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Aetiology

Discussing causes, origins, evolution, and implications of disease and other phenomena.

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Tara C. Smith is an Assistant Professor of Epidemiology. Her research involves a number of pathogens at the animal-human nexus. Additionally, she is the founder of Iowa Citizens for Science and also writes for The Panda's Thumb and previously for WIRED SCIENCE's Correlations. Please note the views expressed on this site are Dr. Smith's alone and may not be representative of the groups mentioned above.

"...a veritable expert on tawdry cosmetic procedures gone horribly awry..."--Kevin Beck

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Infectious Disease Series

« On Hiatus | Main | ASM anyone? »

Front row seat for hand, foot, and mouth disease in Asia

Category: General EpidemiologyInfectious diseaseOutbreakPublic healthVarious viruses
Posted on: May 15, 2008 10:50 AM, by Tara C. Smith

I'm taking a quick hiatus from my hiatus. I mentioned that I had quite a bit of travel upcoming, and I happen to be in the midst of my first trip. However, it just so happens that where I've landed--Ulaanbaatar, Mongolia--is experiencing an outbreak of hand, foot, and mouth disease in kids, caused by Enterovirus-71. More after the jump...

You may have read about this virus in prior weeks, as China has been dealing with a major outbreak there:

The number of hand-foot-mouth disease (HFMD) cases reported in China this year rocketed to 15,799 as of Tuesday, resulting in 26 deaths, according to a Xinhua tally of local official figures. The figure stood at 11,905 on Monday, Xinhua found.

So far, EV71 is blamed for most of the deaths in the outbreak of the disease.

EV71 can cause hand, foot and mouth disease, which usually starts with a slight fever followed by blisters and ulcers in the mouth and rashes on the hands and feet.

The English-language Mongolian paper hasn't updated its website for awhile, but they have a print story on the outbreak in Ulaanbataar:

In Mongolia, the first person who had been infected with Enterovirus-71 was registered on May 8, 2008, and the number of persons infected with this virus has escalated to 346 by May 13.

In connection with this situation, 1-5th grade pupils of all private and State secondary schools and under age children at kindergartens where Enterovirus-71 has been revealed, were placed under quarantine on May 12 for an unspecified period.

...Moreover, the National Emergency Management Agency (NEMA) has issued its decisions to take following action: to create a condition whereby all people entering through Border 8 checkpoints...will be required to undergo medical examinations...as well as to ban the organizing of public activities among people during this quarantine period.

Schools were closed today, and despite the language regarding public activities, it seems to be pretty bustling around here--athough several Ministry of Health and other health officials had to duck out of our conference early to work on the outbreak. No deaths that I've heard of here thus far. Will the measures they've put in place be enough to stem the spread of the virus?

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1

Interesting. All the outbreaks in recent years are focused on southeast Asis. I wonder if there's a specific reason for that. Maybe it's because it's a deisease primarily of children, who don't travel like adults do and so it tends to stay fairly localized?

Posted by: Dave S. | May 15, 2008 1:16 PM

2
All the outbreaks in recent years are focused on southeast Asis. I wonder if there's a specific reason for that.

Yh, n vry spcl rsn thr s. Sthst s s xctly th pnt whr Wrld Hyp rgnztn ∓ C fcs t try t fcs th rst f th wrld n th fct tht thr s ctlly smthng t fcs. Bt f y lk wy frm th dmmy hyprs' pnt f vw, y prtty sn ls ll ntrst n fcsng whr y'r sppsd t fcs.



Nw, wt mnt. Ds tht mk ny sns? trd t rrd myslf nd 'm knd dzzy rght nw... Mst gt wy frm hr... vd tht -Pst- bttn... Dn't psh t Jn, dn't... Dn't... h sht... Srry, t's strngr thn m, swr t s... Srry...

Posted by: jspreen | May 15, 2008 2:04 PM

3

I'm not very familiar with this disease. Like, is there a vaccine? How often is it fatal?

I'm much more familiar with foot-in-mouth disease. It comes from saying stupid things. It seems to be prevelent everywhere. It's not fatal very often. But there's no cure. It was hoped that many years of education would help, but it the data show that this, if anything, just makes it worse.

Posted by: Stephen | May 15, 2008 4:19 PM

4

"I'm not very familiar with this disease. Like, is there a vaccine? How often is it fatal?"

Hand-foot-mouth is quite common but is usually caused by Coxsackievirus A16 (at least in the US and Canada). Disease caused by enterovirus 71 is often much more severe and can lead to encephalitis. There's no vaccine though I hear there's work being done on one for enterovirus 71.

Great post--I sure hope they can contain this before things get out of control.

Posted by: FF | May 16, 2008 12:40 AM

5

I got the Coxsackie version of hand, foot and mouth disease just after my 1 year old started in a childcare center (in Australia) They had a small outbreak; she didn't get it but I did. It gave me the worst set of small mouth ulcers I've ever had. I don't recall any other symptoms (but its 14 years ago). No treatment needed.

Posted by: davidp | May 16, 2008 8:30 PM

6

Cnsrshp/cnsrshp/cnsrshp/cnsrshp/cnsrshp/cnsrshp/cnsrshp/cnsrshp/cnsrshp/cnsrshp

Posted by: cnsrshp | May 18, 2008 2:34 AM

7

OK Tara, so it's disemvoweling. The horror method leaving the creator of some more or less interesting contribution without a soul.
I think it's a pity but let it be, your choice to slip back into the insignificant "everbody agrees with everybody" zone of non-information and, much worse, into some machiavelic jungle of indoctrination.
There are quite some interesting threads on this blog and I noticed that some of them have been transfered to other sites in order to prevent them from getting wiped out and thus lost to humanity.
Anyway, too bad aetiology belongs to the past. Now I have to move on and find some other place I can promote to my daily favorite.

Posted by: jspreen | May 19, 2008 4:19 PM

8


Now I have to move on and find some other place I can promote to my daily favorite

Please, make haste.

Posted by: Chris | May 19, 2008 6:52 PM

9

jspreen writes,

There are quite some interesting threads on this blog and I noticed that some of them have been transfered to other sites in order to prevent them from getting wiped out and thus lost to humanity.

That's true. In fact, certain denialist blogs have practically become mirrors of aetiology, with nothing of their own except an errant science faux pas here and a sexist remark there. What will become of these blogs if Tara's disemvoweling continues, and there's nothing left on the (very) low end of the comment quality spectrum for their hosts to understand?

Posted by: ElkMountainMan | May 19, 2008 10:21 PM

10

Dear Tara,

I really enjoy your blog, that I've read a few times, I've thought that a blog might correspond with your interests...

This blog is called Scientific Discovery and collects any important news regarding the global science world such as biology, health, medecine, technology, engineering, astronomy, environment ect.

Here is the adress: http://blog.elabspace.com/science/

Regards,

Pauline

Posted by: pauline | May 20, 2008 5:40 AM

11

Interesting stuff about HFMD. And even more interesting to follow the response of civil and medical authorities in the affected area. Ever since I watched the bureaucrats and politicians of my country (the USA) drop the ball so horrendously during Katrina, I've gained a greater interest in disaster preparation and response.

And disemvoweling the proven trolls seems a pretty civil solution. How can it be censorship when they have so many other venues to spew in?

Posted by: wright | May 22, 2008 2:43 PM

12

Tara, how awesome to be in Mongolia! I hope the conference goes well. Don't catch the enterovirus.

As for the trolls, if someone is persistently tiresome, say three times, why not just ban them? This is a garden, not a vacant lot. You're entitled to keep litter out.

Posted by: Monado | May 26, 2008 12:52 AM

13

Hey Never-Wrong Geniuses!

What's this?

Writing's on the wall for UNAIDS.
http://www.bmj.com/cgi/content/full/336/7652/1072

UNAIDS myths on AIDS pandemic costing billions
http://www.fightingdiseases.org/main/pr.php?pr_id=27

Posted by: Genius | May 27, 2008 12:23 PM

14

Thanks for the tip Genius, very interesting that James Chin includes a reference and link to this website in his paper:

http://www.man2manalliance.org/

"A coalition gay. bi- and straight-identified men...who reject anal penetration, promiscuity, and effeminacy among men who have sex with men"

Sounds right up Claus Jensen's alley.

Posted by: FDB | May 27, 2008 1:14 PM

15

Oh look. All of Africa, not suffering the sex plague.

What are you lot gonna do for fun, if not circumcise black men and drug their women to death?

Oh yeah, that's right. That stuff never happened, (in Uganda, don't ask for Dr. Fishbein at the NIH, he's been "relocated")

And you know, damn that FDA for putting black-box labeling on all our wonderful drugs. Just to SCARE people. Denialists!

And that BMJ - full of denialists. And these idiots too - http://www.fightingdiseases.org/main/pr.php?pr_id=27

And these morons - http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49958

Kaiser networks? Who do they think they are. "Basic health concerns?" Bah! Denialism.

Might as well lump them in with the bogus monkeys who fixed Padians research, and who make all HIV tests have no standards. I mean, GOD, who do these people at ABBOTT labs think they are?

And those reports on Nevirapine! What a sick joke somebody must be playing! Got to be fakes. GOT TO BE!

Must be.

Thanks goodnesses that some gay men have learned their lesson and still are terrified of sex (at least they're nice enough to LIE to us properly, when they fill out their monthly request for funds, for participating in our suicide machine.)

Yes, god bless 'em.

And you too, FDB. God even loves you. (What's wrong with him?)

Posted by: supergenius | May 27, 2008 3:01 PM

16

Some 15 thousand cases, and 26 deaths. Out of how many people? You did not that the cases, and deaths, are occurring in very young children. Which shrinks the pool of possible patients, but which still means not all that many people are coming down with Hoof, Hand, and Mouth Disease, and a scant low fraction of those are dying of it.

I suspect more people get it than are recorded, but most either don't recognize it, attribute the symptoms to another cause, or don't think it important enough to bother about. We hear about the little kids because they don't yet have an immune system capable of handling HF&M as an older one would.

We have West Nile out here in California. Every year one man---that's one---dies of West Nile. West Nile has been a great disappointment. This strain of Hand, Foot, and Mouth Disease will likely to be another no show in the greater scheme of things.

Posted by: Alan Kellogg | June 1, 2008 11:45 PM

17

infectiuous disease paranoia is a disease in itself... I will most likely get mowed down by a car myself...or struck by lightning. I'll live in serene peace until then.

Fear mongers...we are aware of them.

Posted by: pat | June 2, 2008 12:09 AM

18

FBD - "reject anal penetration"? Oh gracious me, that's a relief - I was worried that some gay bloke down the road might anally penetrate some horrid, dirty homo, catch "HIV-the-virus-that-causes-AIDS", and pass it on to the puppies in the local pet shop just by spinal fur penetration. The puppies could then go on to infect Mrs Miggins, 93-year-old incontinent pet shop volunteer who thoughtlessly and criminally has the temerity to eat in the same Ye Olde English Tea Shoppe as I do - and I'm sure she sneezed on my Eccles cake last Thursday. Now if only the powers that be could only persuade the inferior classes that vaginal sex must equally be denounced as a disgusting vector of HIV disease (until the heroic Dr Moore has an effective microbicide - 57th time lucky eh John?) and the AIDS SAUCEPANDEMIC would be over.
Thanks so much FDB - I don't have to worry about AIDS any more.

Posted by: SuperUnctuousRiceKrispieGenius | June 2, 2008 2:53 AM

19

Look who funds the "Campaign for Fighting Diseases" http://www.sourcewatch.org/index.php?title=Campaign_for_Fighting_Diseases

Posted by: FHB | June 2, 2008 7:51 AM

20

Did you manage to get out of UB at all? I spent a month in Mongolia in 2006 - http://danny.oz.au/travel/mongolia/ - and the countryside is rather different to the capital! I heard that Mongolia had some problems with foot-and-mouth disease, but hand-and-mouth is a new one to me too.

Posted by: Danny Yee | June 8, 2008 8:07 PM

21

There is indeed a rise of enterovirus among children up here in Canada.

Posted by: Crusoe | June 9, 2008 1:18 PM

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