On the afternoon of June 24, Thanh Nien reporters recorded at the Department of Infectious Diseases, Can Tho Children's Hospital (which receives children from the whole Mekong Delta), the number of children with hand, foot and mouth disease (HFMD) being treated in the hospital has reached 103 cases, an increase of 23 cases compared to last week. Worryingly, the number of severe cases hospitalized at this hospital has increased dramatically compared to 2022. Specifically, since the beginning of the year, there have been 9 cases of grade 3 and grade 4; of which 5 cases had to be transferred to a higher level in Ho Chi Minh City, 2 cases of grade 4 died. Meanwhile, in the whole year of 2022, there were only 8 cases of grade 3 HFMD, no deaths.
Doctors at Can Tho Children's Hospital examine a child with hand, foot and mouth disease
According to statistics at Can Tho Children's Hospital, in the first 6 months of this year, the number of inpatient TCM cases at this hospital has reached 834. Doctor Phuoc Thinh, on duty at the hospital's Infectious Diseases Department, said that currently, there are 20-25 new cases admitted to the hospital every day. Therefore, the hospital has to add more beds in the hallway for children to lie down for treatment, and having to share beds is inevitable.
According to Dr. Phuoc Thinh, the biggest difficulty now is that the source of TCM Immunoglobulin treatment drugs paid for by health insurance has been exhausted, due to the end of the bidding process and is still waiting for the bidding procedure. The hospital has had to find a third-party source of drugs to treat patients. In many cases of severe pediatric patients requiring intravenous drugs, the hospital has had to explain to the patient's family that they have to spend more money on treatment that should have been paid for by health insurance.
Hand, foot and mouth disease caused by EV71 can easily cause brain complications.
The two common groups of pathogens causing HFMD are Coxsackievirus A16 (CA16) and Enterovirus 71 (EV71). While CA16 infections often present mild symptoms that can be treated at home, EV71 causes more severe illness with many dangerous complications such as encephalitis, meningitis, myocarditis, pneumonia, pulmonary edema, respiratory failure, circulatory failure, and can be fatal if not treated promptly.
In the first 6 months of this year, the National Children's Hospital (Hanoi) received more than 1,200 children with HFMD for examination, with nearly 500 children having to be hospitalized for treatment, of which 20 - 30% were infected with the EV71 strain.
There are two common complications of TCM: neurological complications and respiratory and circulatory failure. However, this year, doctors have received more children with neurological complications, the most typical of which is encephalitis.
Early detection of HFMD in children: The disease usually begins with symptoms of fever, poor appetite, discomfort and sore throat. 1-2 days after the fever, sores appear in the mouth causing burning pain. Initially, they are red blisters and often develop into ulcers. These ulcers are mainly on the tongue, gums and inside the cheeks. Children may have a non-itchy rash that appears for 1-2 days with flat or raised red lesions, some with blisters. The rash is often concentrated on the palms of the hands or soles of the feet; it may also appear on the buttocks and/or genitals. However, children may not have typical symptoms or may only have a rash or mouth ulcers.
Children with TCM are considered to be severely ill when they have symptoms of continuous high fever that does not respond to antipyretics; fatigue, not playing, not eating, sleeping a lot, lethargy; frequent startles (2 or more times in 30 minutes); sweating, cold all over the body or in the hands and feet; rapid breathing, abnormal breathing: apnea, shallow breathing, chest retraction, wheezing; trembling limbs, body tremors, unsteady sitting, staggering.
Because TCM progresses rapidly and unpredictably, when a child is found to have the disease, the family should take the child to a medical facility for advice on care and how to detect severe symptoms, so that timely treatment can be given.
Nam Son
Similarly, in Dong Thap, the provincial Center for Disease Control has recorded 902 cases of hand and foot lice since the beginning of the year, including 1 death. In An Giang, for about a month now, the number of hand and foot lice cases has increased rapidly with 90 new cases per week, exceeding the epidemic forecast threshold. In total, since the beginning of the year, An Giang province has recorded 600 hand and foot lice cases, including 1 child hand and foot lice patient transferred from Dong Thap to An Giang who died.
Mr. Tran Quang Hien, Director of An Giang Department of Health, said: "Currently, like many other localities, An Giang mainly lacks Immunoglobulin to support the treatment of severe TCM disease, and it is expected that the medicine will not be available until early July 2023. The Department has requested medical units to review resources, strengthen treatment activities and reserve medicines, test reagents, equipment and medical supplies to ensure timely admission and treatment of TCM patients."
Urgent prevention of hand, foot and mouth disease and dengue fever
According to the Pasteur Institute of Ho Chi Minh City, for the Hand-foot-mouth disease epidemic, from the beginning of 2023 until now, 20 southern provinces and cities have had more than 11,000 cases and 7 deaths.
In Ho Chi Minh City alone, there have been 3,432 cases of TCM since the beginning of the year. Currently, hospitals in the city are treating 184 cases, 100% of which are under 6 years old. Of these, 16 are severe cases (8 cases at Children's Hospital 1, 2 cases at Children's Hospital 2, 6 cases at City Children's Hospital), including 1 case with an address in Ho Chi Minh City.
Regarding dengue fever, since the beginning of 2023, 20 southern provinces and cities have had more than 25,000 cases of dengue fever, including 6 deaths. In Ho Chi Minh City, since the beginning of the year, 8,485 cases of dengue fever have been hospitalized for treatment. Hospitals in the city are treating 109 cases, including 14 severe cases (6 cases are located in Ho Chi Minh City), 1 case is on invasive ventilation.
According to Deputy Minister of Health Nguyen Thi Lien Huong, localities that have plans, if they have not yet or are submitting them for approval, are requested to consult the Provincial People's Committee to urgently approve funding to proactively implement epidemic prevention and control activities.
Unique
According to Thanh Nien reporters, normally, a child weighing 10 kg, if infected with TCM, depending on the severity of the disease (from level 2b group 2 and above), will have to be transfused with 1-2 doses of specific drugs such as Phenobarbital, Immunoglobulin. Each dose is 5 vials of medicine, with a cost of nearly 30 million VND. While waiting for localities to complete bidding procedures, the child's family is suffering many disadvantages when having to bear the cost of the above treatment drugs.
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