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

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 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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Hand, Foot and Mouth Disease (HFMD, not to be confused with a disease of cattle, Foot and Mouth Disease) is the result of an infection by one of several intestinal viruses, the most common being Coxsackie A and Enterovirus 71 (Ev71). HFMD is a fairly common contagious infection of infants and…
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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?

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

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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.

"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.

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.


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.

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?

By ElkMountainMan (not verified) on 19 May 2008 #permalink

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:



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?

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.

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

"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.

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 -

And these morons -

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?)

By supergenius (not verified) on 27 May 2008 #permalink

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.

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.

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.

By SuperUnctuousR… (not verified) on 01 Jun 2008 #permalink