Health officials have confirmed that the illnesses and deaths among children in Cambodia were a result of a severe form of hand, foot and mouth disease caused by enterovirus 71, according to the World Health Organization.
A disease outbreak ongoing since April that has resulted in more than 78 illnesses and 54 deaths among children in 14 Cambodian provinces. Laboratory samples were unavailable for most of the patients because they died before appropriate samples could be taken. Of the 31 samples available, most tested positive for enterovirus 71 (EV-71), a known cause of hand, foot and mouth disease (HFMD). However, some of the patients also tested positive for other pathogens, including dengue and Streptococcus suis. None of the samples tested positive for any type of influenza, SARS or Nipah.
The 78 cases were identified from several hospitals, but the investigation focused on 61 cases that met the specific case definition. Most of the children were aged younger than 3 years and some of the children suffered from chronic conditions. A significant number of cases were treated with steroids at some point during their illness, which has been shown to have adverse effects on patients with EV-71.
The Ministry of Health has requested that health centers report all patients with HFMD, and enhanced surveillance in now in place for neurorespiratory syndrome, a key syndrome observed among patients with severe HFMD caused by EV-71. Occasional new cases are expected in the coming months as a result of the enhanced surveillance, according to WHO.