What is the current situation?

The Vietnamese Ministry of Health has confirmed an outbreak of hand, foot and mouth disease (HFMD) attributed to enterovirus 71 (EV71). The outbreak is concentrated in the southern part of the country, but cases have been reported from all regions. Cities and provinces with the highest HFMD number of deaths are Ho Chi Minh City, Dong Nai, Binh Duong, Long An, Ba Ria-Vung Tau, Bac Lieu, Dong Tap, Tien Giang, and Quang Ngai. As of mid-October 2011, Vietnam had reported 80,000 cases of HFMD and 137 deaths.

As in other outbreaks of EV71 HFMD reported in Southeast Asia since 1997, a small proportion of children with the disease have developed severe, often fatal complications, including encephalitis (swelling of the brain).

What is HFMD?

HFMD is a common illness that usually affects infants and young children. However, older children and adults can also become infected. HFMD can be caused by several different viruses. Symptoms of HFMD include fever, painful blister-like sores in the mouth, and a skin rash.

HFMD is spread from person to person by direct contact with the viruses that cause this disease. These viruses can be found in saliva, nasal secretions, blister fluid, and feces of the infected persons. The viruses also may be spread when an infected person touches objects and surfaces that are then touched by others.

How can travelers protect themselves?

You can protect yourself from HFMD by practicing healthy personal hygiene.

• Wash your hands often with soap and water, especially before you eat, after you cough or sneeze, and after you go to the bathroom or change a baby's diaper. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol). Consider packing alcohol-based hand gel in your carry-on luggage to ensure you have it when needed.
• Disinfect dirty surfaces and soiled items.
• Avoid close contact such as kissing, hugging, or sharing eating utensils or cups with people with HFMD.

There is currently no vaccine to protect against the viruses that cause HFMD. The personal hygiene measures described above are the best protection.

There is no specific treatment for HFMD. However, some things can be done to relieve symptoms, such as

• Taking over-the-counter medications to relieve pain and fever. (Caution: Aspirin should not be given to children.)
• Using mouthwashes or sprays that numb mouth pain

If a person develops mouth sores, staying hydrated is important. An ill person who cannot swallow enough liquids to stay hydrated should see a doctor. Fluids may need to be given through the veins.

Information for Health Care Providers

The current outbreak in Vietnam has been attributed to EV71. HFMD is one of many infections that cause mouth sores. If laboratory diagnosis is required, throat swabs or stool specimens may be tested for enteroviruses. Contact your local or state health department to find laboratory resources in your area.

Additional Information:

• Hand, Foot, and Mouth Disease CDC website