Hand, Foot, Mouth Disease Found in Cambodia Outbreak

July 8, 2012
By PATRICK BARTA
The Wall Street Journal

Health officials investigating an unexplained disease outbreak that has killed more than 50 children in Cambodia say they have detected the presence of a virus that causes hand, foot and mouth disease. But they stressed the investigations were ongoing, with other illnesses, including dengue, also associated with some of the cases.

The outbreak has drawn international attention because of longstanding fears that poor countries such as Cambodia could be incubators for new, virulent disease strains that defy treatment. The latest outbreak has killed at least 52 children since early April and was first reported as an unexplained illness involving respiratory and neurological symptoms by Cambodian and international health authorities last week.

In a news release, the Cambodian Ministry of Health and the World Health Organization said that laboratory samples were not available for the majority of cases, because the victims died before appropriate samples could be taken. But in the cases for which samples could be studied, the officials said "a significant proportion" tested positive for Enterovirus 71 (EV-71), which causes hand, foot and mouth disease. Hand, foot and mouth disease is a common infectious illness among infants and children and typically involves fever, painful mouth sores and a skin rash, among other symptoms. Although less serious than some other feared culprits, with patients often recovering, there is no specific treatment for the disease and it can involve other, more serious complications.

The authorities said tests also showed the presence of other pathogens, including dengue and streptococcus suis. The samples were found negative for H5N1 bird flu and other influenza viruses, severe acute respiratory syndrome (SARS) and Nipah.

The authorities said the age of the victims ranged from three months to 11 years old, with the majority being under three years old. According to the latest news release, 52 of 59 children infected with the illness have died, which is fewer than earlier estimates of 61 out of 62 children. The Cambodian Health Ministry and World Health Organization did not immediately explain the discrepancy.

"Further investigation is ongoing and this includes the matching of the laboratory and epidemiological information," said Cambodian Health Minister Mam Bunheng, according to the statement. "We hope to be able to conclude our investigation in the coming days," the minister said.