Hand-foot-and-mouth disease historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Notable outbreaks have occured in Malaysia, Taiwan and China.

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[1]. There were 405 severe complications, and 78 children died[2]. The total number of cases in that epidemic is estimated to have been 1.5 million[2].
  • In 2006, 7 people died in what seems 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. [3]
  • In 2007, during the week of April 15-21 alone, Singapore recorded 688 cases of the disease. [4]
  • In 2007, 30th May 2007, outbreak in the Maldives. [5]
  • In 2008, an outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths, by May 13.[6][7][8][9][10][11][12] Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20, 2008),[13] Vietnam (2,300 cases, 11 deaths),[14] Mongolia (1,600 cases),[15] and Brunei (1053 cases from June–August 2008)[16]
  • 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.[17] Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.[18]
  • 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. [19]
  • 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.[20]
  • 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. 437 deaths, down from 2010 (537 deaths) [21][22]
  • In Cambodia, 52 of 59 reviewed cases of children reportedly[23] dead (as of 09 July 2012) due to a mysterious disease was diagnosed to be caused by a virulent form of HFMD. [24] 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." [25]

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.[26]

References

  1. 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.
  2. 2.0 2.1 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.
  3. http://www.hindu.com/2005/11/17/stories/2005111706880700.htm
  4. http://www.channelnewsasia.com/stories/singaporelocalnews/view/272220/1/.html
  5. http://www.traveldoctor.com.au/healthalerts.asp?UnqID=0.3960801&HealthAlertID=640
  6. Viral epidemic maintains grip in China, with three more deaths (accessed May 15, 2008)
  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. Viet Nam News: HFMD cases prompt tighter health screening at airport (accessed May 15, 2008)
  14. EV-71 Virus Continues Dramatic Rise (accessed May 23, 2008)
  15. http://www.bt.com.bn/en/home_news/2008/11/07/1_053_hfmd_cases_recorded
  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.wpro.who.int/cambodiaPRdisease.pdf
  23. http://www.cbsnews.com/8301-504763_162-57468483-10391704/mysterious-deadly-illness-in-cambodian-children-tied-to-hand-foot-and-mouth-disease/
  24. http://www.who.int/csr/don/2012_07_09/en/index.html
  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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