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==Overview==
Notable outbreaks have occurred in Malaysia, Taiwan and China in the past. Hand, foot and mouth disease infected 1 520 274 people with 431 deaths reported up to end of July in 2012 in China. <ref>http://www.wpro.who.int/emerging_diseases/HFMD/en/index.html</ref>.


==Historical Perspective==
===Recorded outbreaks===
* In [[1997]], 34 children died in an outbreak in [[Sarawak]], [[Malaysia]].
* In [[1998]], there was an outbreak in [[Taiwan]], affecting mainly children<ref>Centers for Disease Control and Prevention (CDC). Deaths among children during an outbreak of hand, foot, and mouth disease--Taiwan, Republic of China, April-July 1998. ''MMWR Morb Mortal Wkly Rep'' 1998;47:629-32. PMID 9704628.</ref>. There were 405 severe complications, and 78 children died<ref name=Ho>Ho M, Chen ER, Hsu KH, Twu SJ, Chen KT, Tsai SF, Wang JR, Shih SR. An epidemic of enterovirus 71 infection in Taiwan. Taiwan Enterovirus Epidemic Working Group. ''N Engl J Med'' 1999;341:929-35. PMID 10498487.</ref>. The total number of cases in that epidemic was estimated to be 1.5 million<ref name=Ho/>.
* In [[2006]], 7 people died in what seemed to be a new outbreak in [[Kuching]] Sarawak (according to the New Straits Times, 14th of March).
* In [[2006]], after the outbreak of [[Chikungunya]] in Southern and some Western parts of [[India]] cases of [[Hand-foot-and-mouth disease|HFMD]] were reported. <!--These cases were termed as [[Monkeygunya]] or Thakaligunya. The symptoms included rashes and yellowish spots on the edges of ears, hands or legs. --><ref>http://www.hindu.com/2005/11/17/stories/2005111706880700.htm</ref>
* In [[2007]], during the week of April 15-21 alone, Singapore recorded 688 cases of the disease. <ref>http://www.channelnewsasia.com/stories/singaporelocalnews/view/272220/1/.html</ref>
* In [[2007]], 30th May, outbreak in the [[Maldives]] was reported. <ref>http://www.traveldoctor.com.au/healthalerts.asp?UnqID=0.3960801&HealthAlertID=640</ref>
* In 2008, an outbreak in [[China]], beginning in March in [[Fuyang, Anhui|Fuyang]], Anhui, led to 25,000 infections, and 42 deaths.<ref>[http://news.xinhuanet.com/english/2008-04/27/content_8061094.htm Mass intestinal virus infection kills 19 children – XinHuaNet.com] (Retrieved on May 2, 2008.)</ref><ref>[http://news.xinhuanet.com/english/2008-05/01/content_8088299.htm Mass intestinal virus infection in east China up to 2,477, kills 21 – XinHuaNet.com] (Retrieved on May 2, 2008.)</ref><ref>[http://news.bbc.co.uk/1/hi/world/asia-pacific/7381741.stm China on alert as virus spreads]</ref><ref>[http://www.cnn.com/2008/WORLD/asiapcf/05/07/china.virus/index.html Spreading virus kills 28 children] (Retrieved on May 7, 2008.)</ref><ref>{{Cite news| url=http://news.bbc.co.uk/1/hi/world/asia-pacific/7383796.stm | work=BBC News | title=China virus toll continues rise | date=May 5, 2008 | accessdate=May 4, 2010}}</ref><ref>[http://www.cnn.com/2008/WORLD/asiapcf/05/03/china.virus/index.html?eref=rss_topstories China on alert over deadly child virus] (Retrieved on May 3, 2008.)</ref> 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),<ref>[http://ubpost.mongolnews.mn/index.php?option=com_content&task=view&id=1847&Itemid=1 EV-71 Virus Continues Dramatic Rise] (accessed May 23, 2008)</ref> and Brunei (1053 cases from June–August 2008)<ref>http://www.bt.com.bn/en/home_news/2008/11/07/1_053_hfmd_cases_recorded</ref> <ref>[http://vietnamnews.vnagency.com.vn/showarticle.php?num=01HEA150508 Viet Nam News: HFMD cases prompt tighter health screening at airport] (accessed May 15, 2008)</ref>
* 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]].<ref>{{Cite news| title=Hand-foot-mouth disease death toll rises to 17 in East China's Shandong Province | date=April 9, 2009 | work=China View | url=http://news.xinhuanet.com/english/2009-04/09/content_11159556.htm | accessdate=September 29, 2009}}</ref>  Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.<ref>{{Cite news| title=Health Ministry: Hand-foot-mouth disease claims 50 lives this year | date=April 10, 2009 | work=China View | url=http://news.xinhuanet.com/english/2009-04/10/content_11165126.htm | accessdate=September 29, 2009}}</ref>
* 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. <ref>http://news.xinhuanet.com/english2010/china/2010-06/24/c_13367598.htm</ref>
*In 2010 in [[Vietnam]], by 04.09 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.<ref>{{Cite news| title=Childhood Virus Kills 70 In Vietnam| date=July 29, 2011 | work= NPR | url=http://www.bbc.co.uk/vietnamese/vietnam/2011/09/110908_hand_foot_mouth.shtml | accessdate=September 11, 2011}}</ref>
*The [[World Health Organization]] between January to October 2011, (1,340,259) states the number of cases in China dropped by approx 300,000 from 2010 (1,654, 866) cases, with new cases peaking in June. 437 deaths, down from 537 deaths in 2010. <ref>http://english.peopledaily.com.cn/90001/90782/90880/7039439.html</ref><ref>http://www.wpro.who.int/health_topics/hfmd/</ref>
*In [[Cambodia]], 52 of 59 reviewed cases of children reportedly dead (as of 09 July 2012) due to a mysterious disease was diagnosed to be caused by a virulent form of [[Hand-foot-and-mouth disease|HFMD]]. <ref>http://www.cbsnews.com/8301-504763_162-57468483-10391704/mysterious-deadly-illness-in-cambodian-children-tied-to-hand-foot-and-mouth-disease/</ref> Although a significant degree of uncertainty exists with reference to the diagnosis, [[World Health Organization|WHO]] report states, "Based on the latest laboratory results, a significant proportion of the samples tested positive for [[enterovirus]] 71 (EV-71), which causes [[Hand-foot-and-mouth disease|hand foot and mouth disease]] ([[Hand-foot-and-mouth disease|HFMD]]). The EV-71 virus has been known to generally cause severe complications amongst some patients." <ref>http://www.who.int/csr/don/2012_07_09/en/index.html</ref><ref>http://www.wpro.who.int/cambodiaPRdisease.pdf</ref>
===United States===
*In 2012 in [[Alabama]], [[United States]] there was an outbreak of an unusual type of the disease. It occurred in a season it is not usually seen and affected teenagers and older adults.  There were some hospitalizations due to the disease but no reported deaths.<ref>{{cite web |url=http://blog.al.com/spotnews/2012/02/outbreak_of_hand_foot_and_mout.html|title=Outbreak of hand, foot and mouth disease severe in Alabama |author= Hannah Wolfson |date=13 February 2012 |work= |publisher=The Birmingham News |accessdate=11 May 2012}}</ref>
==References==
{{Reflist|2}}
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

Notable outbreaks have occurred in Malaysia, Taiwan and China in the past. Hand, foot and mouth disease infected 1 520 274 people with 431 deaths reported up to end of July in 2012 in China. [1].

Historical Perspective

Recorded outbreaks

  • In 1997, 34 children died in an outbreak in Sarawak, Malaysia.
  • In 1998, there was an outbreak in Taiwan, affecting mainly children[2]. There were 405 severe complications, and 78 children died[3]. The total number of cases in that epidemic was estimated to be 1.5 million[3].
  • In 2006, 7 people died in what seemed to be a new outbreak in Kuching Sarawak (according to the New Straits Times, 14th of March).
  • In 2006, after the outbreak of Chikungunya in Southern and some Western parts of India cases of HFMD were reported. [4]
  • In 2007, during the week of April 15-21 alone, Singapore recorded 688 cases of the disease. [5]
  • In 2007, 30th May, outbreak in the Maldives was reported. [6]
  • In 2008, an outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths.[7][8][9][10][11][12] 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),[13] and Brunei (1053 cases from June–August 2008)[14] [15]
  • 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.[16] Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.[17]
  • 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. [18]
  • In 2010 in Vietnam, by 04.09 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.[19]
  • The World Health Organization between January to October 2011, (1,340,259) states the number of cases in China dropped by approx 300,000 from 2010 (1,654, 866) cases, with new cases peaking in June. 437 deaths, down from 537 deaths in 2010. [20][21]
  • In Cambodia, 52 of 59 reviewed cases of children reportedly dead (as of 09 July 2012) due to a mysterious disease was diagnosed to be caused by a virulent form of HFMD. [22] Although a significant degree of uncertainty exists with reference to the diagnosis, WHO report states, "Based on the latest laboratory results, a significant proportion of the samples tested positive for enterovirus 71 (EV-71), which causes hand foot and mouth disease (HFMD). The EV-71 virus has been known to generally cause severe complications amongst some patients." [23][24]

United States

  • In 2012 in Alabama, United States there was an outbreak of an unusual type of the disease. It occurred in a season it is not usually seen and affected teenagers and older adults. There were some hospitalizations due to the disease but no reported deaths.[25]

References

  1. ↑ http://www.wpro.who.int/emerging_diseases/HFMD/en/index.html
  2. ↑ Centers for Disease Control and Prevention (CDC). Deaths among children during an outbreak of hand, foot, and mouth disease--Taiwan, Republic of China, April-July 1998. MMWR Morb Mortal Wkly Rep 1998;47:629-32. PMID 9704628.
  3. ↑ 3.0 3.1 Ho M, Chen ER, Hsu KH, Twu SJ, Chen KT, Tsai SF, Wang JR, Shih SR. An epidemic of enterovirus 71 infection in Taiwan. Taiwan Enterovirus Epidemic Working Group. N Engl J Med 1999;341:929-35. PMID 10498487.
  4. ↑ http://www.hindu.com/2005/11/17/stories/2005111706880700.htm
  5. ↑ http://www.channelnewsasia.com/stories/singaporelocalnews/view/272220/1/.html
  6. ↑ http://www.traveldoctor.com.au/healthalerts.asp?UnqID=0.3960801&HealthAlertID=640
  7. ↑ Mass intestinal virus infection kills 19 children – XinHuaNet.com (Retrieved on May 2, 2008.)
  8. ↑ Mass intestinal virus infection in east China up to 2,477, kills 21 – XinHuaNet.com (Retrieved on May 2, 2008.)
  9. ↑ China on alert as virus spreads
  10. ↑ Spreading virus kills 28 children (Retrieved on May 7, 2008.)
  11. ↑ "China virus toll continues rise". BBC News. May 5, 2008. Retrieved May 4, 2010.
  12. ↑ China on alert over deadly child virus (Retrieved on May 3, 2008.)
  13. ↑ EV-71 Virus Continues Dramatic Rise (accessed May 23, 2008)
  14. ↑ http://www.bt.com.bn/en/home_news/2008/11/07/1_053_hfmd_cases_recorded
  15. ↑ Viet Nam News: HFMD cases prompt tighter health screening at airport (accessed May 15, 2008)
  16. ↑ "Hand-foot-mouth disease death toll rises to 17 in East China's Shandong Province". China View. April 9, 2009. Retrieved September 29, 2009.
  17. ↑ "Health Ministry: Hand-foot-mouth disease claims 50 lives this year". China View. April 10, 2009. Retrieved September 29, 2009.
  18. ↑ http://news.xinhuanet.com/english2010/china/2010-06/24/c_13367598.htm
  19. ↑ "Childhood Virus Kills 70 In Vietnam". NPR. July 29, 2011. Retrieved September 11, 2011.
  20. ↑ http://english.peopledaily.com.cn/90001/90782/90880/7039439.html
  21. ↑ http://www.wpro.who.int/health_topics/hfmd/
  22. ↑ http://www.cbsnews.com/8301-504763_162-57468483-10391704/mysterious-deadly-illness-in-cambodian-children-tied-to-hand-foot-and-mouth-disease/
  23. ↑ http://www.who.int/csr/don/2012_07_09/en/index.html
  24. ↑ http://www.wpro.who.int/cambodiaPRdisease.pdf
  25. ↑ Hannah Wolfson (13 February 2012). "Outbreak of hand, foot and mouth disease severe in Alabama". The Birmingham News. Retrieved 11 May 2012.

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