Severe hand, foot and mouth disease cases increase, many children in the province transferred to hospital

In recent days , Ho Chi Minh City Children's Hospital 1 has admitted more than 10 children with severe hand, foot and mouth disease requiring ventilators, while two weeks ago there were no cases requiring intensive care.

Associate Professor, Dr. Pham Van Quang, Head of the Department of Intensive Care and Anti-Poisoning, Children's Hospital 1, said the above, adding that on June 21 alone, 5 consecutive severe cases of hand, foot and mouth disease were admitted to the department - a peak. "For the past two weeks, critical cases have been admitted to the department continuously, the number of serious illnesses is increasing," said Mr. Quang.

The Intensive Care and Anti-Poison Department has 30 beds, of which 10-12 beds are reserved for resuscitation of children with severe hand, foot and mouth disease. The Infection - Neurology Department has more than 60 children being treated.

There are critical cases, where breathing stops, doctors must combine many measures to save lives. For example, a 14-month-old girl was hospitalized a week ago. The first three days she had a mild fever, a rash on her hands and feet, and sore throat. After that, the fever subsided but she often startled when she slept. On the fifth day, she startled a lot when she slept, her family took her to the hospital but the rapid progression led to respiratory failure. The baby stopped breathing, the doctor intubated her and transferred her to the intensive care unit to be ventilated, but she suffered from cardiovascular collapse, rapid pulse, low blood pressure, and life-threatening conditions. The doctor had to use vasopressors to support the heart, anti-shock IV fluids, and emergency blood filtration.

Blood filtration is an effective method that helps save the lives of many severe cases of hand, foot and mouth disease. For young children, this method is very difficult because access to the blood vessels is very difficult, the disease progresses quickly and is easy to fail. For the above child patient, after blood filtration, the condition improved, he is now off the ventilator, awake, and has no organ damage.

According to Associate Professor Quang, in the past 5 years since the 2018 epidemic, severe hand, foot and mouth disease cases have been rare. This year, the Enterovirus 71 (EV71) strain has appeared, which is highly contagious and virulent, so severe cases have increased. The Ho Chi Minh City Department of Health recorded a nearly 150% increase in hand, foot and mouth disease cases in the past month, with many severe cases.

Not only Nhi Dong 1, other children's hospitals also have an increase in the number of hand, foot and mouth disease cases, while in previous months, on average, only 5-6 children were hospitalized or there were no cases at all. For example, the City Children's Hospital is treating more than 50 cases of hand, foot and mouth disease, 15% of which are seriously ill. Nhi Dong 2 Hospital has more than 40 children being treated, 20-25% of which have complications in the nervous system with symptoms such as startle, weak limbs (hand, foot and mouth disease level 2B).

Since the beginning of the year, city hospitals have recorded 4 deaths due to hand, foot and mouth disease, all of which were children transferred from the provinces, none of whom were children residing in Ho Chi Minh City. The number of seriously ill children being treated is also mainly transferred from other provinces .

Ms. Han's 9-month-old son was transferred from Dong Thap to the City Children's Hospital in a lethargic state five days ago. On June 21, Ms. Han said that at that time, the baby had been sick for three days, with fever, vomiting, red rash and blisters on the palms of his hands and feet, then he started to feel dizzy, his hands and feet trembled, the doctor diagnosed him with grade 3 hand, foot and mouth disease. The baby had to be treated intensively until his condition improved before being transferred to the Infectious Diseases Department. "I'm still not over my fear," the mother said, adding that hospitals in the West lacked medicine to treat hand, foot and mouth disease, so she had to take her child to Ho Chi Minh City.

Hospitalized with Ms. Han's son was a 24-month-old boy, the son of Mr. Hoang, from Tra Vinh . "My son got worse so quickly, I regretted it, I wish I had taken him to the hospital sooner," this father said. At first, the child only had a slight fever, the couple subjectively did not take him to the hospital for examination but bought medicine at home. When the child was transferred to the City Children's Hospital, he was very lethargic, had a high fever continuously, and after two days of treatment, he stabilized and is being monitored further.

A child with severe hand, foot and mouth disease is being treated at the Intensive Care and Anti-Poison Department, Children's Hospital 1, June 22. Photo: Le Phuong

Explaining the reason why hand, foot and mouth disease has increased rapidly this year , Dr. Truong Huu Khanh, Vice President of the Ho Chi Minh City Infectious Diseases Association, noted the re-emergence of the EV71 virus but "could not explain why the dangerous strain reappeared." However, he said that viral diseases often return every 3-4 years, especially viruses for which there is no vaccine.

Dr. Khanh also said that after a long period of Covid-19, children have to stay at home for a long time, so their immunity to some common infectious diseases is weakened. After Covid-19, children's community activities have increased, so the risk of "paying off their immune debt" is very high.

"Therefore, this hand, foot and mouth disease epidemic is very worrying," said Dr. Khanh, citing the fact that there are many seriously ill children even though the total number of cases is not equal to the same period last year.

Another difference with this year’s disease is that older children are also getting hand, foot and mouth disease, while previously it was more common in children under 3 years old. This means that children who have had the disease before, but continue to come into contact with the source of infection, are still at risk of getting infected again, according to Mr. Khanh.

The Ho Chi Minh City Department of Health is concerned that many seriously ill patients are being transferred from other provinces and cities, while the city's drug supply is limited. In early June, the Department of Health asked the Drug Administration of Vietnam (Ministry of Health) to help find a drug supply source, which is expected to be available in July. The Department has also prepared three scenarios to respond to the risk of an outbreak.

In this situation, doctors recommend that children with hand, foot and mouth disease should be diagnosed early, closely monitored and treated promptly. In case of sore throat, rash, blisters on the palms, soles, buttocks, knees... should be examined at a medical facility, especially when the child has signs of being startled and dizzy.

Severe symptoms include persistent high fever that is difficult to reduce, fever lasting more than two days, frequent vomiting, sudden dizziness, tremors, unsteady gait, cold hands and feet, sweating, lethargy, and labored breathing. When your child has these symptoms, you need to take them to the emergency room immediately.

Preventive measures include cleaning children's toys and the house with soap, Javel solution or common disinfectants. Early detection of signs of hand, foot and mouth disease in children for timely isolation and to limit the spread.

Le Phuong - My Y

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