Communication Across Borders: Hand, Foot, and Mouth Disease (HFMD)

Hand, Foot, & Mouth Disease (HFMD) is prevalent in many Asian countries and commonly occurs among children aged less than five years. Of the Association of Southeast Asian Nations (ASEAN) and Plus Three Countries, large increases in cases have been identified in China, Japan, Malaysia, Republic of Korea, Singapore, Thailand and Vietnam over the past few decades. The etiologies include several enteroviruses (subgenotype B5, C4, etc.). Mild disease is most common and caused by coxsackievirus A16. The severe form of HFMD caused by Enterovirus 71 (EV 71) can lead to neurological, cardiovascular, and respiratory problems as well as death. The disease is transmitted through exposure to the upper respiratory tract secretion, saliva, feces of patients or by asymptomatic cases. Outbreaks commonly occur in day care centers and schools. Currently, there is no vaccine or anti-viral treatment for HFMD.

As of 22 July 2012, the accumulated number of confirmed HFMD cases increased to 16,860 in Thailand. Three deaths have been confirmed to have been caused by EV 71. In response to the HFMD situation, Thailand's MoPH has informed the public and medical specialists that steroids should not be taken if HFMD is suspected. The MoPH has also set up a panel of experts that can be contacted by both public and private practitioners located nationwide for medical advice. Thailand's Field Epidemiology Training Program (FETP) is currently conducting an investigation.

In light of Thailand's HFMD situation, ASEAN+3 FETN hosted a regional HFMD Situation and Testing of "Real Time" Information Sharing Video Conference, Monday, 6 August 2012, 13.30-15.00. Thailand shared information for cases both mild and fatal, laboratory surveillance, genotype identified in Thailand, and Thai FETP's role in outbreak investigations. Cambodia, Philippines, Singapore and Vietnam also shared their current HFMD situation. Meeting participants included Cambodia's Dr. Bun Sreng and Dr. Sok Touch; China's Dr. Huilai Ma; Indonesia's Dr. I Nyoman Kandun; Singapore's Dr. Pengiran Hishamuddin, Mr. Mohammad Fauzy Bin Mos, and Mr. Soon Kok Lim; Thailand's Dr. Kumnuan Ungchusak, Dr. Rungreung Kitphati, & Dr. Rome Buathong; Vietnam's Dr. Hoang Quoc Cuong; WHO Indonesia's Dr. Khanchit Limpakarnjanarat; WHO SEARO's Dr. Vason Pinyowiwat; WHO WPRO's Dr. Tamano Matsui, Dr. Wu Huanyu, Mr. Taku Wakui, and Mr. Noel Orosco; and ASEAN Secretariat's Ms. Jintana Swirawongsa. Technical difficulties prohibited participation for representatives based in Japan, Lao PDR, Myanmar, and the Philippines.

Below you will find relevant information, publications and progress of HFMD events in the ASEAN Plus Three Countries.