Deadly virus spreads among children in eastern China

Medical workers examining a young patient on Thursday at No.2 People's Hospital in Fuyang City, in east China's Anhui Province. (Li Jian/ Xinhua, via The Associated Press)

By Andrew Jacobs
Published: May 2, 2008

BEIJING: A fast-spreading viral outbreak in eastern China has killed 21 children, sickened nearly 3,000 others and caused panic among parents in an impoverished corner of Anhui Province, state news media reported Friday.

The intestinal virus, commonly known as hand, foot and mouth disease, has been spreading in the city of Fuyang since early March, but local health officials only announced the outbreak last week, raising questions of whether they were trying to conceal word of the growing problem. In recent days the Chinese media have heavily criticized the government response, offering comparisons to the SARS epidemic of 2003, which drew widespread attention to China's shaky public health system and official attempts to cover up the outbreak.

On Thursday the World Health Organization warned that the disease, which thrives in warm weather, could spread in the coming months. It advised child-care centers and schools to stay closed until the spread of new infections was curtailed.

The virus, which has no relation to the foot-and-mouth disease that infects livestock, is easily passed between children. The illness begins with a fever and often leads to mouth ulcers and blisters on the hands, feet and buttocks. There is no vaccine or cure, but most patients recover in a week without treatment. In severe cases, however, brain swelling can lead to paralysis or death. Rigorous hygiene dramatically reduces the spread of the pathogen, which is an enterovirus known as EV71.

Health officials in Fuyang say that more than 700 children remain hospitalized, 36 of them in serious condition. All of the fatalities have been in children younger than 6, the majority of them under 2. Although the number of infected children has been steadily climbing, the fatality rate has dropped substantially in recent weeks, falling to 0.2 percent from 11 percent in March, according to World Health Organization officials.

Anxious parents have been overwhelming local hospitals in Fuyang, a hardscrabble city of 170,000 people. A doctor at No. 2 People's Hospital said by telephone that health care workers there were coping with 200 sick children. He said there had not been any fatalities in the past five days.

"I think the disease itself can be controlled, but it is hard to treat if there are complications," said the doctor, who would only give his surname, Li.

Among parents, though, there is still widespread concern and confusion. Reached by telephone, the father of a 1-year-old boy said misinformation was rife. The current rumor, he said, suggested that a local river was the source of the infection. The man, a truck driver surnamed Wang, said schools had been closed and local health officials were instructing parents to frequently wash their children's hands. "We really hope journalists can come and report more on this," he said.

Since early April, teachers at the Dongfanghong kindergarten have been assiduously cleaning children and classrooms with a daily disinfectant spray. Still, the measures did not assuage everyone's fears. By Tuesday, when the authorities shut the school, nearly 100 of the school's 500 students were being kept home by their parents. "A lot of parents are concerned about the contagiousness," said Xu Yanyan, the school's headmistress.

Fuyang is perhaps best known as the epicenter of a powdered milk scandal four years ago that sickened 200 infants, killing 13 of them.

In recent days the Chinese media have not been shy about lambasting health officials for waiting a month to sound the alarm bells. In mid-April, they noted, local officials who were confronted by reporters denied there was a problem. Two weeks later, after more than a dozen children had died, they were forced to acknowledge that an outbreak was well under way.

In an editorial headlined "Tragic Costs of Delay," the state-run English-language China Daily cited the SARS epidemic and the powdered milk scandal, and chastised the government for its sluggish response. "The memory of the last tragedy only adds to the bitterness of the new one," it said.

During the SARS outbreak, Chinese officials withheld information from the World Health Organization, restricted media reporting and undercounted the cases of those stricken. After the disease spread beyond China's borders and provoked worldwide panic, the government apologized and pledged to confront future health emergencies with greater openness.