China: EV-71 outbreak Kills 43 Children Nationwide, 24,934 Children infected

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

<TABLE cellSpacing=0 cellPadding=0 width="100&#37;" border=0><TBODY><TR><TD class=HeadLine>Outbreak of intestinal virus kills 19 children</TD></TR><TR><TD class=Title>2008-4-28 </TD></TR><TR><TD style="PADDING-RIGHT: 5px; PADDING-LEFT: 5px; FONT-WEIGHT: bold; FONT-SIZE: 11px; PADDING-BOTTOM: 5px; COLOR: #bb171c; PADDING-TOP: 5px"></TD></TR><TR><TD class=Content id=Content style="FONT-SIZE: 16px; LINE-HEIGHT: 25px">
A VIRUS outbreak has killed at least 19 children and made nearly 800 others sick in a city in eastern China's Anhui Province since March, local government said yesterday.

The fatality toll may rise, as four children are in critical conditions

</TD></TR></TBODY></TABLE>The government in Fuyang City identified the virus as enterovirus 71 or EV71, a contagious intestinal virus that can trigger hand-foot-mouth disease, in an effort to dissolve panic among its population of about 9 million that has been worried about a "mystery illness."

As of Saturday, the city had reported 789 cases of EV71 infection, including the 19 fatalities. Fuyang authorities said four of the 204 children still hospitalized are in critical conditions. All victims were aged below six, and most under two, Xinhua news agency reported last night.

No adult cases have been reported.

Hospitals in Fuyang started to take in children with fever, along with blisters, ulcers in the mouth, or rashes on the hands and feet, in early March. Some of the victims were diagnosed with brain, heart and lung damage.

Enterovirus spreads mostly via contact with infected blisters or feces, or everyday items including toys, towels, bed clothes and underwear that have been infected with the virus, medical sources said. It can also spread through throat secretions and saliva or close contact with a patient.

Usually the virus brings fever and blisters or ulcers inside the mouth and on the limbs. Sometimes it can cause deadly high fever, paralysis and swelling of the brain or its lining.

EV 71 outbreaks tend to occur from April to September, though it is possible throughout the year, medical experts say.

Rumors and panic had earlier spread among residents in downtown Fuyang, with many parents keeping children out of school, the Democracy and Law Times newspaper reported. Some sent their children to other cities.

"All sorts of claims rapidly spread via the Internet, phone calls and text messages, and an air of panic spread," the newspaper said.

Minister of Health Chen Zhu visited Fuyang on Saturday, and other officials and doctors have gone there to investigate, help patients, and "fully roll out prevention and control work," said a Xinhua report.

From May 2003 to April 2004, Fuyang became the center of a national scandal when 13 babies died and another 189 suffered malnutrition from drinking baby formula that investigators later found had no nutritional value.

http://www.shanghaidaily.com/article/?id=357493

[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

I search my google and HFMD can also be caused by EV71 and can also case encephalitis which can also cause cardiopulmonary failure. That was the only way I could tie in any respiratory ailments. The bottom line would be encephalitis, which could cause cardiopulmonary failure....

But, also see #5 (from WHO website):
(...)
? Clinical syndromes
Replication of the enterovirus begins in the gastrointestinal or respiratory tract and once the virus is present in the blood stream, infection may affect various tissues and organs, causing a variety of diseases.

The majority of infections are symptomless or mild in nature, the most common effect being a non-specific illness, with fever.

Other manifestations include exanthems (rashes), herpangina (vesicular eruption and inflammation of the throat), acute respiratory disease, conjunctivitis, aseptic meningitis, encephalitis (inflammation of the brain), myopericarditis (inflammation of the heart tissue), and, occasionally, paralytic diseases.
(...)

[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

. All the patients are children under the age of six, most living in rural areas, and no obvious correlation between the cases.

Also from #5 (WHO facts sheet):
(...)
Transmission is usually by the faeco-oral or by the respiratory route when there is an associated respiratory illness.

The virus may be excreted in the stool for many weeks.

Enteroviruses have been detected in water, soil, vegetables and shellfish and may possibly be transmitted in the community by contact with contaminated food or water.
(...)

[sharon sanders]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

But, also see #5 (from WHO website):
(...)
? Clinical syndromes
Replication of the enterovirus begins in the gastrointestinal or respiratory tract and once the virus is present in the blood stream, infection may affect various tissues and organs, causing a variety of diseases.

The majority of infections are symptomless or mild in nature, the most common effect being a non-specific illness, with fever.

Other manifestations include exanthems (rashes), herpangina (vesicular eruption and inflammation of the throat), acute respiratory disease, conjunctivitis, aseptic meningitis, encephalitis (inflammation of the brain), myopericarditis (inflammation of the heart tissue), and, occasionally, paralytic diseases.
(...)

This makes sense to me.

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

so...ET-71 can be caused by anything and can cause just about anything.... ...."The majority of infections are symptomless or mild in nature, the most common effect being a non-specific illness, with fever.

Other manifestations include exanthems (rashes), herpangina (vesicular eruption and inflammation of the throat), acute respiratory disease, conjunctivitis, aseptic meningitis, encephalitis (inflammation of the brain), myopericarditis (inflammation of the heart tissue), and, occasionally, paralytic diseases."
..........Transmission is usually by the faeco-oral or by the respiratory route when there is an associated respiratory illness.

The virus may be excreted in the stool for many weeks.

Enteroviruses have been detected in water, soil, vegetables and shellfish and may possibly be transmitted in the community by contact with contaminated food or water

[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

so...ET-71 can be caused by anything and can cause just about anything.... ...."The majority of infections are symptomless or mild in nature, the most common effect being a non-specific illness, with fever.

Other manifestations include exanthems (rashes), herpangina (vesicular eruption and inflammation of the throat), acute respiratory disease, conjunctivitis, aseptic meningitis, encephalitis (inflammation of the brain), myopericarditis (inflammation of the heart tissue), and, occasionally, paralytic diseases."
..........Transmission is usually by the faeco-oral or by the respiratory route when there is an associated respiratory illness.

The virus may be excreted in the stool for many weeks.

Enteroviruses have been detected in water, soil, vegetables and shellfish and may possibly be transmitted in the community by contact with contaminated food or water

A very bad bug... Poor hygiene, overcrowded classrooms, huge infant population... The best recipe for an outbreak

[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

China steps up monitoring of deadly virus outbreak
28 Apr 2008 07:20:38 GMT
Source: Reuters
BEIJING, April 28 (Reuters) -

An eastern Chinese province has instituted a daily reporting system to monitor the spread of a virus that has killed 19 children and spread panic among residents, Xinhua news agency reported on Monday.

The enterovirus 71, or EV71, which can cause hand, foot and mouth disease, began spreading in Anhui province's Fuyang city from early March, Xinhua said, but was only publicly reported on Sunday.

But in a sign of new attention to the outbreak, Health Minister Chen Zhu visited Fuyang at the weekend and other officials and doctors have gone to investigate.

The provincial health department will also host workshops to train more medical workers in prevention and cure of the virus, the report said.

By Saturday, there were 789 cases, including 19 deaths, the majority of them children under the age of two. A total of 204 children remain in hospital, four in critical condition, Xinhua said.

Enteroviruses spread mostly through contact with infected blisters or faeces and can cause high fever, paralysis and swelling of the brain or its lining.

EV71 outbreaks have occurred in past years in Southeast Asia and some East European countries.

(Reporting by Lindsay Beck; Editing by Nick Macfie)
-

http://www.alertnet.org/thenews/newsdesk/PEK266556.htm

------

[Commonground]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

April 28, 2008
China steps up monitoring of deadly HFMD outbreak

BEIJING - AN eastern Chinese province has introduced a daily reporting system to monitor the spread of a virus that has killed 19 children and spread panic among residents, Xinhua news agency reported on Monday.
The enterovirus 71, or EV71, which can cause hand, foot and mouth disease, began spreading in Anhui province's Fuyang city from early March, Xinhua said, but was only publicly reported on Sunday.

The virus had been found before in China, but 'we believe the situation is still of concern, especially because of the current high reported case fatality rate compared to previous years', the World Health Organisation's acting China Representative, Cris Tunon, said in a statement.

WHO recommended that parents keep their children away from public places during an outbreak and make sure they frequently wash their hands.

In a sign of new attention to the outbreak, Health Minister Chen Zhu visited Fuyang at the weekend. The provincial health department will also host workshops to train more medical workers in prevention and cure of the virus, the report said.

By Monday, there were 915 cases, a jump of more than 100 from the figures released at the weekend, Xinhua reported.

Among them were 19 deaths, the majority of them children under the age of two. A total of 269 children remained in hospital, seven in critical condition, Xinhua said.

Enteroviruses spread mostly through contact with infected blisters or faeces and can cause high fever, paralysis and swelling of the brain or its lining.

There is no vaccine or antiviral agent available to treat or prevent the virus. Instead, treatment focuses on managing its complications, which can include meningitis and heart failure, the WHO's Tunon said.

EV71 outbreaks have occurred in past years in Southeast Asia and some East European countries. -- REUTERS

http://www.straitstimes.com/Latest%2BNews/Asia/STIStory_231903.html

[Malcolm]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Hand Foot Moth disease epidemic---SINGAPORE

EV-71 causes Hand foot mouth disease.

April 26, 2008

http://www.brunei-online.com/weekend/news/apr26h6.htm

Parents concerned over Singapore HFMD outbreak


By Azlan Othman
Several parents have expressed their concern over the Hand, Foot and Mouth Disease (HFMD) outbreak which has been reported in Singapore where 880 new cases were reported in four days. This is especially so for those who travelled to the neighbouring country.

The dpa news service reported yesterday that teachers, administrative staff and cleaners scrubbed Singapore preschools and childcare centres Friday to curb the HFMD outbreak.

Dpa added, with the latest Health Ministry of Singapore data showing this year's total infections at 8,400, officials are now providing daily updates instead of weekly ones.

At least 16 schools have been closed because of the outbreak. Another nine have been urged to voluntarily shut down for 10 days. The disinfection is aimed at halting the transmission of the disease, which is spread through saliva, blister fluid, faeces and droplets in the air. Professionals have been called to service air conditioners and fumigate.

Sources said such HFMD cases have also occurred in Brunei but have been on the decline lately. From early to end of August 2007, about 90 HFMD cases were recorded in Brunei, the Ministry of Health said. While from early March to mid April 2006, some 580 cases were recorded, the majority of which were outpatient cases.

[Commonground]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Post #24:

where 880 new cases were reported in four days. This is especially so for those who travelled to the neighbouring country.

[Shiloh]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Source: http://www.pr-inside.com/children-de...by-r560389.htm

20 children dead, 1,200 sickened by viral infection in eastern China
? AP
2008-04-28 14:11:13 -

BEIJING (AP) - A viral outbreak in eastern China has sickened almost 1,200 children, killing 20 of them, health officials said Monday.
Enterovirus 71 infections were discovered in March in Fuyang, a city in Anhui province, but may have gone undetected for a while because the symptoms appeared to be ailments common in children, said
Feng Lizhong, an official at the Anhui public health bureau.
Hospitals in Fuyang started to take in patients with fever, blisters, ulcers in the mouth, or a rash on their hands and feet, the official Xinhua News Agency said.
Most were under 2 years old and none was older than 6, Xinhua said.
There were 1,199 reported cases between early March and Sunday, 20 of which were fatal, the health bureau said in a statement on its Web site.
Some 371 children were still being treated and more than 550 had recovered, it said.
It was not immediately clear what triggered the outbreak, but the bureau said it is the season when the virus is prevalent.
Enterovirus 71 is one of several viruses that cause hand, foot and mouth disease, which is characterized by fever, mouth sores and a rash with blisters. It is spread by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons.
The illness mainly strikes children below age 10 and is not related to foot and mouth disease, which infects cattle, sheep and swine.

The World Health Organization's Beijing office said there didn't appear to be an epidemiological link among the cases although most of the children lived in rural areas.
?We believe the situation is still of concern, especially because of the current high reported case fatality rate compared to previous years,? said Dr. Cris Tunon, the acting China representative.
The number of cases of hand, foot and mouth has been on the rise in China.
Last year, Beijing reported more than 1,000 cases in the first six months. In the eastern province of Shandong, 1,200 children were infected in May.

[Shiloh]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Source: http://www.shanghaidaily.com/sp/arti...cle_357616.htm

Province combats deadly virus
2008-4-29
Change font size:
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EASTERN China's Anhui Province has installed a province-wide daily reporting system to fight the spread of a deadly virus that has killed at least 19 children in Fuyang City so far.

By yesterday, the number of infections had risen to 915 cases of Enterovirus 71, including 19 deaths. A total of 269 children remain in hospital. Seven of them are said to be in critical condition, Fuyang City government revealed yesterday.

Enterovirus 71 can cause hand, foot and mouth disease, which usually starts with a slight fever followed by blisters or ulcers in the mouth and on the hands and feet.

Serious infections can lead to death. No vaccines nor therapeutic treatments are available.

More medical workers will be trained to prevent the deadly intestinal virus in workshops run by the province's health department, officials said yesterday.

The outbreak started in early March, when hospitals in Fuyang, in the northwest of Anhui, started to take in children with fever, along with blisters, ulcers in the mouth, or rashes on the hands and feet. Some victims suffered brain, heart and lung damage.

All of the victims were aged below six. The majority were under the age of two.

The virus has spread to neighboring counties such as Huoqiu in Liu'an City and Lixin in Bozhou City.

Infections have also been detected in Henan Province's Huibin County in central China.

All sick children have been receiving medical treatment at No.1 and No.2 hospitals in Fuyang City, according to the city government.

Officials have stepped up their fight against the spread of disease, taking measures to clean up the environment in a bid to keep the outbreak under control.

Workers have been organized to disinfect the major areas where many infections were found, and to destroy sources of infectious intestinal diseases and parasites, including killing mosquitoes.

In rural areas, sewage is often collected for centralized treatment.

All families with children below the age of five have been given leaflets with tips on how to prevent infection.

[Commonground]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Trying to wrap my brain around this. From Post #23, #26 & #27:

#23:

began spreading in Anhui province's Fuyang city.....By Monday, there were 915 cases, a jump of more than 100 from the figures released at the weekend, Xinhua reported.

Among them were 19 deaths, the majority of them children under the age of two. A total of 269 children remained in hospital, seven in critical condition, Xinhua said.

#26:

almost 1,200 children, killing 20 of them,...discovered in March in Fuyang, a city in Anhui province.....There were 1,199 reported cases between early March and Sunday, 20 of which were fatal, the health bureau said in a statement on its Web site.
Some 371 children were still being treated and more than 550 had recovered, it said.

#27:

killed at least 19 children in Fuyang City so far.....By yesterday, the number of infections had risen to 915 cases of Enterovirus 71, including 19 deaths. A total of 269 children remain in hospital. Seven of them are said to be in critical condition, Fuyang City government revealed yesterday.

So there are two articles that say 269 are still being treated, and one article that says 371.
Pretty much 20 children have passed away.
Two articles says 915 cases since March. Another says 1,200.

[Shiloh]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Source: http://news.xinhuanet.com/english/20...nt_8070187.htm

Mass intestinal virus infection sickens 1199 children, kills 20
www.chinaview.cn 2008-04-29 06:06:13 Print

HEFEI, April 29 (Xinhua) -- A total of 20 children have died and 1179 others fallen ill in an outbreak of a lethal intestinal virus in Fuyang City, east China's Anhui Province, since March.

The enterovirus 71 has sickened a total of 1,199 children and kills 20 of them by Sunday night, the municipal government of Fuyang said Monday night, quoting statistics from local hospitals and center for disease control.

By Sunday night, 341 children remain in hospital for further medical observation, of whom, 27 are said to be in critical conditions and 8 terminally ill.

Hospitals in Fuyang, in northwest Anhui, started to take in children with fever, along with blisters, ulcers in the mouth, or rashes on the hands and feet, in early March. Some of the victims were diagnosed with brain, heart and lung damage.

All of the victims were aged below six, of whom, the majority being children under the age of two.

Enterovirus 71 can cause hand, foot and mouth disease which usually starts with a slight fever followed by blisters of ulcers in the mouth and on the hands and feet.

It may cause high fever, meningitis, encephalitis, pulmonary edema and paralysis in a small number of children. Paralysis is more common in children under 2 years of age and meningitis is more common in children from 2-5 years of age, said Yang Weizhong, deputy chief of Chinese Center for Disease Control and Prevention.

Infections could lead to high mortalities in serious cases and neither vaccine nor therapeutic treatment is available.
Editor: Mu Xuequan

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Fuyang epidemic: the city hospital overcrowding
[2008-04-29]


<CENTER>■ Second People's Hospital of Fuyang City, the corridor has already fill beds.
(Independent Fuyang reporters YIN Hui Xia Shi Yan)-Second People's Hospital of Fuyang City of sick children growing, the hospital needs to continue to Luo Yi and the children extra beds. It is understood that in addition to local children in Fuyang City, Anhui Province have come to visit the Bozhou, Huaibin County, Henan and other places in Xinyang city kids.

At around 8:30, the reporter entered the Second People's Hospital of Fuyang City.This reporter has learned that the children were sick in the emergency room floor, and the newly completed first floor of the hospital floor, a Division of infectious diseases. At this time, emergency room floor, first floor, second floor, and all who have lived in the wards, a few reporters on the first floor and second floor, only 30 beds are nearly the entire ward voice noisy, some corner of piles of refuse. Reporter noted that these children were diagnosed in病名not unanimous, some hand, foot and mouth disease, and some of bronchial pneumonia. But several parents said that children now no longer OK.

By contrast, newly renovated by the Chuan Ranke, it is a quiet and comfortable, middle aisle no extra beds. However, at 8:44, the reporter in the nurses station several times to hear nurses internal communications tool to inform colleagues: "Another two, can be arranged beds&#187; "nurses station is surrounded by more than parents, Among them, two kids there is no bed, lying on the parents are sleeping in the Biwan.

"We 6:00 p.m. on to the hospital, until now no beds." Bozhou City, who comes from the parents of Lixin County, emotional, holding the child's mother, who looked distressed anxious. Subsequently, the reporter found that the hospital has not yet applied a set of opening the assembly and packaging beds, the patients resettlement. Medical Section Chief of the hospital Meng Xiaolin told reporters that the bed is very tense, they are arranged one by one. A nurse told the reporters that they have no rest, some doctors and nurses, not even rice to eat.
Although the EV71 virus infection for intestinal infectious diseases, and may be transmitted through the spittle, but reporters found that in addition to the hospital nurses, sick children and parents and caregivers are not wearing masks.

In an interview with reporters a number of city people, they know that such thing, but they all called "abnormal", no one knows what is the specific disease. They told reporters that the local media rarely reports of the disease. http://209.85.135.104/translate_c?hl=en&langpair=zh%7Cen&u=http://www.xkb.com.cn/view.php%3Fid%3D242156</CENTER>