The severe form of hand, foot and mouth disease (HFMD) was the cause of illnesses and deaths of 54 Cambodian children since April, concluded the findings of a joint investigation on Thursday.
The Ministry of Health, the World Health Organization, the Institut Pasteur du Cambodge and the U.S. Centers for Disease Control and Prevention conducted investigation following reports from Kantha Bopha Children's hospital of unusual numbers of illness and deaths among children hospitalized since April.
The investigation included a thorough review of the hospital records of the patients from Kantha Bopha hospital as well as other hospitals, laboratory tests, active follow-up with the affected families by the local Rapid Response Teams and evaluation of the data from national surveillance system, said a joint statement from the Ministry of Health and the WHO.
Based on the investigation, a total of 78 cases were identified. These included the initial 62 cases reported by Kantha Bopha hospital, and cases reported from other hospitals. Of these the investigation focused on 61 cases who fitted the criteria used ( the case definition), of which 54 had died.
It said that it was not possible to test all the patient as some of them died before appropriate samples could be taken. Samples from a total of 31 patients were obtained and tested for a number of pathogens by Institut Pasteur du Cambodge.
Of these, majority tested positive for Enterovirus 71 (EV-71) which causes hand, foot and mouth disease.
A small proportion of samples also tested positive for other pathogens including Haemophilus Influenzae type B and Streptococcus suis, it said.
The investigation revealed that most of the cases were below 3 years old with some suffering from chronic conditions and malnutrition.
The cases were from 14 different provinces and many of them were given steroids at some point during their illness. Steroid use has been shown to worsen the condition of patients with EV-71.
HFMD virus is contagious and infection in spread from person to person by direct contact with nose or throat discharges, saliva, fluid from blisters, or the stool of infected persons.
Good hygiene practice can prevent HFMD. Presently, there is no specific treatment available for HFMD, said the joint statement. Parents should seek medical advice if their children develop high fever, vomiting, lethargy and limb weakness.