An epidemic of one type of hand-foot-mouth disease in China is starting to appear in news reports around the world as the child-killing virus. More than forty people have already died in this outbreak; all of them have been children. The culprit is enterovirus 71, or EV-71. It’s already made more than 25,000 children sick on the Chinese mainland.
Hand-foot-mouth disease can be caused by any of several related viruses, most commonly by one called coxsackievirus A-16. All forms of hand-foot-mouth disease are very contagious. Most of the time, hand-foot-mouth disease is very mild. But it can be extremely serious, sometimes resulting in paralysis, heart problems, or even death. The current outbreak is a serious one, but it is not unique. There was a similar serious outbreak about 10 years ago in Taiwan, Malaysia, and Borneo, and it did not become a global epidemic.
There are two reasons to follow the story this time around: 1) EV-71 likes warm weather and usually peaks in the late summer months so the outbreak will likely get worse, and 2) China is hosting the world for the Olympics later this summer.
Most children who get EV-71 will recover completely, but of the viruses that cause hand-foot-mouth disease, EV-71 is the most likely to cause polio-like paralysis and brain infections that can have lasting consequences. Those with weakened immune symptoms are more likely to be the ones who have complications. Breastfeeding, beneficial bacteria, a healthy diet (with the appropriate vitamins and minerals), avoiding cigarette smoke, avoiding the unnecessary use of antibiotics, and getting plenty of sleep are all ways to help the immune system to function at its best.
The EV-71 virus can live for days at room temperature. It is very contagious. Refrigerating and freezing does not inactivate it. It is, however, easy to kill with heat and with disinfectants. Someone who is sick may shed the virus in their stool for weeks. From there is often spreads to someone’s hand and then someone’s mouth. Careful hand washing, especially after toileting or diapering and before eating, can prevent some cases of EV-71. Because the virus can live so long on surfaces, it is often spread via infected toys or other objects (fomites). Cleaning or disinfecting these before they are shared with your child could also help. Again, the problem comes when the virus-laden hands or objects go in the mouth.
But this virus may also be spread by the respiratory route. The only way to prevent this is to avoid contact with those who are infected, which can be very difficult during an epidemic.