May 4, 2008
WHO reports outbreak =
of
over 1800 cases of enterovirus 71 in China
On May 1st the World health Organization (WHO) posted on
their website a summary of the outbreak of Enterovirus (EV) 71 in
The clinical disease caused by EV-71 is termed "han=
d,
foot, and mouth disease (HFMD)". It is NOT related to "foot and m=
outh
disease (FMD)" of animals. The human disease HFMD typically invol=
ves
a rash on the palms and soles with vesicles and inflammation in the mouth. =
The 20 deaths have been linked to "serious
complications such as neurogenic pulmonary edema". Fortunately, the ca=
se fatality7
rate (CFR) has dropped from 11% during March 10-31 to 0.2% between
April 17-29.
Of note, initial testing for respiratory diseases did not
show the cause of the illness. Further testing and "several expert
consultations were conducted at the national level" and on April 23rd
Enterovirus-71 was confirmed as the cause of the illness, and in some cases,
death of affected infants and young children.
No specific antiviral medication, or vaccine, is
available for enteroviruses, including EV-71. The WHO "Fact sheet"=
; on
enteroviruses (non-polio type) states that "Males more often develop
clinically recognizable diseases than females. Transmission is usually by t=
he
faeco-oral or by the respiratory route when there is an associated respirat=
ory
illness. The virus may be excreted in the stool for many weeks...and may
possibly be transmitted in the community by contact with contaminated food =
or
water".
Appropriate target prevention and control measures have =
been
instituted in Fuyang city and
An appropriate travel history should be obtained for any
patients or their contacts presenting to clinics or hospitals in the
Daniel R.Lucey, MD, MPH
EROne Institutes, Department of Emergency Medicine
website for this posting: www.BePast.org