Assam sees surge in Hand, Foot and Mouth diseases: Health experts

GUWAHATI, Oct 18: A spurt in cases of Hand, Foot and Mouth Disease (HFMD) – a childhood viral infection – has been reported in the state, triggering an alarm among parents.

The actual number of cases is yet to be ascertained due to lack of laboratory tests, but doctors, particularly in Guwahati, have confirmed a spike in HFMD cases following clinical diagnosis of affected children. Paediatricians in Dibrugarh have also reported multiple cases of late.

Dr Yasin Ali of Health City Hospital in Guwahati said he has been getting cases for more than a month now.

“This week, there is a slight drop. HFMD, caused by Coxsackie virus, is highly contagious and spreads through direct contact with an infected person’s bodily fluids like saliva, mucus, blister fluid, and stool, as well as airborne droplets from coughing or sneezing. The affected child needs to be isolated for some days, and medication is required in some cases,” Dr Ali said.

Dr Rahul Verma of Guwahati, who has been getting patients almost every day, said affected children have fever, sometimes accompanied by headache, body ache, and there are blisters in the mouth, hand and foot.

“Sometimes, blisters may be seen on the back, the scapula, knee joint, and elbow. It’s commonly seen in preschool and school going children and it spreads through close contacts. Parents should not send their children to school in case they see such symptoms. This will help in preventing the spread,” he said.

“But it is a very mild illness and nothing to be afraid of. Many parents, however, assume it to be chicken pox or measles and they keep the children at home and do not seek medical advice, which they should not do,” Dr Verma said.

Pratiksha Hospital too has been getting lots of cases and some parents also reported second infection in their children, which is more painful.

According to an earlier study by the Regional Virus Research Diagnostic Laboratory of ICMR-Regional Medical Research Centre and Paediatrics Department of Assam Medical College and Hospital, the first outbreak of hand, foot and mouth disease in India was reported from Calicut in 2004. After 3 years, the first large-scale outbreak occurred in 2007 in Kolkata and the surrounding areas of West Bengal. Since then, many small-scale outbreaks have been repeatedly reported from different places based on clinical description. The first laboratory-confirmed hand, foot and mouth disease outbreak was reported in Assam in 2014.

Although no cases of neurological or pulmonary manifestations were detected in the initial years and all the cases improved spontaneously without any requirement for hospitalization, the spread of the disease over larger parts of the country reminds the pre-epidemic periods of China and Taiwan.

“This necessitates awareness as all previous cases of severe outbreaks worldwide followed many years of milder attacks, intermittent periods of quiescence and progressively larger areas of involvement. The reported hand, foot and mouth disease outbreak in Northeast India, which is in close geographical proximity to China and other Southeast Asian countries with previous incidence of fatal outbreaks, sends an alert that the disease has now acquired the potentiality to affect larger parts of the country,” the study had noted.

The study had also observed that CV-A6 serotype identified in Tezpur district shares 98-99 per cent nucleotide homology with CV-A6 strain of China, which caused a large outbreak of hand, foot and mouth disease in 2012 and CV-A6 in Finland in 2008.

Unfortunately, awareness among the primary level doctors or medical staff regarding the disease is limited. Health awareness among school teachers, school authorities, daycare centers about the contagious nature of hand, foot and mouth disease would help in limiting the outbreak of the disease, the researchers had said.