Hand, foot and mouth disease in China kills 3 children and sickens over 100 others

In the latest health scare in China three children have died from hand, foot and mouth disease and another 110 are sick - this is China's second outbreak of the virus this year in young children.

Hand, foot, and mouth disease (HFMD) is a common illness among infants and children and begins with a fever and a rash with blisters.

Within one or two days of the fever appearing, painful sores develop in the mouth and other lesions form on the hands and feet.

HFMD is caused by a virus from the group called enteroviruses and the most common culprit is the coxsackievirus A16 virus - but sometimes, HFMD is caused by enterovirus 71 or other enteroviruses.

Those most at risk from HFMD are mainly children under 10, but it can also affect adults - infants, children and adolescents are more susceptible because they are less likely than adults to have antibodies and to be immune from previous exposures to them.

There is no vaccine or treatment for HFMD but its symptoms can be treated to provide relief from fever, aches or pain from the mouth ulcers.

HFMD is usually not dangerous and the infection caused by coxsackievirus A16 infection is as a rule a mild disease with most patients recovering without medical treatment - complications are rare.

However sometimes a patient with coxsackievirus A16 infection will also develop "aseptic" or viral meningitis, which is characterised by fever, headaches, and stiff neck or back pain, and may require hospital treatment for a few days.

The last outbreak in April and May in China which killed at least 42 people, was mainly linked with enterovirus 71 which can also cause viral meningitis and, rarely, more serious diseases, such as encephalitis, or a poliomyelitis-like paralysis which can be fatal; cases of fatal encephalitis occurred during HFMD outbreaks in Malaysia in 1997 and in Taiwan in 1998.

HFMD is spread from person to person, by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stools of infected people and a person is most contagious during the first week of the illness.

HFMD can be prevented by good personal hygiene including frequent handwashing and the disinfecting of contaminated areas as well as isolating those with the disease.

All the latest cases have occurred in eastern China, in Jian'ou city, in the Fujian province, from October 1st to 17th - provincial health officials say the children who died were under a year old and came from different towns - 22 children remain in hospital undergoing treatment.

Officials say eight epidemic prevention experts have been sent to the area to help local medical staff conduct citywide checks on children.

HFMD is not related to foot and mouth disease, which infects cattle, sheep and swine.

An outbreak in May affected more than 24,000 people and killed dozens across China - Anhui was the worst-hit province with 26 deaths - the outbreak was first reported there in March.