or perhaps just better at invading the neurological system than other strains.

The disease is in the same family as polio and gets its name from the telltale symptoms it causes, including rash, mouth sores and blisters covering the hands and feet. It mainly affects children younger than 5, and is difficult to control because it spreads easily through sneezing, coughing and contact with fluid from sores or infected feces.

In daycare centers and schools, it’s nearly impossible to keep little blistered hands from coming into contact with other children and everything they touch. Another problem is that many infected kids never get sick, but they can still transmit the virus to others. Frequent hand-washing and disinfection of toys and surfaces are advised, and sometimes schools are forced to shut down to help halt the spread.

The first EV-71 infection with neurological symptoms was reported in California in 1969. Outbreaks have since occurred periodically in the U.S. and Europe, but the disease has been a stubborn menace that has continued to batter Asia, typically occurring in cycles. Some experts have warned that if the virus isn’t controlled, it can jump borders and threaten other regions as well. In fact, some wonder if the recent Cambodia cases could have spread from Vietnam, where about 63,000 cases have been reported so far this year.

Dr. Pham Nhat An, vice director of the National Hospital of Pediatrics in Hanoi, says he has dealt with the disease for three decades, but it didn’t start killing until two years ago, when the number of hospitalized cases started to spike.

“It’s worrying,” he said in his office. “We need to think about a vaccine. It will help, especially for the EV-71.”

In a unit on the other side of the building, the dedicated father, Trung, sits on the edge of a bed fanning Giang, who probably caught the disease from a mildly ill cousin who was staying with them at the time.

Giang was just 13 months old when he began burning hot with fever. He didn’t seem overly sick and continued to play, so his parents believed it was a bug that would quickly pass. By morning, the baby was purple and convulsing. His lungs were shutting down.

Now the boy can sit, and he occasionally musters a quick smile. But he remains lethargic, with tubes running out of his nose and throat. Trung had to quit his job to help his wife care for the child 24 hours a day in the hospital, which is common in many parts of Asia where nursing staff is thin.

“This is a very serious disease, and it can result in very serious health consequences,” Trung said. “People need to be very cautious and they need to strengthen surveillance to try to prevent the disease.”

____

Associated Press writer Gillian Wong contributed to this report from Hunan, China.

Follow Margie Mason at http://www.twitter.com/margiemasonap

More Margie Mason.

Next Article

Related Stories

More Related Stories

Featured Slide Shows

The week in 10 pics

close X
  • Share on Twitter
  • Share on Facebook
  • Thumbnails
  • Fullscreen
  • 1 of 11
  • This photo. President Barack Obama has a laugh during the unveiling of the George W. Bush Presidential Center in Dallas, Tx., Thursday. Former first lady Barbara Bush, who candidly admitted this week we've had enough Bushes in the White House, is unamused.
    Reuters/Jason Reed

  • Rescue workers converge Wednesday in Savar, Bangladesh, where the collapse of a garment building killed more than 300. Factory owners had ignored police orders to vacate the work site the day before.
    AP/A.M. Ahad

  • Police gather Wednesday at the Massachusetts Institute of Technology to honor campus officer Sean Collier, who was allegedly killed in a shootout with the Boston Marathon bombing suspects last week.
    AP/Elise Amendola

  • Police tape closes the site of a car bomb that targeted the French embassy in Libya Tuesday. The explosion wounded two French guards and caused extensive damage to Tripoli's upscale al-Andalus neighborhood.
    AP/Abdul Majeed Forjani

  • Protestors rage outside the residence of Indian Prime Minister Manmohan Singh Sunday following the rape of a 5-year-old girl in New Delhi. The girl was allegedly kidnapped and tortured before being abandoned in a locked room for two days.
    AP/Manish Swarup

  • Clarksville, Mo., residents sit in a life boat Monday after a Mississippi River flooding, the 13th worst on record.
    AP/Jeff Roberson

  • Workers pause Wednesday for a memorial service at the site of the West, Tx., fertilizer plant explosion, which killed 14 people and left a crater more than 90 feet wide.
    AP/The San Antonio Express-News, Tom Reel

  • Aerial footage of the devastation following a 7.0 magnitude earthquake in China's Sichuan province last Saturday. At least 180 people were killed and as many as 11,000 injured in the quake.
    AP/Liu Yinghua

  • On Wednesday, Hazmat-suited federal authorities search a martial arts studio in Tupelo, Miss., once operated by Everett Dutschke, the newest lead in the increasingly twisty ricin case. Last week, President Barack Obama, Sen. Roger Wicker, R.-Miss., and a Mississippi judge were each sent letters laced with the deadly poison.
    AP/Rogelio V. Solis

  • The lighting of Freedom Hall at the George W. Bush Presidential Center Thursday is celebrated with (what else but) red, white and blue fireworks.
    AP/David J. Phillip

  • Recent Slide Shows

  • Share on Twitter
  • Share on Facebook
  • Thumbnails
  • Fullscreen
  • 1 of 11

Related Videos

Comments

 0 Comments

Comment Preview

Your name will appear as username

You may use these HTML tags and attributes: <a href=""> <b> <em> <strong> <i> <blockquote>

follow salon

Most Read

Popular on Reddit

links from salon.com

From Around the Web

Presented by Scribol
listener_new_rect The Listener: "The Shelter Cycle": Raised in a cult

Recommendations