Disease in Cambodia traced to FMD strain

By Ira Pedrasa, ABS-CBNnews.com

Posted at Jul 09 2012 12:08 PM | Updated as of Jul 10 2012 02:12 AM

Symptoms: fever (1-2 days), poor appetite, sore throat, malaise, sores in mouth after fever, non-itchy skin rashes

MANILA, Philippines (2nd UPDATE) - The Cambodia Ministry of Health and the World Health Organization (WHO) reported today that a strain of the hand foot and mouth disease (HFMD) was identified in the bodies of those affected by an “unknown disease” in Cambodia.

In a statement sent to reporters in the Philippines, health officials said, “Based on the latest laboratory results, a significant portion of the samples tested positive for Enterovirus 71 (EV-71), which causes HFMD.”

Further analysis from laboratory samples showed the victims had dengue and Streptococcus suis, a bacterium that causes meningitis. The latter is typically found in places where swine is raised.

Other strains of bacteria are also being monitored, said Dr. Nima Asgari in an interview with ANC. Asgari is the team leader of the emerging disease, surveillance and response of the WHO in Cambodia.

The samples, however, were found negative for H5N1 and other flu viruses, SARS and Nipah.

Cambodia Minister of Health Mam BunHeng said further investigation is still ongoing. “This includes the matching of the laboratory and epidemiological information. We hope to conclude our investigation in the coming days,” the minister said in the same statement.

The “unknown disease” has already affected 59 children in Cambodia, 52 of whom died.

The children were aged between 3 months and 11 years.

Airports, hospitals warned

WHO earlier warned the Philippines and other neighboring countries of the disease, which manifests mostly in the respiratory system.

WHO said those carrying the disease, which has “neurological symptoms,” usually manifest signs of high fever, followed by respiratory or neurological symptoms with rapid deterioration of respiratory functions.

It is transferred via direct contact with the patient, usually from their mucus and saliva.

In an interview with radio dzMM, Health Secretary Enrique Ona said airport authorities are now on alert in screening arriving passengers.

“All the necessary information has been sent to the airports…We have also doubled up our temperature scans,” he said.

Ona added airport authorities are not just monitoring passengers who came from Cambodia, but from the rest of the Asian region.

DOH concerned

In an another interview with ANC, DOH National Epidemiology Center director Eric Tayag said the government is “concerned” since HFMD is one of the emerging threats in the region.

Different strains were also recorded in China, Taiwan and Vietnam, he said. “That is why WHO alerted neighboring countries, including the Philippines.”

Besides airports, he said Secretary Ona has also directed health officials to look into hospital cases.

“We appeal to pediatricians if they have similar cases [like in Cambodia] to report to the DOH so we can investigate,” he said.

He said children are most susceptible to the HFMD since their immune systems are not yet fully developed. “Adults get infections early in their childhood so they already have a level of protection.”

Tayag said the spread of the strain in Cambodia should be limited “because of the high death rate there.”

Signs of HFMD

Tayag described EV-71 as a “fatal form” of HFMD and is “moderately contagious.” What the country experienced in the past was in its “mild form,” he added.

Based on information submitted by the WHO, the usual period of infection to onset of symptoms is three to seven days.

It said the common symptom is fever, which lasts 24-48 hours.

Besides fever, symptoms include poor appetite, malaise, sore throat. WHO also said one or two days after the onset of fever, painful sores can be seen in the mouth. They start as red spots and then become ulcers.

Non-itchy skin rashes, usually flat or raised red spots, also develop over one to two days. The rashes are usually located on the palms and soles of feet. They may also appear on the buttocks or genitalia.

Tayag added that the strain in Cambodia also manifested cough, diarrhea, convulsions, sleepiness, paralysis in the victims. In around 24 hours, the victim may die, he said.

WHO said HFMD is not transmitted via pets or animals.