CAMBODIA MYSTERY VIRUS: How Are We Affected?

July 19, 2012 at 5:07 pm 2 comments

Last July 6, the World Health Organization (WHO) released a medical bulletin regarding the mystery disease that was reported by the Ministry of Health of the Kingdom of Cambodia. In the initial report, the country had a total of 74 cases of hospitalized patients from April to first week of July. Fifty- seven of the cases presented with similar symptoms of fever, respiratory and neurologic symptoms, 56 of which had died within 24 hours from admission. Children from age 3 months to 11 years were the ones affected by the suspected deadly virus. Majority were under 3 years old and with an overall male to female ratio of 1.3:1. The victims were mostly from the southern and central parts of Cambodia and received treatments from a pediatric reference hospital, Katha Bopha Children’s Hospital in Phnom Penh.

The Ministry of Health together with WHO and the US Center for Disease Control and Prevention (CDC) have been doing investigations on what was causing the mysterious illness. Samples taken from patients were tested at Institut Pasteur du Cambodge. They tested negative for H5N1 (Avian flu), SARS, and Nipah virus. By July 9, reports showed that samples were positive to Enterovirus 71 (EV-71), a virus causing the mild and commonly-occurring  in children, the Hand, Foot and Mouth disease or HFMD. Other organisms identified were dengue virus, haemophilus influenza type B , and streptococcus suis bacteria.  As of July 13, a total of 78 cases were identified and 61 of these fitted the criteria for EV-71, of which 54 died.  At present, they have strengthened their surveillance and has apparently contained it’s spread.  Kindergartens and primary schools in Cambodia were ordered tclose temporarily.

Being a neighboring country of Cambodia, the Philippines has been forewarned to perform necessary actions to prevent probable spread of the said virus. The Department of Health (DOH) has tasked the National Epidemiology Center and the Bureau of Quarantine to do surveillance of the disease to prevent it from entering and spreading in the country. The public has been advised to refrain from traveling to Cambodia; to take the necessary precautions if  travel is imperative; and to report to public health officers once similar symptoms are experienced after visiting the country.  Likewise, the airports have been advised to screen in-bound passengers from Cambodia for fever using thermal scan. As of July 10, the DOH made Enterovirus 71 infection a notifiable disease, which will enforce reporting of identified cases by hospitals, physicians and other health providers. Parents are also advised to seek medical consult if their children develop high grade fever, vomiting, limb weakness or paralysis, and impaired consciousness or drowsiness.

EV-71 is a virus causing extreme types of illnesses, from the mild, more common HFMD to a severe, rare encephalitis (infection of the brain) and polio-like paralysis type of disease that is fatal. It is this encephalitis type of EV-71 that caused the outbreak in Cambodia. HFMD is a self-limiting illness manifesting as fever with painful sores in the mouth, rash with blisters on hands, feet and buttocks.  It is transmitted from person to person by direct contact with oral and nasal secretions, fluid from blisters, and stools of infected persons.  There is no treatment nor vaccine for this disease, only symptomatic treatment such as paracetamol for fever and increasing fluid intake.  Preventive and control measures are very vital which includes regular hand washing & personal hygiene especially after diaper changing, proper disposal of diapers or human waste, and regular cleaning of toys of children particularly in day care centers.

Last July 17, news broke that 2 Filipino children tested positive for EV in the investigations being conducted in Research Institute of Tropical Medicine (RITM) but further studies were still being done to confirm if it has the same strain with that in Cambodia. The DOH, however, did not continue informing the public of new cases to avoid unnecessary panic.

The latest DOH update released July 20, confirmed that 1 patient tested positive for EV-1. Initially, there were 8 suspected HFMD cases diagnosed from July 10-14 who underwent screening test using throat, stool, and vesicular fluid specimens. All of them developed mild disease of fever followed by skin lesions on hands, soles of feet and mouth, of which, 5 were admitted in the hospital. Only 1 was female, and their ages ranged from 1-29 years old. Six of them were from Region 4-A (Calabarzon) and 2 from Davao. Six out of 8 were positive in the screening test and only 1 was positive in the confirmatory test. The patient is a 1 year and 7 months old boy from Davao City who developed symptoms last July 6 and has now recovered.  He had no history of travel to Cambodia and there were no other cases reported in their household and their community.

The DOH National Epidemiology Center gathered representative physicians of hospital and medical societies for an orientation on the Guidelines in the Surveillance and Clinical Case Management of HFMD. Meanwhile, the public is constantly being reminded to take all necessary precautions to prevent development and control spread of the disease.

©pinoykidsMD

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Revamping of Pinoy Kids MD Website Childhood Immunization in the Philippines

2 Comments Add your own

  • 1. Codi  |  July 23, 2012 at 5:08 am

    we were about to go to cambodia but cancelled it for health and safety purposes. this is a very helpful article!

    Reply
    • 2. pinoykidsmd  |  August 14, 2012 at 12:44 pm

      I know it is a big sacrifice in your part, but for me, you made a good decision. Going there at the height of the outbreak is very risky for you, your family members, and for the children in the Philippines. Thanks for appreciating the article. 🙂

      Reply

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