12/12/07

Cases of fatal encephalitis occurred during the outbreaks of HFMD in Malaysia in 1997, Taiwan in 1998, and Singapore in 2000. The outbreak typically occurs at small epidemics in nursery schools, child daycare or kindergartens. According to the Centers for Disease Control (CDC), the large outbreak of HFMD in Taiwan caused by Enterovirus 71 had a high mortality rate of 19.3% in the severe cases. During this outbreak, mortality rates were highest in children under 3. In a large epidemic of HFMD related to Enterovirus 71 in Singapore. 725 cases of HFMD and 7 fatalities occurred which most from interstitial pneumonitis or brainstem encephalitis. A later study of an HFMD epidemic in Australia, again with Enterovirus 71, reported that about 64% of patients developed severe neurologic disease in which the host immune response seemed to cause most of the neurologic manifestations.

The recent outbreak is in Thailand. From August in 2006, a total number of 1009 cases of hand-foot-mouth disease (HFMD) have been detected. Then caused 4 children died from the disease and most of the patients were between 2 and 5 years old. In 2007, HFMD patients increase to 2,567 in Bangkok, and total number of the infection cases are 7,578 in Tailand this year. And more than 90 percent of the patients were children younger than 5. From the case, the total number of patients of this year was twice than last year in Thailand. The disease continued to spread in the cool season and despite the fact that it usually only spreads during the humid season.