Re: 17 children die of hand-foot-mouth disease in Vietnam
Re: 17 children die of hand-foot-mouth disease in Vietnam
From ProMED;
Archive Number 20110607.1739
Published Date 07-JUN-2011
Subject PRO/EDR> Hand, foot & mouth disease - Viet Nam (03): HCM
HAND, FOOT AND MOUTH DISEASE - VIET NAM (03): HO CHI MINH CITY
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Date: Tue 7 Jun 2011
Source: Report received from the Institute Pasteur, Ho Chi Minh City,
Viet Nam [edited]
Cases of hand, foot and mouth disease (HFMD) increased sharply in Ho
Chi Minh City between April and May 2011. Samples from 174 HFMD cases
were obtained from Children's Hospitals No. 1 and No. 2 in Ho Chi Minh
City (HCMC) and from several southern provinces, including Dong Thap,
Dong Nai, Binh Duong and Tien Giang provinces and were tested in the
Laboratory of Enteric Viruses of the Pasteur Institute in HCMC. Data
from RT-PCR assays showed the presence of human enterovirus 71 (HEV
71) in 43/174 (25 percent) of cases and other enteroviruses in 91/174
(52 percent) of cases. HEV 71 was identified in 5 fatal cases of HFMD
from specimens that included CSF and throat swabs.
In 9 cases, HEV 71 was isolated in cell culture, and the sub-genotype
was identified by nucleotide sequencing. These data showed that 8
patients (including 2 fatal cases from Ho Chi Minh City) were infected
with HEV 71 sub-genotype C4, and a single HFMD case from Dong Thap
province was infected with HEV71 sub-genotype C5. According to
surveillance data obtained from the Pasteur Institute in Ho Chi Minh
City, HEV 71 C4 and C5 strains have been prevalent in southern Viet
Nam since 2003.
(This report has been approved by Dr Tran Ngoc Huu, MPHM, Ph.D,
Director, Pasteur Institute, Ho Chi Minh City, Viet Nam.)
--
Communicated by:
Dr Nguyen Thi Thanh Thao,
Enteroviruses Lab.,
Immunology and Microbiology Dept.,
Ho Chi Minh Institute,
167 Pasteur str., 3 Dist.,
Ho Chi Minh City,
Viet Nam
tthao1103@yahoo.com
[ProMED-mail welcomes receipt of this authoritative report.
It is clear that, as elsewhere, the epidemiology of HFMD in Viet Nam
is complex and that human enterovirus 71 plays a major role in the
causation of this disease. As commented previously, a great diversity
of human enterovirus 71 strains circulate globally, and no particular
genogroup has been specifically associated with severe disease.
Different human enteroviruses co-circulate in the community annually.
According to a recent review (Lee, T.C. et al., Pediatr Infect Dis J.
2009 Oct;28(10):904-10), the emergence in recent years of the human
enterovirus 71 epidemic in the Asia Pacific region has been associated
with the circulation of 5 genetic lineages (genotypes B3, B4, C1, C2,
C4) that appear to be undergoing rapid evolutionary changes. More
recent reports indicate that sub-genotype C4 predominates in China at
the present time (Mao LX, et al., J Clin Virol. 2010 Oct;49(2):100-4),
and this, on the basis of the above report, appears to be the
situation in Viet Nam also. The identification of a B2 sub-genotype
virus in the preceding ProMED report from Viet Nam [Hand, foot & mouth
disease - Viet Nam (02): (QN, HCM) 20110604.1712] appears not to be
indicative of the current epidemiological situation in this part of
South East Asia.
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