The Ministry of Health (MOH) is closely monitoring the current situation of hand foot and mouth disease in Viet Nam. Since 01 January 2011 to 04 September 2011, 98 deaths and 42,673 cases of HFMD have been confirmed across the country. Three quarters of the deaths have been in children aged 3 years or less. Viet Nam has implemented precautionary measures in an effort to reduce the spread of HFMD. The Prime Minister of Viet Nam has instructed all provincial authorities and relevant ministries to strengthen prevention and control measures against HFMD. In addition, formal guidelines for surveillance, prevention and treatment of the disease have been sent to all health care facilities. "The number of HFMD cases might increase in the coming months when preschools and kindergartens resume,” said Minister of Health, Ms. Nguyen Thi Kim Tien.
HFMD is a common viral illness among infants and children under the age of 10 years but can also occur in adults. The virus causes fever and sores in the throat and blisters on the hands and feet. The disease is usually mild and patients generally recover in 7-10 days. The disease is caused by a group of viruses known as Enterovirus (EV). One of these is EV71 which on occasion can cause severe complications, including neurological, cardiovascular and respiratory problems. In Vietnam, the epidemiology of HFMD is complex but EV71 is responsible for nearly half of the infections in those who have tested positive for HFMD. Typically, HFMD sporadically occurs across Viet Nam but remains most concentrated in the Southern and Central provinces. Higher rates of infection occur from March to May and September to December.
The Ministry of Health has begun conducting 84 training courses on surveillance, prevention and control of HFMD that include preventive medicine staff at provincial, district and communal level as well as pre-school teachers. There is also an ongoing nation-wide public awareness campaign on television and other media to highlight these preventative measures.
The World Health Organization (WHO) along with the US Center for Disease Control and Prevention (CDC) is supporting the Ministry of Health's General Department of Preventive Medicine’s (GDPM) efforts to control the disease. “WHO and CDC are working closely with MOH to determine the cause of the unusual increase in cases and deaths, and investigate the epidemiological characteristics of HFMD in Viet Nam,” Acting WHO Representative, Dr. Graham Harrison said.
The virus causing HFMD is spread from person to person through direct contact with virus contained in nose and throat secretions, saliva, blister fluids, stools of infected persons and asymptomatic carriers. The virus is most often spread by virus-contaminated hands and through contact with contaminated surfaces. Infected persons are most contagious during the first week of the illness. The viruses that cause HFMD can remain in the body for several weeks after a patient's symptoms have gone away. This means that the infected person can still pass the infection to other people even though they may appear to be well.
Currently, there is no vaccine or specific medication against HFMD. However, the risk of infection is lowered significantly with high standards of personal and environmental hygiene. The Ministry of Health recommends the following precautionary measures:
• Frequent hand washing with soap and water, especially after changing diapers, before preparing food, before eating, and before feeding children, and after using the toilet;
• Cover mouth and nose when coughing or sneezing;
• Thoroughly clean contaminated surfaces and soiled items first with soap and water and then with common disinfectant in homes, in child care centers, kindergartens and schools, and maintain clean surroundings;
• Avoid sending children to child care centers, kindergartens or schools if they are suffering from HFMD;
• Follow safe food and water practices. Children should eat well-cooked food and drink boiled water. Do not share feeding utensils;
• Avoid close contact (kissing, hugging etc.) with infected people;
• Monitor children’s health for early detection of symptoms and take those who have persistent fever and blisters on hands, feet or mouth to the nearest health facility for treatment as soon as possible;
• Ensure that kindergartens and pre-schools provide hand-washing facilities, with soap and water, for young children, and have an appropriate system for managing human waste.