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Posted by on Dec 24, 2008 in Infectious diseases, Pediatrics

Top 10 Medical Stories of 2008: No. 8

Top 10 Medical Stories of 2008: No. 8

HFMD.jpg

An epidemic that would have rocked any other country is a vague memory in China, where dozens of pediatric deaths from hand, foot, and mouth disease (HFMD) in 2008 were overshadowed by a devastating earthquake, the historic Beijing Olympics, and another melamine scandal.

From January 1 to May 9, at least 61,459 children contracted the disease, caused by enterovirus 71 (EV71), according to the Chinese Center for Disease Control and Prevention and the WHO Representative Office in China. As of mid-May, at least 43 children (typically infants or toddlers) died as a result. Hardest hit were the mainland provinces of Guangdong, Anhui, Zhejiang, Shandong, and Henan. The infection was especially concentrated in Fuyang City, in the eastern part of the Anhui province, where thousands of children were hospitalized and most of the deaths occurred.

HFMD is a common and usually mild childhood disease, caused by coxsackie virus A16 or EV71; although EV71-related HFMD can manifest infrequently as encephalitis or poliomyelitis-like paralysis. Outbreaks of EV71-related HFMD throughout southeast Asia and Australia have been documented since 1997, but the disease had not affected mainland China to any significant extent before this year (or at least as far as anyone outside of China knows). There are indications that this year’s major epidemic, which reportedly began in March, was exacerbated by the slow reporting of escalating cases from local health officials. 

A smaller outbreak of HFMD occurred in the Fujian province in October. Contemporary news reports indicate that 113 children became ill, and 3 infants died (all of whom were younger than 1 year of age)

Treatment of the highly contagious HFMD consists of supportive, symptomatic care. Because there is no available vaccine, prevention relies on appropriate hygienic measures, particularly handwashing. A nationwide personal-hygiene campaign was reportedly instigated in China during the Spring epidemic. The Xinhua News Agency indicated that traditional Chinese medicine was also urged by local health authorities, including “a recipe involving a number of Chinese herbs that must be used continuously for at least 7 days.”

For more background, read these Pathophilia posts:

Also an official report of the major HFMD epidemic in China is available here.

Image of HFMD rash from the Report of the Hand, Foot, and Mouth Disease Outbreak in Fuyang City, Anhui Province and the Prevention and Control in China.

bmartin (1130 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.