Category Archives: HEV 71 HFMD (12)

Enteroviruses are a genus of positive-sense single-stranded RNA viruses associated with several human and mammalian diseases. Serologic studies have distinguished 68 human enterovirus serotypes on the basis of antibody neutralization tests. Additional antigenic variants have been defined within several of the serotypes on the basis of reduced or nonreciprocal cross-neutralization between variant strains. On the basis of their pathogenesis in humans and animals, the enteroviruses were originally classified into four groups, polioviruses, Coxsackie A viruses (CA), Coxsackie B viruses (CB), and echoviruses, but it was quickly realized that there were significant overlaps in the biological properties of viruses in the different groups. Enteroviruses isolated more recently are named with a system of consecutive numbers: EV68, EV69, EV70, and EV71, etc

Enteroviruses affect millions of people worldwide each year, and are often found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) and stool of an infected person. Historically, poliomyelitis was the most significant disease caused by an enterovirus, poliovirus. There are 64 non-polio enteroviruses that can cause disease in humans: 23 Coxsackie A viruses, 6 Coxsackie B viruses, 28 echoviruses, and 5 other enteroviruses. Poliovirus, as well as coxsackie and echovirus are spread through the fecal-oral route. Infection can result in a wide variety of symptoms ranging from mild respiratory illness (common cold), hand, foot and mouth disease, acute hemorrhagic conjunctivitis, aseptic meningitis, myocarditis, severe neonatal sepsis-like disease, and acute flaccid paralysis.[2]

Enterovirus 71[edit]
Main article: EV-71
Enterovirus 71 (EV-71) is notable as one of the major causative agents for hand, foot and mouth disease (HFMD), and is sometimes associated with severe central nervous system diseases. EV71 was first isolated and characterized from cases of neurological disease in California in 1969.To date, little is known about the molecular mechanisms of host response to EV71 infection, but increases in the level of mRNAs encoding chemokines, proteins involved in protein degradation, complement proteins, and proapoptotis proteins have been implicated.

Outbreaks
• In 1997, 31 children died in an outbreak in the Malaysian state of Sarawak.[15]
• In 1998, there was an outbreak in Taiwan, affecting mainly children.[16] There were 405 severe complications, and 78 children died.[17] The total number of cases in that epidemic is estimated to have been 1.5 million.[17]

• In 2008 an outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths, by May 13. Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20, 2008), Vietnam (2,300 cases, 11 deaths), Mongolia (1,600 cases), and Brunei (1053 cases from June–August 2008)
• In 2009 17 children died in an outbreak during March and April 2009 in China’s eastern Shandong Province, and 18 children died in the neighboring Henan Province. Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.[
• In 2010 in China, an outbreak occurred in southern China’s Guangxi Autonomous Region as well as Guangdong, Henan, Hebei and Shandong provinces. Until March 70,756 children were infected and 40 died from the disease. By June, the peak season for the disease, 537 had died.
• In 2011 Vietnam, by September 4 the disease was reported to have claimed 98 lives, 75% of whom were children under 3 years old. Although there was no official declaration of an outbreak, over 42,000 cases were reported. Over 10,000 new cases were recorded in the second half of August alone. The World Health Organization reporting between January to October 2011 (1,340,259) states the number of cases in China had dropped by approx 300,000 from 2010 (1,654,866) cases, with new cases peaking in June. There were 437 deaths, down from 2010 (537 deaths).
• In 2012 in Cambodia, 52 of 59 reviewed cases of children reportedly dead (as of July 9, 2012) due to a mysterious disease were diagnosed to be caused by a virulent form of Hand, foot and mouth disease. It has infected 1,520,274 people with 431 deaths reported up to end of July in 2012 in China.

Hand, foot and mouth disease spreading through central Indiana kids

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By Lindy Thackston

INDIANAPOLIS (Aug. 14, 2014) — Pediatricians say a highly-contagious virus is spreading like wildfire through central Indiana kids.

Hand, foot and mouth disease is common this time of year, but doctors say they’ve been swamped this week and want to warn parents it’s making the rounds.

Children six months to 5 years old are at the highest risk, says St. Vincent pediatrician Brian Aguilar.

It usually starts with a fever before blisters appear in the mouth and a rash develops on the hands and feet. But this year, Aguilar says he’s seeing several kids without fevers and just suffering from blisters and a rash.

It typically lasts three to five days, but the rash can last longer.

It’s very contagious and easily spreads through coughing, sneezing, changing diapers and toys.

Westfield mom Dena Parker has her 2-year-old daughter home from daycare this week after she was diagnosed with hand, foot and mouth disease.

“If you work full-time and your husband works full-time and daycare is where your child has to go, you’re more than likely going to be affected with hand, foot and mouth sometime in the course of being at daycare,” said Powell. “And I spoke to a friend who is a stay-at-home mom and her son had it a couple of weeks ago and he does not attend daycare.”

Aguilar says while the virus is commonly spread at daycare, other kids are at risk too, especially at playgrounds and pools.

“The most important thing in hand, foot and mouth disease prevention is washing hands,” said Aguilar. “The time that you should call your doctor is if your child can’t eat or drink well.”

“Everybody can get the virus, even adults, but we won’t show the symptoms, so everybody needs to practice good hand hygiene.”

There is no vaccine to prevent hand, foot and mouth disease.

There is no specific treatment, but if the sores are preventing the child from eating and drinking, medicine can be prescribed. If your child is eating and drinking with no problem, Aguilar says Tylenol and ibuprofen can be used.

Hand, foot and mouth disease is a threat through the fall season.

Aguilar also wants to point out that hand, foot and mouth disease has nothing to do with the hoof and mouth disease that affects animals.