The rashes of a child patient in HCM City with stage-4 hand, foot, and mouth disease caused by the EV71 virus strain. — VNA/VNS Photo

HCM CITY — Children's Hospital 2 in HCM City announced on April 10 that it had successfully treated two critically ill child patients with hand, foot, and mouth disease, stage 4 (the most severe stage), caused by the EV71 virus strain.

Dr. Đỗ Châu Việt, Head of the Intensive Care Unit for Infectious Diseases, said that on April 7, a one-year-old boy was admitted to the hospital in a state of difficulty breathing and respiratory failure.

Two days prior to admission, the boy had a high fever and was brought to a local hospital, where he was diagnosed with hand, foot, and mouth disease and developed a rash.

Due to the rapid deterioration of the child's condition, with localised sweating around the head, difficulty breathing, and respiratory failure, the doctors intubated the child and transferred him to Children's Hospital 2, after which he was admitted to the Intensive Care Unit for Infectious Diseases.

Doctors urgently provided mechanical ventilation, hemodialysis, and cardiac support medication. After more than 3 days of intensive treatment, the child's condition stabilised, he was weaned off the ventilator and switched to CPAP.

Another three-year-old boy was admitted to the hospital at almost the same time as the previous patient, also diagnosed with stage-4 hand, foot, and mouth disease.

According to his family, the child had a fever and a rash and was taken to a local hospital for treatment. 

After receiving intravenous immunoglobulin and being closely monitored for 12 hours in the intensive care unit, the child continued to have a high fever of 39 degrees Celsius, labored breathing, pink frothy sputum mixed with blood, pulmonary edema, a heart rate twice as fast as normal, and sudden fluctuations in blood pressure.

The child was then transferred to Children's Hospital 2. Upon admission, the child's blood oxygen saturation was only 75 per cent, with respiratory and heart failure, and was prescribed hemodialysis, mechanical ventilation, and vasopressors.

After 6 hours of intensive treatment, the heart rate decreased, and after three days of treatment, his condition became more stable, and hemodialysis and vasopressors were discontinued.

They are both being monitored for neurological sequelae.

Dr. Việt said that both children were infected with the EV71 strain – a virus strain that causes severe complications of hand, foot, and mouth disease.

The symptoms of this strain are usually very mild or subtle rashes. Many children are admitted to the hospital in critical condition, with respiratory failure and cardiogenic shock, but without any obvious rash or mouth ulcers.

The EV71 strain can directly attack the central nervous system, causing acute brain damage and rapid death within 12-24 hours.

Most children diagnosed with stage-4 hand, foot, and mouth disease experience neurological sequelae, ranging from mild to severe.

“Once the disease begins to affect the nervous system, every minute counts. Parents should take their children to the nearest medical facility immediately if they notice any alarming symptoms, even if there is no rash or mouth ulcers,” Dr. Việt advised.

Signs that a child is at risk of developing serious symptoms include startling or jerking even while sleeping or awake (especially if it occurs more than twice in 30 minutes), and high fever that is difficult to bring down, lasting more than 48 hours.

Other symptoms include motor disturbances, unsteady gait, loss of balance, tremors, weakness in the limbs, or inability to sit steadily, as well as frequent vomiting throughout the day, persistent crying, lethargy, or restlessness. — VNS