Facts about the HFMD strain EV-71 all parents must know

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Read on to find out more about the potentially life-threatening strain of virus causing HFMD.

We all know that Hand Foot Mouth Disease (HFMD) is a common viral disease that affects children. However, recently, the new strain of HFMD, called Enterovirus 71 (EV-71), has been much more hostile in neighbouring Malaysia.
 
HFMD cases spiked to epidemic proportions in 2018 in Malaysia. There were at least 55,000 reported patients in August 2017, with Penang seeing at least 3,700 cases. 
 
Singapore is no stranger to the disease, too. There have been at least 31,000 reported patients until today.
 
But parents, you have to know that the new strain is different to the HFMD we are used to. This one is far more aggressive, going so far as claiming the lives of two toddlers in Malaysia earlier this year.
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HFMD has been rampant this year.

EV-71 Kills Two Healthy Toddlers

Among the massive number of patients affected by HFMD, the EV-71 strain has taken two young lives: 17-month-old Yusuf Danial and a 27-month-old toddler in Sarawak.

Mazlin Khairudin, the mother of 17-month-old Yusuf Dainal explains what happened before his death. 

Initially, Yusuf only experienced fever. Mds Khairudin treated him with some anti-fever medication to last the night.

The next day, the fever continued well into the night. Even though Ms Khairudin consulted a doctor, she advised that it was “a normal fever with a little rash on his throat”, said the Penang resident. 

Sadly, it was much more than that. In two days, young Yusuf’s condition worsened rapidly. Ms Khairudin hurried him to the hospital for treatment, but it was too late. Yusuf had HFMD, but he contracted the new, deadly strain EV-71. He was the first fatality of the disease. 

“His lungs were filled with virus,” Mdm Mazlin told CNA’s Talking Point. “The doctor said he’d try his best to treat Danial. He gave antibiotics, but Danial’s body rejected them. Around 8.48pm, his heart stopped beating.”

New Strain of HFMD More Aggressive Than Usual

Normally, HFMD isn’t much cause for worry, and can be managed quite easily. 

EV-71 is different.

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What scientists think the EV-71 strain looks like. | Image Source: CNA

This new strain is potentially life-threatening. It can cause serious issues if you’re infected, affecting your neurological, respiratory and cardiovascular systems. 

What’s more, it is also more contagious compared to the Coxsackie virus – the usual culprit causing HFMD.

KK Women’s and Children’s Hospital senior consultant (Infectious Diseases) Chong Chia Yin, 
illustrates its virulence with an example.

She says that normally, children infected by a Group A Coxsackie virus generally spread it to 2.4 other kids. An EV-71 infected child, however, could spread the disease to 3.5 other children.  

Symptoms Specific to EV-71

There are a few telling signs that HFMD is caused by the EV-71 strain.

Associate Prof Chong says to look for the following EV-71 red flags:

  • vomiting 
  • irritability towards things
  • seizures
  • finding breathing a struggle
  • being very lethargic, including unwillingness to eat and drink
  • dehydration, indicated by reduced urine output 

Ms Yin does clarify one symptom that isn’t specific to EV71.

“If your child has a lot of bubbles and blisters on the hands and feet, it’s less likely to be EV-71,” she explains.

Still, if your child has a combination any of the symptoms above, please a visit a hospital soon. Early treatment is your best chance at recovering form this illness. 

Yusuf Danial, the 17-month-old toddler who passed away from the disease, had developed symptoms of the flu, struggled with breathing and mouth ulcers. Looking back, Ms Khairudin regrets not bringing him to the hospital faster.

She urges all parents to be alert and take action if something seems unusual. “If there’s something different about your child, and the fever doesn’t seem to go down in one or two days, better send your child for a blood test or X-ray straightaway because this virus is everywhere,” she advises.

As seen from Yusuf’s case, contracting HFMD from EV-71 is a serious, and possibly deadly. Please do not delay medical attention should your child show any of these symptoms.  

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Even adults can get HFMD.

Adults Can Contract the Disease, Too!

HFMD isn’t limited to making children sick. Adults who are near children infected with HFMD can also contract the disease.

Ms Glynisa Yeo was one of these patients. Her four-year-old son developed HFMD three times within two years. In 2016, Ms Yeo became infected with HFMD from her son.

There were some painful consequences, as Ms Yeo:

  • couldn’t eat due to her mouth ulcers
  • struggled with walking normally due to her foot sores
  • experienced throbbing rashes which covered her hands
  • flaking and peeling skin

Even after she was allowed to leave the hospital, her ordeal with HFMD did not end there. Within a couple of weeks, she noticed that the one of her fingernails “started peeling off”.

It eventually worsened in the coming weeks. Ms Yeo’s nails on both her hands and feet dropped off. She also began losing hair. 

The now healthy 42-year-old mum recalls that “I did a check with my doctor, and he said (those) could be some of the after-effects because the virus that I was hit with was pretty severe.” She is much more concerned about HFMD, saying that “To me, (HFMD) is quite scary now. So I’m very worried, and sincerely hope that my son won’t catch it again.”

Safety Reminders to Heed

Associate Prof Chong advises that parents should take proactive steps to avoid contracting HFMD. She advises everyone to:

  • wash your hands regularly, especially
    •  prior to and following a meal
    •  after making use of the bathroom
  • shield your mouth or nose when coughing or sneezing
  • avoid sharing
    • food and beverages
    • personal things like toothbrushes and towels 
  • not make physical contact with patients, like kissing or hugging
  • always use hand sanitisers to cleanse your hands (although wet wipes are enough for surfaces)

Travelling Concerns and EV-71 in Singapore

“Can I still visit Penang?”

In short, yes. But do be careful when it comes to hygiene. 

2018 has seen a very bad outbreak of HFMD in Malaysia. Mid-July was the worst, with Penang Health Committee chairman Afif Bahardin quoting the situation as “beyond the danger level”. There were double the amount HFMD patients in mid-July this year compared to 2017. 

Thankfully, these cases are seeing “a tremendous decline now”. Two months ago, the state’s Health Department responded to the outbreak by increasing sanitation programs.

For instance, they coordinated the sanitation of trolleys, child rides and public benches of shopping malls. 

Dr Afif has said that EV-71’s spread is unusually high, as it’s “at a bigger number compared to the usual pattern we’ve seen for the past few years”,  a time when the Coxsackie virus was more common.

The main takeaway, though, is to be vigilant when it comes to hygiene. “(For) those who are visiting Penang, what’s important is to keep a self-awareness of cleanliness,” explains Dr Afif.

Perhaps the next most concerning question is, how about Singapore? Is EV-71 also dominating HFMD cases here?

Has the EV71 Strain Arrived in Singapore?

The Ministry of Health has observed a “slight increase” in the percentage of EV-71 cases in Singapore.  2018 has seen 31,015 patients in total this year, which, compared within the same time frame, is 28% more than last year. 

The most recent peak came as near as two years ago, when the number of reported patients hit an all-time high of 42,000. 

Fortunately, the Coxsackie virus type A, similar to previous years, is still the most common strain that causes HFMD. 

No vaccines available in Singapore… yet

Although there currently aren’t any authorised antiviral medication or vaccines in Singapore, science is making progress. 

Associate Professor Justin Chu, from the National University of Singapore’s Yong Loo Lin School of Medicine, is developing a vaccine which could become usable within five years.

In addition, Prof Chu is also spearheading another project. He, along with other scientists, have managed to create an HFMD test kit. This practical diagnostic tool might help test children at home or in a childcare centre for HFMD in the near future. 

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Justin Chu, the chief scientist in devleoping a test and vaccine for EV-71. | Image source: CNA

All the kids need is to provide some saliva and wait two hours for the kit’s diagnosis. 

The main benefit of this test kit is that it can detect HFMD before its symptoms take hold, and it’s very cheap, too. Prices have been predicted to be roughly $2. However, it will probably take an additional two or three years before the test kits actually enters the market.

 

Reference:  Channel NewsAsia

Also read:

10 foods to eat if you have HFMD (and what to avoid!)

Protecting your child from HFMD

HFMD in babies: Mum says THIS is how her baby got HFMD

An expert’s view of the HFMD virus and how you can prevent it

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