PRO/EDR> Hand, foot & mouth disease

Published Date: 2012-08-16 17:47:48
Subject: PRO/EDR Hand, foot mouth disease – USA (03): (NV), Coxsackie A6
Archive Number: 20120816.1248050

HAND, FOOT AND MOUTH DISEASE – USA (03): (NEVADA), COXSACKIE A6 VIRUS
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Date: Tue 14 Aug 2012

Source: RGJ.com [edited]

http://www.rgj.com/article/20120814/NEWS/308140047/Washoe-County-issues-hand-foot-mouth-alert?nclick_check=1

Washoe County’s health and school districts sent out alerts on Monday night [13 Aug 2012] about an outbreak of a rare, new hand, foot and mouth disease (HFMD), which can be passed easily from children to adults. More than 400 self-reported cases of Coxsackie A6 virus infection, which arrived in the United States in December [2011], have been received by the health district in 2012.

HFMD is a common viral illness that predominantly affects children 5 and younger. The health district sent its first alert on 30 Mar 2012, when there were about 30 cases of the unusual Coxsackievirus A6 virus, which included 6 adults. Some of the symptoms include a rash that may appear as small pimply sores at first, progressing to larger sores (some fluid filled) that scab over after a day or 2, according to the health district’s website. The sores do not usually itch but can be painful as they emerge and may appear on parts of the body other than the hands, feet or mouth, including groin, buttocks, torso, arms and face. Sores in the mouth and/or throat may cause loss of appetite and/or dehydration.

“This strain is not [affecting] just the hands, feet and mouth,” said Phil Ulibarri, public information officer for the health district. “It’s also seen on the elbows, the knees, the arms, buttocks, legs and in the genital area.” Ulibarri said the Coxsackie A6 virus strain also can cause finger and toenail shedding after other symptoms subside.

The school district sent a message to parents via its ConnectEd automated phone system at the request of the health district. It asked parents to familiarize themselves with the information so that if their child developed symptoms consistent with this [virus infection], they will be prepared with the information needed to stop its spread. “We want kids to stay home until the sores dry up or scab over,” Ulibarri said. “We don’t want to see people having person to person contact if they’re still contagious.” He said children, especially younger children, can spread the disease as they share objects, such as toys, eating utensils and cups.

Dana Balchunas, director of the school district’s student health services, said it began sending literature to the school nurses and other staff at the end of last school year. It was sending another round of alerts in advance of the traditional school year beginning 27 Aug 2012, he said. “We communicate with nurses about what they should look for, and they in turn tell the principals and teachers,” Balchunas said. “It’s an ongoing process.” Some of the year-round schools have reported cases of students with the virus, she said. “It’s not a high number of reports from schools,” Balchunas said.

The health district says that a student must be kept home until there are no new sores for 2 days, all sores are dry or scabbed over, and no fever for 24 hours without the use of fever reducing medications. A person infected should rest, take food and fluids as they are able, use fever reducing medications appropriately and consult a physician if needed. With no treatment or vaccine for the disease, the best defense is prevention.

The Washoe County Health Department issued these hand, foot and mouth disease (HFMD) prevention tips:

- wash hands with soap and water carefully and frequently, especially after going to the bathroom, after changing diapers, and before preparing foods or beverages;

- disinfect surfaces and items, including toys. First wash the items with soap and water, then disinfect them with a solution of 2 tablespoons of bleach and 4 cups of water;

- avoid close contact such as kissing, hugging or sharing eating utensils or cups with infected people;

- report suspected cases of HFMD; contact the Washoe County Health District at 775-328-3764.

[byline: Michael Martinez]

–

communicated by:

ProMED-mail from HealthMap alerts

promed@promedmail.org

[HFMD occurs globally. In developed countries, HFMD is generally mild and often associated with outbreaks of Coxsackie A16 virus infection. Contrary to the above report, Coxsackie A6 virus infection is a frequent cause of HFMD in North America and has not "arrived".

It is not clear whether the Nevada outbreak is more severe than usual or merely that the surveillance in Washoe county is more sensitive than elsewhere. In East Asian countries in recent years, the disease has been associated with outbreaks of human enterovirus 71 infection and can be more severe, with a small proportion of children experiencing neurological complications, occasionally with fatal outcomes. The occurrence of Coxsackie A6 virus as a cause of HFMD in Nevada does not appear to be associated with the severe form of the disease.

A map of the counties of Nevada showing the location of Washoe county can be accessed at http://www.digital-topo-maps.com/county-map/nevada.shtml. - Mod.CP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1FX1.]

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