Health Threats in China: Enterovirus-71 (EV-71) and Avian Flu
- Kathy Block, China Primer
Individuals looking to Travel in China should stay current on any potential health threats when traveling to and within China. This article provides information specifically on the Enterovirus-71 (EV-71) and the Avian Flu (Bird Flu) including a general overview and some tips on prevention.
Enterovirus 71 (EV-71)
In recent months there has been a lot of attention around the growing outbreak of the intestinal virus known as Enterovirus-71 or EV-71. The outbreaks occurred in several provinces in mainland China including Anhui, Zhejiang and Hubei. Nearly 12,000 cases have been reported to date by the Chinese reporting agency, Xinhua News Agency. 26 cases have been fatal where all were children under the age of 6.
According to the American Citizens Services department at the Embassy of the People’s Republic of China Beijing, the symptoms are described as follows: “…similar but more severe than the common hand, foot, and mouth disease (HFMD). Typically, it starts with a generalized illness, poor appetite, and sore throat, followed by a fever, rashes on the hands, feet, and buttocks along with mouth ulcers.”
In a recent report published by the World Health Organization (WHO), the most severe cases are defined as having two of the following symptoms
- Continuous High Fever
- Weakness, vomiting, irritability
- Abnormal White Blood Cell count
- High blood glucose level
- Poor blood circulation of limbs
There is no antivirual treatment for EV-71 and no vaccine available at this time. The government has continued to work with public health officials and experts to further educate the public on disease control and prevention.
The World Health Organization also states that public health officials are expecting cases to peak around June and July. However, based on conversations with several concerned parents, it seems that there are many who believe that these numbers are underreported.
Avian Influenza (Bird Flu) and Avian Influenza A (HN51)
Avian Influenza is generally referred to as “Bird Flu” because it was a virus that occurred naturally among birds. It is highly contagious among birds and can oftentimes kill them. The cases you hear about the most involve domesticated birds such as chickens, ducks and turkeys.
There are many strains of the Avian Influenza virus but the most well known that affects humans is the HN51 strain. Most human infections have been a result of having contact with infected poultry or with surfaces contaminated by infected poultry.
In a recent update from the World Health Organization, they have included the number of cases that have been reported since January 1, 2008.
- In China – 3 cases and 3 deaths
- In Vietnam – 5 cases and 5 deaths
- In Bangladesh – 1 case and 0 deaths
- In Indonesia – 16 cases and 13 deaths
These numbers are current as of May 28, 2008. You can get more information from their website at: http://www.who.int/csr/disease/avian_influenza/en/.
At this time, the HN51 virus is not easily passed from human to human and there have only been limited cases of human to human infection. There was one case where a sick child passed it to her mother and another case where an infected child passed it other immediate members of his family (but the infection did not spread beyond that). Even with these limited cases, public health officials continue to stay alert for additional human to human cases and the potential for an outbreak of pandemic levels remains very real. However, no one can predict if and when this will happen.
The Avian Flu is resistant to some of the more commonly used antiviral medications. There are currently two antiviral drugs that have shown some positive effects: Oseltamivir and Zanamivir. However, at this time there is not enough information collected to make any solid conclusions of their effectiveness.
Precautions
Where humans have the highest risk of exposure to Avian Flu virus is during the preparation of infected poultry. However, the Avian flu is not resistant to heat. Therefore, if poultry is cooked properly, the risk of infection is very low. Proper food hygiene steps include cooking the poultry meat thoroughly and not allowing any juices from the raw meat to come into contact with any other food items that will be eaten.
At this time, the EV-71 virus seems to present the greatest threat to young children (there have not been any adult cases reported). If you are traveling to China with small children, be sure to practice strict personal hygiene habits such as washing your hands frequently, carrying antibacterial gel with you at all times (since many places do not have proper washing facilities).
As always, be sure to follow the usual precautions around eating and drinking such as:
- Avoid drinking water and/or ice where you’re unsure or suspicious of the purity
- Do not eat uncooked shellfish or uncooked fruits or vegetables that you have not peeled or prepared yourself.
For more tips on staying healthy while traveling in China, click here.
To get the most up to date information on EV-71 and Avian Influenza, you can visit the following links:
- Centers for Disease Control and Prevention covering the HFMD topic - http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm
- Centers for Disease Control and Prevention covering the Avian Influenza - http://www.cdc.gov/flu/avian/
- The WHO Representative Office in China - http://www.wpro.who.int/china
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