China child virus cases high but no cause for panic

BEIJING (Reuters) - China should expect more cases of hand, foot and mouth disease, but there is no sign it is facing a new or more virulent strain despite an unusually high number of child deaths, officials said on Wednesday.

Hand, foot and mouth is a common childhood illness, but the current outbreak has led to 28 fatalities in China, mostly when linked with enterovirus 71 (EV71), which can cause a severe form of the disease characterized by high fever, paralysis and meningitis.

"There is no indication of a change or a more virulent virus," World Health Organisation China representative Hans Troedsson told a news conference.

But he said there were still questions about why there were so many cases in Fuyang, in the eastern province of Anhui, and why they presented unusual symptoms that made it difficult to identify the virus -- a delay that may have cost lives.

"We usually don't see a cluster like this ... so we have to investigate that further together with the government," he said.

China's official Xinhua news agency put the number of cases of hand, foot and mouth disease at 15,799, up from about 12,000 cases reported on Tuesday, but the rise was due to more thorough reporting, not the disease's spread, a health official said.

"As we just started the web-based surveillance effort and reporting system, it is quite natural to see a rapid increase in numbers in the first few days of such reporting," said Health Ministry spokesman Mao Qunan.

The ministry recently made it mandatory for local health authorities to notify the government of cases.

HIGH NUMBERS

But around Asia, cases of the disease, which mostly affects children under five, were at higher than usual levels.

Singapore reported a 75 percent surge in hand, food and mouth to 10,490 so far this year compared with last year, while Vietnam's health ministry said the country had about 3,000 cases in the first four months of the year, more than the total number of reported cases for 2007.

Ten children had died from the disease in Vietnam.

Hong Kong was also on alert.

"The cases are higher than previous years and could even hit record levels," said Thomas Tsang, Hong Kong's Controller of the Centre for Health Protection.

There is no vaccine or antiviral agent available to treat or prevent EV71. Enteroviruses spread mostly through contact with infected blisters or faeces and can cause high fever, paralysis and swelling of the brain.

In China, a 2-year-old girl in the central province of Hunan and a 3-year-old boy in the southwestern region of Guangxi have become the latest to die of the EV71 strain, Xinhua reported. They were the first deaths reported in those areas.

Health officials say the disease's high season is usually June and July and caution that it has yet to peak.

BEIJING STABLE

But the Health Ministry's Mao said Fuyang had reported no fatalities for the past six or seven days and said that now the virus had been identified, doctors were better able to treat symptoms and control the situation.

Still, Anhui, a poor, inland province, was facing problems of proper treatment and unscrupulous doctors, the China Daily reported, saying 10 doctors there had been punished for malpractice relating to the outbreak.

In one of the cases, doctors were given demerits for delaying the transfer of a patient to a larger, county hospital. In another, a doctor was fined for giving 17 children an injection he claimed could prevent EV71.

But the WHO's Troedsson said public health measures were beginning to take effect and that there were no signs that the disease had been covered up.

The sentiment was repeated by Zhong Nanshan, a prominent Chinese doctor, who said the outbreak was not a repeat of the SARS virus, whose reporting Chinese authorities muzzled in 2003, leading to the sacking of the health minister and Beijing mayor.

In Beijing, host city of the August Olympics, two kindergartens were suspended after children showed symptoms of hand, foot and mouth, but Mao said the number of cases in the city was in line with that of previous years.

"We are confident the potential outbreak will not affect the Beijing Olympic Games," he said.

(Additional reporting by Nguyen Nhat Lam in Hanoi, Daryl Loo in Singapore and James Pomfret in Hong Kong; Editing by Alex Richardson)