China: EV-71 outbreak Kills 43 Children Nationwide, 24,934 Children infected

[Shiloh]

Source:

http://news.xinhuanet.com/english/2008-04/27/content_8061094.htm

Mass intestinal virus infection kills 19 children
www.chinaview.cn 2008-04-27 19:31:16 Print

HEFEI, April 27 (Xinhua) -- A total of 19 children have died and more than 700 others fallen ill because of an outbreak of a lethal intestinal virus in Fuyang City, Anhui Province, since March.

The virus has been identified as enter virus 71 or EV 71, according to the health department of Fuyang City.

Hospitals in Fuyang, a city in northwestern part of Anhui, started to take in children with fever, along with blisters, ulcers in the mouth, or rashes on the hands and feet, beginning in early March.

Most of the victims were aged between two and six.

By Saturday, there were 789 cases of infections, of which, 19 were fatal. A total of 204 children remain in hospital for further medical observation, of whom, four are said to be in critical conditions.

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

This very long report talks of very large rumors and widespread HFM disease is killing children,mentions "atypical pneumonia deaths", and is trying to calm the public with this story.Bf is also mentioned and some parents have sent their children away to the countryside.Lots of info and a recap of the last month that may coincide with the above story as it is in the same area.It sound like a very serious situation.Any interpretations are welcome . Anhui 16 infants suffering from hand, foot and mouth disease subsided to the city official death rumours
<SMALL>(Boxun - April 27, 2008</SMALL> reprint <SMALL>reprint)</SMALL> <!--bodystart-->

城市上空。

Trainee reporter Li Jifeng from Anhui Fuyang / together with public health incidents, rumors and panic, the rapid adoption of Internet and mobile phone messages, filled in April in Fuyang city in the sky.

(博讯boxun.com)

(Boxun辟谣the local government said: that "several" spring infants died of respiratory disease have died, and several cases of this disease has not spread of mutual ties.

而市民觉得政府的公告显得有点迟缓与暧昧，因为出现在医院和幼儿园门口的宣传单的内容是?怎样预防手足口病 ?。

And the public feel that the Government's announcement was a bit slow and ambiguous, as in hospitals and kindergartens in front of the publicity alone is "How to prevent Hand, Foot and mouth disease."

However, as the truth gradually opened the epidemic, "rumours" and "lies" immediately crumbled to pieces.
"Grandma, I have to flowers."

野花。

Sha Xiangru powder toot of a pair of little hands reach out tricycles, reaching Zhongchun the Huaibei Plain wheat fields, which is the embellishment of small yellow flowers.

About 20 hours after the two-year-old half of the sand Xiangru has died.

This will say, sing, to 15 the number of the little boy in Fuyang City of Anhui Province Gulou four offices in the pre-primary schools, only to the 40 days of school.

He was a kind of "disease" claimed young lives. Done in 32 villages barefoot doctor's grandfather, often Murandaizuo, stare at their feet meditation. Yao Wang grandchildren until more than three weeks, he would not understand what is Shabing killed his grandson.

Understand that there is no written records, no one is willing to tell him.

April 23 morning, an urgent meeting held in Fuyang City health school.According to a knowledgeable person said, was attended by the Ministry of Health and the Provincial Health Office of experts, city and county health departments and the leadership of the head of the major hospitals.

紧锁的大幕终于揭开其神秘的一角。

Jinsuo the curtain has finally opened its mystery of the iceberg.

不知道从什么时候起，至4月23日，阜阳市已经有16名婴幼儿被这种?怪病?吞噬。

Do not know from what time, to April 23, Fuyang City has 16 such infants were "abnormal" swallowed up.

On the 24th morning, dozens of kilometers away, far away in the Funan County government will Longxiang, a village held responsible for people to participate in an emergency meeting, after receiving a large number of villages 84 disinfection liquid, goals against rampant "disease "Virus. On the 24th evening, the urban areas in Fuyang City of all kindergarten teachers concentrated in Fuyang City Board of Education Building conference room, held an emergency meeting.

市卫生局发动全体幼儿教师立即调查本班的学生，有没有手足口病的发病史。

City Health Bureau launched an immediate investigation of all child care teachers Benban students have hand, foot and mouth disease in the history of the disease. Time from March 1 to April 22, and fill "in Fuyang City of cases of Hand, Foot and mouth disease investigation," the next day to be handed over the survey.

The screening of an order issued from the sand Xiangruyaowang exactly three weeks have elapsed time.

But no one knows, since the first case in Fuyang City-hand, foot and mouth disease deaths is long gone.



Kills people "abnormal"



Urban and rural areas in Fuyang City in the western suburbs of the Department of Hu Chuang, just before the completion of the three cities from Cunpang through the loop, the Country Folk farming here for generations turned into a city people.

沙香茹原本幸福的8口之家，就紧靠在这条公路的旁边。

Sha Xiangru well-being of the original eight House, close in on the side of the road.

However, kills people "abnormal" and not to view, set its sight on the smallest member of the family.

"We Yi Jiazi, a few days do not eat." 52-year-old Yu-Ying Zhang sitting in the building on the corner of the Aideng wept, "two hours ago, the children said," Grandma, Let's go home ", two hours after the The leave. "

Under a heavy heart sitting in the sand of fluorescent rocks, just 27 years old this year, the Department of the father of the child.

听到母亲说话，他双眼噙满泪水，悄悄走进了隔壁的屋子。

Heard her mother speak, tears in his eyes Qin Man, quietly walked into the house next door. Three weeks ago suddenly befall the unfortunate, to a people still immersed in grief, unable to extricate themselves.

April 1, Yu-Ying Zhang, to go to a more outside the home, riding a tricycle with her grandchildren walk in the countryside a small road.

?孩子很高兴，又是唱又是跳，还嚷着让我给他去麦田里掐野花。?

"The kids are pleased, but also a singing and dancing are also Rangzhuo Let me give him to Catcher in Qia wildflowers."

Close to noon, Yu-Ying Zhang found that children with fever, Liangti Wen, 38 ? C and more. She rushed to her husband Dale Ge telephone. The children's grandfather Kai Sha Guangxi Yaoxiang back, look at the children ride motorcycles, play a needle injections of anti-fever, and the joyful children and playing to the Paozhuo.

2

Two

阜阳?手足口病事件?调查

Fuyang "hand, foot and mouth disease incident" investigation



Meals eaten at home, Kai Sha Gui found that children high fever saying. He was immediately linked to the children of the Diaoping. 2:00 pm, sand Xiangru's mother returned from work, carefully, she found the child and Jiaoxin palms, the expiration of the size of a grain of rice herpes.

沙启桂起初以为孩子起了疹子，没有太在意。

Kai Sha Guangxi initially thought the children had rashes, not too concerned about.

?疱疹周围有红晕，但疱内还有少量液体，跟起疹子又有点不一样。?

"Herpes is around Hongyun, but also a small amount of liquid in the blisters, starting with a bit rash and not the same."

Withdrawal of the burn, sand Xiangru eat or drink as usual, play, do not cough not breath.

Two 10-minute night with their own urine. 4:00, the children saying a high fever, 39 ? C, also linked to the Diaoping. More than 40 minutes after his wife Hanxing the sand Kai-Gui said that the withdrawal of the child's high fever. Kai Sha slightly Shulekouqi of Guangxi after listening to the way children's chest-and found that the children have lung infection, breathing becomes rapid start up.

他才意识到病情的严重性，立即拨打了120。

He was aware of the seriousness of illness, immediately call 120.


At 5:10 on April 2, they rushed to the Second People's Hospital of Fuyang City.

值班医生让他们先挂急诊，给孩子送到住院处。

Doctor on duty to enable them to link emergency, to the children sent to the hospital. "120 is sent to the emergency room, so that we registered, and so I head south from the yard go head linked to the North to return to the good of the hospital, the children also did not find beds; pegged Diaoping, several are not扎position." Kai Sha Gui said, "As a practising doctor for more than 30 years, I see that they have no such symptoms in patients with rescue experience, a few doctors have no clothes to wear full lineup, it Shoumangjiaoluan."

Started the rescue, although the children breathe more rapidly, their mouths constantly out of light pink bubble, but he can always speak clearly consciousness.

爱干净的孩子伸着舌头，还让大人给擦去下巴上的泡沫。

Shen Zhao kids love to clean the tongue, but also allow adults to wipe chin on the bubble.

"Grandma, Let's go home." This is the time to rescue children in the largest Yu-Ying Zhang put it, and finally, it has still think of her broken heart不已.

但两个多小时后的8时30分左右，孩子不幸夭折。

But more than two hours after the 8:30 about the unfortunate child mortality.

孩子发个烧，却丢了性命。

The children were burned, but lost their lives.

孩子的亲属不明白，要向医院讨个说法。

The child's relatives do not understand, to seek hospital said.

沙香茹死后的当天上午，面对情绪激动的家属的质疑，一位医生向他们说：我们也尽了力了。

On the day after the death of sand Xiangru morning, in the face of emotional family members of the doubt, a doctor said to them: We, too, do the capacity. Before the People's Hospital of Fuyang City have been five cases of infant deaths, with symptoms similar to your children.

省里的专家都来了，但现在还没有找出具体的病因。

The province to the experts, but has not identified specific causes.

"Democracy and the rule of law Times" reporter rushed to the hospital in Fuyang City, to take part in the entire rescue process to verify details of the doctors, doctors have avoided.

记者联系到该院的一位葛姓副院长，该副院长称要了解情况，要到市卫生局去。

Contact the reporter to the hospital named a GE vice president, the vice president said that to understand the situation, to the Municipal Health Bureau.

Things just the past three weeks, two years ago of sand-married couples the new house, now could not detect the slightest traces on the child. "We can not see things the children, heart could not take. Children's clothing, shoes, quilts, toys, school bags, threw all the snacks, to reject those who pick up the full rack of cars go." White in the living room on the walls, There are children Cabu Diao graffiti. Corner of the living room on top of the refrigerator, a child had used a bottle and have the conch Chuiguo, Laman above the thick layer of dust.

Kai Sha Gui said that they saw all their lives to the disease, the end of the day, his grandson is unclear to death.

?我孙子犯病时，得这种病的幼儿在市人民医院都已经死亡了5例，如果政府早向老百姓公布这是什么病，这种病 怎么厉害，孩子也许就不会被耽误。?

"My grandson Fan Bing, a disease of children in the City People's Hospital have been dead five cases, if the Government this morning announced to the people of what is, how terrible this disease, the children may not be wasted on."



The city's "rumours"


"Rumours" and panic filled in April over the Fucheng.

In Fuyang, the Beijing West-bound train 1621, the Fuyang passengers pushed to get together to discuss infant deaths in Fuyang lead to the "abnormal" in Yunnan, a large shipment of Fuyang driver who received his wife on the "abnormal" SMS immediately after reading to kindergarten daughter will not go to school in the urban areas in Fuyang City, a taxi driver from the multi-channel understanding of "abnormal" the situation of groups, the reporters get from their mouth is "abnormal" died "a few Cases "or" more than 10 cases of "data ranging from the community.

No official on the "abnormal" any information, the Town "rumors" Zisi and become distorted.

Some people call the disease "atypical pneumonia in children," said as "atypical pneumonia" as infectious; person is a human infection, "bird flu" disease in children have a fever of flu symptoms was also said to be "FMD" , As clearly seen in children with hands, feet and mouth play Mei Guise of herpes, some said to be "hand-foot-mouth disease," In the 1980s and 1990s in some cities in China over the outbreak.

All that started through the network, telephone and mobile phone messages in the community spread rapidly, the fear began spreading in the urban areas and continue fermentation.

Especially those who are home parents of infants and young children are no longer with their children to take to the streets. Many families also do not have to buy from the 84 years of disinfection.

有的家长把孩子送到了外地的亲戚家，有的把孩子送到了乡下。

Some parents of the children sent to the field of relatives, some of the children sent to the countryside. Many heard of "disease" of small classes and pre-school children parents, not even the children go to school. According to a private kindergarten teacher description: "This two week, on weekdays, more than 40 students in small classes, only to over 10."

April 16 at about 5:20, Fuyang City Yingzhou District straight-chuen, kindergarten teachers and staff held a number of the 10 "emergency meeting." The nursery called Wang Zhen Yu (Music), 3-year-old boy died two days ago, until the child's grandmother claims to the school, the teachers will know him as "abnormal" and Yao Wang.

让老师们错愕不已的是，以前只是在市民间流传的婴幼儿死亡事件，竟然发生在自己的园里。

Let the teachers off this shock, just before the municipal civil spread of infant death, even in their own gardens.

Director at the meeting revealed that the higher level arrangements, this matter, no Luanyue, Who says that out, who lost their jobs.

The next day we found that the small class the teacher's son, was in the park pre-school, and since then the school would not come back.

Finally one day of classes, the teachers began to students one by one hand, foot and on the palate a meticulous screening, in the case of small Erban found that "hand-foot-mouth" disease in patients with suspected, immediately allow parents to return to her home.

据一知情者描述当时的情景，该女童上腭起满了米粒大小的红疹。

According to a knowledgeable person at the time described the scene, the girl on the palate the expiration of the size of a grain of rice rash.

Since then, Chen Jian attention of the school day for students in body temperature, on the palate and hand-foot-examination, school requirements, as long as超过37 ? C, calling on them to reclaim their family members. Unexpected new measures, without any explanation Zuopu Dian, so let parents feel bewildered.
The parents also found that carefully, usually two large classes this school will be able to stand for the small playground, the morning activities, 45 classes, are more than sufficient.

Source: Times of democracy and the rule of law
In addition, schools are prepared to each class to the Su-84 and disinfection of water every day on the ground and towels, cups, toys, mugs, Wankuai were disinfected.

At 9:00 on the 18th around, originally scheduled to be held in the Park "on how to prevent respiratory disease in spring," the experts talk some reason cancelled. Parents stand in the park, it seems like to see more things, but vigilance to guard locked the door.

At about 10 am, one marked "Ying-chuen, District Health Authority" quietly car parked in the kindergarten door. Drivers said they are to carry out regular health checks.




Easy Hospital



Turned one year old and five months of the rock, who lives in Fuyang City, South Second Ring of a certain area, in the April 6 were in Fuyang City People's Hospital pediatric diagnosis as "hand, foot and mouth disease."

March 24 rock has a fever for two days, and tongue coating on the palate there are 45 blisters.

在家吃了退烧药，退烧后又反复。

Eating at home, anti-fever drugs, anti-fever and then repeated.

第二天下午挂完吊瓶还是高烧不退，下午5时住进了阜阳市人民医院。

End Diaoping pm the next day linked to high fever or not to 17:00 live in the Fuyang City People's Hospital.

"March 29 morning when the doctors allow us to discharge, 11 Floor, Elevator mouth, two parents in Sixinliefei to cry. Wards of the same people say that because of high fever, severe pneumonia and firing, has two children Ze Days at night have died Yao Wang. "Rock Yang's father recalled his family nearly 10 days with two sons to the Fuyang City People's Hospital of the treatment process:" We met with no fear of how, because our children were initially diagnosed with herpes Gap inflammation of the pharynx, is heard at that time also said the "abnormal". "

April 6 morning, the couple with children shopping, found that children at the hands of a small herpes 12, did not care.

下午5时左右，孩子每个手掌又增加到5~6个，他们不明白是什么病，赶紧带孩子到人民医院就诊 。

Around 5:00 p.m., the children in each hand and to five to six, they do not understand what disease, people rushed to the hospital with children.

这一次，岩岩被诊断为?手足口病?。

This time, the rock was diagnosed as "hand, foot and mouth disease."

This is news in Fuyang see the first confirmed cases of Hand, Foot and mouth disease cases.

Yang said that the doctor was not how the accident, the disease seems to become commonplace.

开了3种药，当时医院药房只有两种药，医生也没有什么异议。

Opened three kinds of medicine, the hospital pharmacy at that time only two drugs, doctors have no objection.

他们也没有住院，回去吃了药孩子的病也就好了。

They did not hospitalized, the children go back to Chile Yao also like a disease.
"Know that their children had never before heard of the" hand, foot and mouth disease ", he had no fear, but now understand, the Houpa Ting." Yang said that although the hand, foot and mouth disease generally more moderate, but if there are concurrent Disease, including encephalitis, aseptic meningitis, pulmonary edema, or pulmonary hemorrhage, Ruantan and acute myocarditis, or very scary.

?医院里，刚才还活蹦乱跳的孩子，两三个小时，说没就没了。?

"The hospital, have also always bustling with children, 23 hours, has not said no."

"Sick child to a month now, we no longer a child Guangguo Street." Yang said, "If the child or the carriers of the virus, do not do harm other people's children."

According to information available, hand, foot and mouth disease in children with the virus parasitic throat, saliva, feces and herpes, not only through saliva, sneeze, cough, saying the droplets spread to other children, but also by hand, daily necessities And tableware, and other indirect transmission.

一旦流行，就会使很多孩子被传染。

Once the epidemic, many children will be infected.
On the 17th morning, this reporter went to Fuyang City People's Hospital, the Hospital of the surface calm, orderly and no two of the past. As the city's only the top three hospitals, recently treated a large number of children with severe.

Xitou surgery in the first floor of the building paediatric I. Xiekao in Taiwan attending the East hall of the wall, table empty,放着mop on the table, Laman the Chengou.

抱着孩子来看病的家长络绎不绝，大家挤在一起，没有任何隔绝措施。

Take the child to a doctor of the parents come, everyone crowded together, there is no isolation measures.
The corridors of out-patient, a doctor in charge to registered single table, Paihao.

听到不耐烦的家长在发牢骚，排号的医生说：今天人还不算多呢，前两天每天都来二百来号人。

Impatient to hear the parents complaining about, Paihao the doctor said: This is also small, two days ago, to Meitiandoulai 200 people.

Put into use a new 11-story building of the inpatient department, paediatric wards, children inside the residence.

病房门大开，静得出奇。

Ward door wide open, Jingde surprising.

On the morning of 18, out-patient pediatric surgery building the first floor corridor posted on the walls of the two "How to prevent Hand, Foot and mouth disease," the leaflets.

一张在门诊的走廊里，一张在走廊外。

An out-patient clinics in the corridors, one in the corridor outside.

Fuyang has never heard of a hand, foot and mouth disease in any argument, previously only said that because of "severe pneumonia" or "acute pneumonia" has led to several cases of infant deaths.

医院突然贴出手足口病的宣传单，着实让人费解。

Hospital sudden display of hand-foot-mouth disease leaflets, people indeed puzzling.

面对询问，医务人员避而不答。

Asked the face, medical personnel Bierbuda.

On the 23rd when a third building to the first floor of paediatric surgery at the clinic, guided Taiwan was polished up a new, re-placed close to the Western Wall.

导诊台内多了两名医生给患者排号，内门多了两名警觉的保安，楼门外还有两位逡巡的保安。

I. consultation with Taiwan more than two doctors for patients Paihao, two more doors within the security alert, outside the House, there are two Qunxun security.

非患者家属被阻挡在内门以外。

Patients with non-family members, were blocked outside the door.

来源：民主与法制时报

Source: Times of democracy and the rule of law




Voice on the Government



Fucheng diffuse in the face of the "rumours" and the parents of fear and doubt, the local daily newspaper, Evening News, radio and television stations, in the April 15 broadcast published at the same time, "the city hospital in respiratory problems Erkezhuanjia on answering a reporter's question" And "Fu Cheng appeared on the recent respiratory infection symptoms in children with serious problems answering a reporter's question."
The so-called "relevant persons" A reporter asked, is a kind of rumors in the community of infectious diseases辟谣. Later, these two "A reporter asked:" Most of the kindergarten through to the children in the hands of parents.

The second "relevant persons" in answering a reporter's question that the recent respiratory infection symptoms in children with relatively heavy, "several cases" has died.

在强调?几例?的。

In stressed that "a few" At the same time, and said a few years ago, has not increased the level of incidence.

For the general public concerned about the infectious, they said epidemiological investigations by the CDC experts, that these cases of disease transmission contact each other not so far found no patients with similar symptoms. According to the survey, and the past three years the incidence of such diseases the city, compared to the level of death, no particularity.

The face of official authority from the voice, "rumours" and have nowhere to hide, collapsed of itself. Many people, especially infants and young children of parents of a heart Xuanzhuo finally put down.

April 21, Fuyang city government under the kindergarten door, the reporter asked about the entrance of the commissary for the elderly on the epidemic situation in kindergarten.

?全是社会上的人在瞎扯淡，政府都说了，正常，不传染，你还不相信政府？?老人回答。

"The whole community is in Xiache short, the Government said that the normal, non-infectious, you do not believe that the Government? "answered the elderly.

同

At the same time, there had been deaths of children Yingzhou District straight-chuen, kindergartens, child care most of last week's non-attendance to return to the kindergarten.

A knowledgeable person, revealed to reporters in the city at the mouth of Health meeting, the leaders said that the infant morbidity, mainly spring upper respiratory tract "severe pneumonia" or is "acute pneumonia"-induced death, and only "a few" Death, and not contagious.

Know that in the external data that killed "a few", in fact, people within the grasp of the data is Fuyang City killed one case of maternal and child health centres, the People's Hospital of Fuyang City died eight cases, but there is no news of the investigation in Fuyang City The House of Sand Xiangru death.

之

The reason is that "several cases", is afraid of the people caused unnecessary alarm.
At the same time, a lot of publicity in the single-paste some of the kindergarten entrance, which is "How to prevent Hand, Foot and mouth disease."

"Kindergarten paste the wall and put the self-contradictory on television, let ordinary people Yitouwushui. Hand, Foot and mouth disease transmission! Vicious and the death records." Yingshang in the Eastern District of Fuyang City, a kindergarten to the child's parents are confused And worrying.

However, things did not develop in the expected direction. From "A reporter asked:" NEW eight days after the 23, the relevant departments in Fuyang City health school on the "emergency meeting" on the announcement: The epidemic 16 infants dead and more than 10 critically ill patients in the care of.

婴幼儿患者。

Since the Tumor Hospital of Fuyang City on the 18th, consecutive days, Case Report, on the 24th day of the two cases admitted a series of hand-foot-mouth disease in infants and young children.

The situation came.

At 13:00 on April 25, Fu Cheng, the temperature reached 26 degrees Celsius.

比天气更燥热的是怀抱、手扯幼子的家长。

Zaore more than the weather is the embrace of hand扯son of the parents.

院外科大楼儿科门口，现在人流络绎不绝。

A few days ago that deserted in the afternoon Fuyang City People's Hospital pediatric surgeon building entrance, people come.

得像马蜂窝。

Security in front of that clinic in the morning Jide like cellular Ma.

外科

Surgery Building, 3rd floor, building 15 new outpatient building, all the children have lived.

"The hospital doctors to let our people Hospital for observation." A young mother holding the son said.

Fuyang City in the Second People's Hospital, pediatric also the first floor of the children have lived.

。

In the north of the "fever clinics", doctors are advised Funan from a rural home linked to the parents Diaoping: stay in the hospital of severe, slightly light to the Hospital for observation, mild Diaoping linked to the home.

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(博讯boxun.com)

(Boxun.com)

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[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Mass intestinal virus infection kills 19 children
2008-04-27 19:31:16
HEFEI, April 27 (Xinhua) --

A total of 19 children have died and more than 700 others fallen ill in an outbreak of a lethal intestinal virus in Fuyang City, east China's Anhui Province, since March.

"Experts from the Ministry of Health, Anhui Province and Fuyang City confirmed the virus is entervirus 71 or EV 71 based on epidemiological surveys, clinical diagnosis and lab work," said the city's health department.

Hospitals in Fuyang, in northwest Anhui, started to take in children with fever, along with blisters, ulcers in the mouth, or rashes on the hands and feet, in early March. Some of the victims were diagnosed with brain, heart and lung damage.

All of the victims were aged below six, of whom, the majority being children under the age of two.

By Saturday, there were 789 cases of infections, of which, 19 were fatal. A total of 204 children remain in hospital for further medical observation, of whom, four are said to be in critical conditions.

The Ministry of Health sent a team in mid-April, and they have been working with health workers to find the cause of the infection.

Chen Zhu, Minister of Health, on Saturday visited Fuyang to oversee work.

Fuyang has set up a leading group for control and prevention of the lethal virus, backed with 3 million yuan (about 428,571 U.S. dollars) from Anhui Province and Fuyang City.

Other efforts to stop the infection spreading include improved disease monitoring, more epidemiological surveys and lab tests.

Schools, kindergartens and villages are being inspected for hygiene.

Enterovirus 71 can cause hand, foot and mouth disease which usually starts with a slight fever followed by blisters of ulcers in the mouth and on the hands and feet.

It may cause high fever, meningitis, encephalitis, pulmonary edema and paralysis in a small number of children. Paralysis is more common in children under 2 years of age and meningitis is more common in children from 2-5 years of age, said Yang Weizhong, deputy chief of Chinese Center for Disease Control and Prevention.

Infections could lead to high mortalities in serious cases and neither vaccine nor therapeutic treatment is available.


Editor: An Lu
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http://rss.xinhuanet.com/newsc/english/2008-04/27/content_8061094.htm

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[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Virus outbreak in Chinese city kills 19 children
27 Apr 2008 14:58:29 GMT
Source: Reuters
(Updates with reports of panic in city)
By Chris Buckley

BEIJING, April 27 (Reuters) -

A virus outbreak in an eastern Chinese city has killed 19 children and left hundreds ill, spreading panic among residents, state media reported on Sunday nearly two months after the outbreak started.

The intestinal virus called enterovirus 71 or EV71, one trigger of hand-foot-mouth disease, began spreading in Fuyang in Anhui province from early March, the Xinhua news agency reported, citing the city health office.

The young victims went to hospitals with "fever, along with blisters, ulcers in the mouth or rashes on the hands and feet," the report said.

By Saturday, 19 children had died from the outbreak and 204 remained in hospital, including four in a critical condition. In total, 789 were struck by the virus, mostly younger then two years old.

China's Minister of Health Chen Zhu visited Fuyang on Saturday and other officials and doctors have gone there to investigate, help patients, and "fully roll out prevention and control work," said Xinhua.

The report did not identify the source of the virus or say why Fuyang has been hit so badly. Nor did it say why the outbreak was publicly reported only now.

Rumours and panic had earlier spread among residents, with many parents keeping children out of school and indoors, according to a newspaper report reprinted by the China News Service.

"All sorts of claims rapidly spread via the Internet, phone calls and text messages, and an air of panic spread," reported the Democracy and Law Times newspaper.

"A kid who was just bouncing and jumping around one moment can be gone for good in two or three hours," one parent with a stricken child told the paper.

In 2004, the industrial and agricultural hub with a population of some 900,000 became the centre of a national scandal when at least 8 babies died from drinking milk powder that investigators later found had no nutritional value.

Enteroviruses spread mostly via contact with infected blisters or faeces, and enterovirus 71 outbreaks have occurred in past years in Taiwan, Malaysia and some East European countries.

Usually the virus brings fever and blisters or ulcers inside the mouth and on the limbs. Sometimes it can cause deadly high fever, paralysis and swelling of the brain or its lining.

Drinking water and food in schools, kindergartens and villages around Fuyang are being inspected for possible sources of the virus, the report said.

(Reporting by Chris Buckley; Editing by Janet Lawrence)
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http://www.alertnet.org/thenews/newsdesk/L27188323.htm

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[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

[Some facts about enteroviral diseases. From WHO website. IOH]

Enteroviruses - non polio

Non-polio enteroviruses are common and distributed worldwide.

Although infection often has no symptoms and goes unnoticed, these viruses are also associated with occasional outbreaks in which a larger-than-usual number of patients develop clinical disease, sometimes with fatal consequences.

? Clinical syndromes
Replication of the enterovirus begins in the gastrointestinal or respiratory tract and once the virus is present in the blood stream, infection may affect various tissues and organs, causing a variety of diseases.

The majority of infections are symptomless or mild in nature, the most common effect being a non-specific illness, with fever.

Other manifestations include exanthems (rashes), herpangina (vesicular eruption and inflammation of the throat), acute respiratory disease, conjunctivitis, aseptic meningitis, encephalitis (inflammation of the brain), myopericarditis (inflammation of the heart tissue), and, occasionally, paralytic diseases.

Many enteroviruses are associated with specific syndromes: for example, the viruses within the Human enterovirus B species more commonly cause meningitis or myopericarditis and those within the Human enterovirus A species more commonly cause hand-foot-mouth disease (rash especially on the palms and soles with vesicular eruption and inflammation of the mouth).

? Diagnosis
Clinically, it is difficult to distinguish the specific cause of most enteroviral infections.

Diagnostic testing for non-polio enteroviruses requires specialized laboratory facilities.

Diagnosis is made by detecting virus in throat or faecal samples or, more convincingly, from specimens collected from the affected part of the body, for example, cerebrospinal fluid (CSF), biopsy material, and skin lesions.

A four-fold rise in the level of neutralizing antibody in specimens collected during the acute and convalescent phases of illness provides the best evidence for a recent infection.

? Epidemiology
Enteroviruses infecting humans are found worldwide and humans are the only known natural hosts.

Young children are most susceptible to infection.

In less developed areas, children may become infected during early infancy while in more socio-economically advanced areas, first infection may not occur until adolescence.

Males more often develop clinically-recognizable diseases than females.

Transmission is usually by the faeco-oral or by the respiratory route when there is an associated respiratory illness.

The virus may be excreted in the stool for many weeks.

Enteroviruses have been detected in water, soil, vegetables and shellfish and may possibly be transmitted in the community by contact with contaminated food or water.

The epidemiological pattern varies by geographical region and climate, but the incidence of infection is higher in the summer and autumn months in temperate climates while remaining prevalent year-round in tropical climates.

Outbreaks of hand-foot-mouth disease associated with enterovirus infection have previously been reported from Taiwan, China (1998), and from Malaysia (1997).

Outbreaks of aseptic meningitis associated with enterovirus infection have previously been reported from the Gaza Strip (1997) and Cyprus (1996).

? Treatment
No specific antiviral agent is available for therapy of enterovirus infection.

Treatment focuses on management of complications (for example, meningitis, abnormal cardiac rhythms, and heart failure).

Intravenous administration of immune globulin may have a use in preventing severe disease in immunocompromised individuals or those with life-threatening disease.

? Prevention and control
Transmission of enterovirus infections is increased by poor hygiene and overcrowded living conditions.

Improved sanitation and general hygiene are important preventive measures.

Measures that can be taken to avoid getting infected with enteroviruses include:
* frequent handwashing, especially after diaper changes or going to the toilet;
* disinfection of contaminated surfaces with bleach (20 ml/litre of water);
* and washing soiled articles of clothing.

The viruses are resistant to many disinfectants so it is important to use chlorinated (bleach) or iodized disinfectants.

During recognised epidemics, it may be advised to close certain institutions such as schools or child care facilities in order to reduce transmission especially among young children.

It is not necessary to restrict travel or trade.
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http://www.who.int/mediacentre/factsheets/fs174/en/

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[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Hand, Foot and mouth disease in Fuyang City of Anhui died of 16 child care rumors filled the city

http://news.QQ.com 2008年04月27日15:06 　 民主与法制时报 李继锋评论0条

http://news.QQ.com 2008年04月27日15:06 democracy and the rule of law Times Li Jifeng comments 0

第 1 23页

1 23

卫生监督车停在幼儿园门口。

Health Supervision car parked at the entrance of kindergarten. http://209.85.135.104/translate_c?hl...427/001805.htm

[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Hand, Foot and mouth disease in Fuyang City of Anhui died of 16 child care rumors filled the city

Clearly, it isn't the first instance of EV-71 outbreaks in China. During last few weeks, Centre of Health Protection of HK SAR reported cases of HFM disease. No surprise for this new outbreak. Chaotic media reports aren't new and perhaps, at least at this joint, bf is innocent.

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Thanks,IOH!Some people are shipping out the children and the Drs wont talk..probably not bf ,but something is amiss as EV-71 seems to cover many symptoms.

[Giuseppe]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Thanks,IOH!Some people are shipping out the children and the Drs wont talk..probably not bf ,but something is amiss as EV-71 seems to cover many symptoms.

Agree. But I search into my archive and here a one year old news from China:

(4) [CHINA, HAND-FOOT-MOUTH DISEASE, HUMAN] Second child dies in hand-foot-mouth outbreak in east China city [5-21-2007]

A 14-month-old child has died of hand-foot-mouth disease in Linyi city, east China's Shandong Province, bringing the death toll in the outbreak to two, the provincial health department has announced.

The baby boy was admitted to Linyi People's Hospital on Saturday morning after developing symptoms of fever and a rash with blisters, said a spokesman of the department.

But his condition worsened quickly and he died on Saturday evening despite doctors' efforts to save him, the spokesman said.

A two-year-old girl -- also diagnosed with hand-foot-mouth disease -- died in hospital on April 29 after developing symptoms of fever and vomiting.

Hand-foot-mouth disease, also known as coxsackievirus infection, is a common childhood illness that mainly affects children under the age of 10.

Symptoms include fever, sores in the mouth and a rash with blisters. It often begins with a sore throat.

Moderately contagious, the disease can be transmitted through nose and throat discharges. It can sometimes be fatal if complications occur.

The city has reported 981 cases of hand-foot-mouth disease since April, 609 of whom have recovered, according to the department.

Local health departments have launched a public awareness campaign -- reminding parents that one of the best preventive measures for the disease is frequent hand-washing -- and isolated the children affected. They are monitoring the outbreak closely using a daily reporting system.

Shandong recorded 2,477 cases of hand-food-mouth disease in 2005, including one death, and 3,030 cases in 2006, two of which were fatal.

Source: Xinhua

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http://english.people.com.cn/200705/...21_376540.html

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http://hygimia69.blogspot.com/2007/0...influenza.html

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[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Those are high case numbers with only a few fatalities, while now we have not even half that many cases and 19 dead.If that is truly what it is,why wont the drs comment and why would people be shipping children to the country?The residents appear very worried about this outbreak of a respiratory HFM outbreak.

[Commonground]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

I search my google and HFMD can also be caused by EV71 and can also case encephalitis which can also cause cardiopulmonary failure. That was the only way I could tie in any respiratory ailments. The bottom line would be encephalitis, which could cause cardiopulmonary failure....

http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm

Hand, Foot, & Mouth Disease

Excerpts:
Hand, foot, and mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise ("feeling sick"), and frequently a sore throat. One or 2 days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters.

What causes HFMD?
Viruses from the group called enteroviruses cause HFMD. The most common cause is coxsackievirus A16; sometimes, HFMD is caused by enterovirus 71 or other enteroviruses. The enterovirus group includes polioviruses, coxsackieviruses, echoviruses and other enteroviruses.
Is HFMD serious?
Usually not. HFMD caused by coxsackievirus A16 infection is a mild disease and nearly all patients recover without medical treatment in 7 to 10 days. Complications are uncommon. Rarely, the patient with coxsackievirus A16 infection may also develop "aseptic" or viral meningitis, in which the person has fever, headache, stiff neck, or back pain, and may need to be hospitalized for a few days. Another cause of HFMD, EV71 may also cause viral meningitis and, rarely, more serious diseases, such as encephalitis, or a poliomyelitis-like paralysis. EV71 encephalitis may be fatal. Cases of fatal encephalitis occurred during outbreaks of HFMD in Malaysia in 1997 and in Taiwan in 1998.

http://www.cdc.gov/eid/content/14/5/828.htm

Acute Encephalitis Caused by Intrafamilial Transmission of Enterovirus 71 in Adult

Excerpts:
Conclusions
Several EV71 outbreaks have been documented throughout the world, and clinical manifestations of EV71 infections can be diverse, including HFMD, herpangina, central nervous system (CNS) complications, and pulmonary edema. Recently, EV71-associated HFMD outbreaks with severe CNS complications have frequently been reported, especially in the Asian-Pacific region (2,3). In children, the CNS complications associated with EV71 manifest clinically in various ways, such as aseptic meningitis, acute flaccid paralysis, and rhombencephalitis; rhombencephalitis is one of the most common severe neurologic symptoms (2).

Genetic analysis among 4 different EV71 isolates from the patients indicated probable intrafamilial transmission of EV71. In a recent study, EV71 transmission rate to household contacts was 52%, and the transmission rate from children to parents was 41% (4). Twenty-one percent of EV71-infected children experienced serious complications, including CNS or cardiopulmonary failure. By contrast, 53% of adults were asymptomatic, and all symptomatic adults recovered completely from uncomplicated illnesses (4). Considerable attention has been paid to EV71 infection in children because young age was considered the major risk factor associated with severe CNS complications, such as encephalitis resulting in severe neurologic sequelae and deaths.

http://www.med.nyu.edu/pediatrics/emergency/cpem/trippals/09CPF.PDF

define pediatric cardiopulmonary failure

Excerpt:
Pediatric cardiopulmonary failure (PCPF) occurs when a child experiences respiratory failure in association with decompensated shock, leading to inadequate oxygenation, ventilation, and perfusion. This continuum of deterioration will devolve into pediatric cardiopulmonary arrest (PCPA) unless it is recognized and managed promptly.

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Virus outbreak in Chinese city kills 19 children

Sun Apr 27, 2008 10:36am EDTBEIJING (Reuters) - A virus outbreak in an eastern Chinese city has killed 19 children and left hundreds ill, state media reported on Sunday nearly two months after the outbreak started.
The intestinal virus called "enterovirus 71" or EV71, one trigger of what is sometimes called "hand-foot-mouth disease", began spreading in Fuyang in Anhui province from early March, the Xinhua news agency reported, citing the city health office.
The victims, mostly aged from two to six, came to hospitals with "fever, along with blisters, ulcers in the mouth, or rashes on the hands and feet," the report said.
By Saturday, 19 children had died from the outbreak and 204 remained in hospital, including four in a critical condition. In total, 789 were struck by the virus.
Province and central Ministry of Health officials and doctors have gone to Fuyang to investigate the outbreak, help the patients, and "fully roll out prevention and control work," said Xinhua.
The report did not identify the source of the virus or say why Fuyang has been hit so badly. Nor did it say why the outbreak was publicly reported only now.
In 2004, the gritty industrial and agricultural hub with a population of some 900,000 became the centre of a national scandal when at least 8 babies died there from drinking milk powder that investigators later found had no nutritional value.
Enteroviruses spread mostly via contact with infected blisters or feces, and "enterovirus 71" outbreaks have occurred in past years in Taiwan, Malaysia and some East European countries.
Usually the virus brings fever and blisters or ulcers inside the mouth and on the limbs. Sometimes it can cause deadly high fever, paralysis, and swelling of the brain or its lining.


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Drinking water and food in schools, kindergartens and villages around Fuyang are now being inspected for possible sources of the virus, the report said.
(Reporting by Chris Buckley) http://www.reuters.com/article/healt...ame=healthNews

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

Anhui Fuyang 789 children infected with enterovirus EV71 19 people were killed

2008年04月27日23:34 [ 我来说两句 ] [字号： 大 中 小 ]

At 23:34 on April 27, 2008 [I Laishuiliangju] [name: Big Medium Small]

来源：中国新闻网

Source: China News Net




China news agency, Fuyang, April 27 (Reporters Wu Lan and Zhang Yazi) - By the Fuyang City of Anhui Province confirmed, Fuyang City has 789 children infected with enterovirus EV71, which despite 19 To rescue died, is still in hospital for observation and treatment of 204 cases.

作。

It is learnt that, at present, the Ministry of Health of Anhui Province and the participation of the Expert Group under the guidance of Fuyang City health department is to strengthen the comprehensive medical treatment and prevention and control work. According to reports, in early March this year, Fuyang City has several hospitals to be treated with oral fever, rash consisting mainly of hand, foot and hip in patients with the disease, with a few brain, heart, lung serious damage. The Ministry of Health, Fuyang City in Anhui Province and experts of the epidemiological investigation, clinical diagnosis and laboratory testing to identify the disease for intestinal EV71 virus infection.

After the illness, the Ministry of Health, the Anhui Provincial Health Office immediately sent expert team to investigate cause of Fuyang guidance, to treat patients, conduct a comprehensive prevention and control work. The local government set up a leading group for prevention and treatment work, from the city's health care system has streamlined the deployment of the medical staff added to designated hospitals for medical treatment, scheduling infant respiratory and other related equipment, opened a green channel for medical treatment. At the same time, strengthening disease surveillance, the focus on schools, kindergartens, the village sanitation, drinking water, food and health control and inspection carried out.

According to previously published data on the 23rd, since early March, has been the case in Fuyang City has 610 cases, of which 18 cases because with the brain, heart, lung and other organ function more serious damage, the To rescue died in the hospital for observation and treatment of 77 cases. All the patients are children under the age of six, most living in rural areas, and no obvious correlation between the cases. http://209.85.135.104/translate_c?hl...56545867.shtml

[Shiloh]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

From what I have read in the last month or so, EV-71 is showing up in the HFMD outbreaks in Singapore and in Taiwan. HFMD is also present in Brunei. The most recent mention of the disease that I could find on the web in Taiwan is this:

http://www.chinapost.com.tw/health/infectious%20diseases/2008/04/10/151196/One-more.htm

[Treyfish]

Re: China: EV-71 outbreak Kills 19 children in Fuyang City

28/04/2008, Monday in the morning 04:05

Local finance and economics entertainment international both banks sports transportation and weather
Local

Enteritis case will increase the department of health to refer to will strengthen the supervision
2008-04-27 22:39

[on.cc special news]The department of health receives inland health authority notification, Anhui Fuyang erupts the EV71 enteritis epidemic situation, the officers to has been close to the local understanding situation, discovered that Taiwan and the Singapore epidemic situation also has the trend of escalation. The department of health indicated that Hong Kong's EV71 virus case altogether has 7 until now this year, will have the slight trend of escalation , the authority will strengthen the supervision. http://svsurl.systransoft.com/?t=out...8cb1129a--1829