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  • HAND, FOOT & MOUTH DISEASE - INDIA (CALCUTTA)

    HAND, FOOT & MOUTH DISEASE - INDIA (CALCUTTA)

    A ProMED-mail post
    <http://www.promedmail.org>
    ProMED-mail is a program of the
    International Society for Infectious Diseases
    <http://www.isid.org>

    Date: Sun 23 Sep 2007
    Source: The Telegraph (Calcutta) [edited]
    <http://www.telegraphindia.com/107092...ry_8350859.asp>


    As of Sat 22 Sep 2007, doctors have warned of a "hand, foot and mouth
    disease" epidemic that they say is infecting city children
    .

    "The disease is spreading like an epidemic in parts of the city. Usually,
    we find a few stray cases every year, but this year [2007], the
    number is huge," said Apruba Ghosh, Director of the Institute of
    Child Health, Calcutta.


    Nearly 300 cases have been reported across the city in the past 4
    days. Children younger than 5 have been found to be vulnerable to the
    coxsackievirus causing the disease. "It is highly infectious and
    causes fever, ulcers in the mouth and vesicles -- small swellings
    filled with liquid under the skin -- in the limb joints,"
    Ghosh said.

    A 4-year-old child had similar symptoms 4 days ago. He had high
    fever, which subsided by evening, but he was unable to eat, as there
    were ulcers in his mouth. "In the morning, we found vesicles in the
    joints of his hands and legs," said his father, a resident of Bagha
    Jatin in south Calcutta. A doctor diagnosed the patient with hand,
    foot and mouth disease.

    The B.C. Roy Memorial Hospital for Children has received several
    patients with the disease in the past 3 or 4 days at its outpatient
    department. Experts say the coxsackievirus is part of [belongs to]
    the enterovirus family of viruses, which includes hepatitis A [virus]
    that is found in the digestive tract. Usually, the coxsackievirus
    causes mild flu-like symptoms, but sometimes the patients show high
    fever. The fever usually subsides in 3 to 4 days.


    Doctors said only symptomatic treatment should be done. There is no
    vaccine to prevent the infection, they said. "Parents are advised not
    to send children suffering from this disease to school, because the
    virus, being air-borne, spreads easily,
    " Ghosh said.

    --
    Communicated by:
    ProMED-mail <promed@promedmail.org>

    [Hand, foot and mouth disease (HFMD) can be caused by several enteric
    picornaviruses: Human enterovirus 71, Human coxsackievirus A16, Human
    echovirus 11 and Human echovirus 4 being the most frequent. HFMD
    disease, although present worldwide, has caused most concern in
    China, Japan and South-east Asia. (HFMDV is a pediatric disease
    unrelated to the foot-and-mouth disease affecting ruminants and some
    other animals). Echovirus 71 has been associated more than the other
    viruses with cases of acute neurologic disease, including
    poliomyelitis-like paralysis, encephalitis, and aseptic meningitis pathogens.

    Sasiharadran et al. (Indian J . 2005 Jan;72(1):17-2) have published a
    description of a previous outbreak in Calcutta and the surrounding
    area which occurred in October 2003 and subsided in February 2004. A
    total of 81 children were followed up on, and it was concluded that
    although that outbreak was caused by echovirus 71 on that occasion,
    the disease was mild, and all children recovered within 2 to 3 weeks.

    Coxsackievirus A16 appears to be the cause of the current outbreak in
    Calcutta. A recent analysis of the molecular phylogeny of
    coxsackievirus A16 (Perera et al., Arch Virol. 2007;152(6):1201-8)
    has revealed that there are 2 distinct strains (genogroups) of this
    virus, one consisting of the prototype virus and the other 2 distinct
    lineages. Lineage 1 viruses circulating before 2000 were later
    displaced by lineage 2 viruses. This genetic heterogeneity may play a
    role in the continuing occurrence of outbreaks of HFMDV in the region.

    A map of the West Bengal state of India showing the location of
    Calcutta (now called Kolkata) is accessible at
    <http://india.gov.in/maps/westbengal.php>.
    - Mod.CP]

    [see also:
    Hand, foot & mouth disease - China (Beijing) 20070713.2253
    Hand, foot & mouth disease - China (Hong Kong) 20070530.1741
    Hand, foot & mouth disease - Maldives 20070529.1719
    Hand, foot & mouth disease - China (Shandong)(04) 20070524.1667
    Hand, foot & mouth disease - China (Shandong) (03) 20070520.1604
    Hand, foot & mouth disease - China (Shandong) (02) 20070516.1560
    Hand, foot & mouth disease - China (Shandong) 20070514.1540
    Hand, foot & mouth disease - Singapore 20070424.1338
    Hand, foot & mouth disease - Sri Lanka (Colombo) 20070311.086
    2006
    ----
    Hand, foot & mouth disease - India (Kerala) 20061024.3044
    Hand, foot and mouth disease - Malaysia (Sarawak)(04) 20060319.0854
    Hand, foot and mouth disease - Malaysia (Sarawak)(03) 20060313.0792
    Hand, foot and mouth disease - Brunei 20060308.0744
    Hand, foot and mouth disease - Malaysia (Sarawak)(02) 20060305.0712
    Hand, foot and mouth disease - Malaysia (Sarawak) 20060303.0671
    2005
    ----
    Hand, foot and mouth disease - Taiwan (central) (02) 20050531.1503
    Hand, foot and mouth disease - Taiwan (Central) 20050523.1417
    2000
    ----
    Hand, foot and mouth disease - South Korea: comment 20000615.0969]
    ........................................cp/msp/jw


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