The Portrait of an Endemic "Olympic Host" -- China orders mandatory
reporting of all cases of deadly virus sickening young children
International Herald Tribune
China orders mandatory reporting of all cases of deadly virus sickening
young children
The Associated Press
Wednesday, May 7, 2008
BEIJING: China announced new rules Wednesday that require health care
providers to report all cases of a viral illness that has killed 28
children and sickened thousands in outbreaks across the country.
So far there have been 16,778 cases of hand, foot and mouth disease this
year, the official Xinhua News Agency said, cropping up in areas ranging
from the tropical island province of Hainan in the south to Jilin
province in the northeast, Yunnan province in the southwest and Inner
Mongolia in the north.
The number and scope of cases in recent years, along with the need for
increased surveillance, prompted the Health Ministry to enforce the new
reporting rules, spokesman Mao Qun'an said.
"This demonstrates our commitment to people's health," Mao said at a
rare news conference held jointly with the World Health Organization.
Under the mandate that took effect Tuesday, health care providers need
to report cases to the ministry within 24 hours.
The outbreaks are the latest headache for authorities as they gear up
for this summer's Beijing Olympics. Preparations have already been upset
by unrest in Tibet and protests during the global torch run.
Mao insisted there would not be any impact on the games, which begin
Aug. 8. Already embassies and foreign schools have sent out notices
urging vigilance against the illness.
Hand, foot and mouth disease spreads through contact with saliva, feces,
fluid secreted from blisters or mucus from the nose and throat. There is
no vaccine or specific treatment, but most children affected by the
disease typically recover quickly without problems. It is unrelated to
the foot and mouth disease that affects livestock.
The rocketing number of cases burgeoning across a large area of China
brings up parallels with the Communist leadership's handling of previous
infectious outbreaks, especially that of SARS in 2003.
Government attempts to conceal the emergence of severe acute respiratory
syndrome a new disease at the time contributed to its spread,
ultimately causing 774 deaths worldwide and forcing Beijing to apologize
amid international criticism.
Both Mao and WHO China representative Hans Troedsson said they expected
more cases of hand, foot and mouth to emerge because of the tighter
reporting requirements and because the disease will likely peak with
warmer weather in June and July.
Last year, some 80,000 hand, foot and mouth cases were recorded in
China, with 17 deaths, Mao said, adding that the figures were likely
incomplete because reporting wasn't mandatory then.
Among the latest deaths, a 2-year-old girl in the southern province of
Hunan died of the disease Tuesday after being in a coma, the provincial
health bureau said on its Web site.
Another death was reported in the neighboring Guangxi region, local
health officials said without giving any details. Xinhua said the victim
was a 3-year-old boy who died May 3.
In the hardest-hit central province of Anhui, 22 children have died
since March. Three fatalities have also been reported in Guangdong
province in the south and one in Zhejiang province in the east.
Most of the cases in China have been blamed on enterovirus 71, or EV-71,
one of several viruses that cause the illness. EV-71 can result in a
more serious form of the disease that can lead to paralysis, brain
swelling and sometimes death.
Xinhua reported this week that 10 people had been punished for failing
to properly tackle hand, foot and mouth in Anhui. Mao said they had been
"criticized" for how they handled the situation but did not give any
details.
Troedsson said there are currently outbreaks caused by variations of
EV-71 in China, Malaysia, Vietnam and Singapore, where there have been a
total of 10,490 cases so far in 2008. No deaths have been reported.
Thailand is seeing infections from the coxsackievirus A16, another virus
that commonly causes hand, foot and mouth. Taiwan has reported two
deaths and 62 cases this year.
Hong Kong, which borders the mainland, has reported 12 EV-71 infections
and is on guard for the spread of the disease. The government on
Wednesday called hand, foot and mouth its biggest health threat this
summer.
"We need to put it in the right perspective," Troedsson said. "This is
something that regularly happens in countries in this region."
Troedsson said investigators were looking into why there were more
victims in Anhui or why their cases had complications. But, he said, the
virus that infected them is genetically similar to specimens analyzed
from previous outbreaks.
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