VZCZCXYZ0008
RR RUEHWEB

DE RUEHGZ #0250/01 1270903
ZNR UUUUU ZZH (CCY ADX8D404B MSI1799 400A)
R 060903Z MAY 08 ZDS
FM AMCONSUL GUANGZHOU
TO RUEHC/SECSTATE WASHDC 7087
INFO RUEHOO/CHINA POSTS COLLECTIVE
RUCNARFC/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEAIIA/CIA WASHDC
RUEKJCS/DIA WASHDC
RUEAUSA/DEPT OF HHS WASHDC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RUEKJCS/CJCS WASHINGTON DC//J2/J3/J5//
RHHMUNA/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RUEORDA/DIRAFMIC FT DETRICK MD//MA-1A//

UNCLAS GUANGZHOU 000250 
 
SENSITIVE, SIPDIS 
 
C O R R E C T E D C O P Y (ADDED CAPTION) 
 
STATE FOR EAP/CM, OES/IHA, MED, CA/OCS/ACS/EAP 
STATE PASS TO USAID FOR ANE AND GH 
CDC FOR OGHA AND DIV-FLU 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP 
HHS PASS TO FIC/NIH 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC, USAID 
BEIJING FOR HHS HEALTH ATTACHE AND RMO 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CASC SOCI CH
SUBJECT: Guangdong Outbreak - Hand, Foot and Mouth Disease Claims 
Three Lives, Infects Over One Thousand 
 
¶1. (U) Summary: A hand, foot and mouth disease (HFMD) outbreak has 
led to three deaths in Guangdong province, and the infection of more 
than 1,600 local children. Guangdong's Department of Health has 
created an HFMD task force to increase local monitoring, prevention 
and control efforts.  Guangdong authorities anticipate more than 
10,000 cases of HFMD by year's end, mostly occurring during the peak 
months of June and July. According to one specialist, the disease 
has occurred sporadically over the past few years; there is more 
public notice of it now that it has been listed in the category of 
statutory reported infections.  End summary. 
 
------------------------- 
The Threat to South China 
------------------------- 
 
¶2. (SBU) HFMD, which has already claimed the lives of 22 children in 
Anhui province, has led to the death of two infants in Guangdong's 
Foshan city, and one infant in Maoming city, both located southwest 
of Guangzhou. As of May 5, Guangdong had documented 1,692 cases of 
HFMD among local children. Of cases reported, 372 were in Guangzhou, 
519 were in Shenzhen, and another 373 in Foshan, the most severely 
affected municipalities.  According to Dr. Tang Xiaoping, well known 
in Guangzhou for his work during the severe acute respiratory 
syndrome (SARS) outbreak and currently serving as Deputy-Director of 
Guangzhou's Public Health Bureau, all of Guangzhou's HFMD cases are 
mild, and the infected infants are recovering.  However, authorities 
are not ruling out increased fatality rates and additional outbreaks 
in the coming months.  According to the Guangdong Government 
Emergency Response Office, Guangdong is expected to see at least 
10,000 cases of HFMD by the end of 2008. 
 
¶3. (U) Hand, Foot, and Mouth Disease (HFMD), which mostly affects 
infants and young children, especially those without access to 
proper healthcare and facilities, is transmitted through direct 
contact with saliva, feces, or mucus.  Symptoms range from rash and 
fever, to severe neurological damage. Various viruses can cause 
HFMD, however, Enterovirus 71 (EV 71), known to attack the 
intestines, is one of the more dangerous.  There is no clearly 
effective vaccine or anti-viral agent for treating EV 71. 
 
¶4. (SBU) Of the three reported deaths in Guangdong, the two in 
Foshan were confirmed to be caused by the EV 71 virus.  Two cases in 
Shenzhen and one other in Foshan have also been linked to EV 71. 
According to Feng Shaomin, Director of the Foreign Affairs Division 
of the Guangdong Department of Health, Guangdong currently does not 
have the capacity to test all cases of HFMD for the EV 71 virus. 
Health officials report that no Guangdong HFMD patients are 
currently in critical condition, and Tang Xiaoping claimed that the 
EV 71 situation is under control.  According to the Guangdong Center 
for Disease Control (CDC), the most significant challenges ahead are 
preventing the spread of HFMD during June and July, the disease's 
peak season.  They are also working to prevent asymptomatic infected 
adults from infecting children. 
 
---------------------- 
Prevention and Control 
---------------------- 
 
¶5. (SBU) The Ministry of Health instructed local authorities to 
address HFMD outbreaks with the same vigilance as they would address 
SARS.  Guangdong's Department of Health has taken steps to control 
the outbreaks and prevent further spreading of the disease. Under 
the direction of the Department's director, an HFMD Prevention and 
Control Team has been established.  The team covers two areas -- 
disease prevention and control, and medical treatment.  In addition, 
the following measures have been implemented: 
 
-- Experts have been dispatched to affected areas to provide 
guidance and assistance to medical professionals and those 
infected. 
 
-- Guangdong health authorities have strengthened all monitoring and 
reporting efforts, including the requirement of hospitals to report 
all cases within 24 hours of detection to the Guangdong Department 
of Health. 
 
-- Authorities are increasing public awareness campaigns to outline 
methods of prevention, including visits to local nurseries and 
primary schools to educate teachers about proper hygiene methods. 
 
In the coming days, the HFMD task force is planning to focus 
attention on enhancing clinical care and diagnosis, and providing 
immediate training for local CDC personnel for HFMD screening and 
testing purposes. 
 
------------------ 
Reporting and Data 
------------------ 
 
¶6. (SBU) Officials disagree on how much more severe this year's HFMD 
outbreaks are compared to previous years. According to Dr. Tang 
Xiaoping of the Guangzhou Public Health Bureau, the number of cases 
seems to have risen this year; however, the President of Guangzhou's 
Children's Hospital said that the number of cases in Guangzhou is 
not significantly higher than last year.  The discrepancy is due in 
part to a lack of consistent data.  An expert from Guangdong's CDC 
told us that the apparent increase in cases in Guangdong is a result 
of this week's changes in reporting practices. Prior to May 2, the 
Ministry of Health did not classify HFMD as an infectious disease 
legally subject to reporting or requiring public notification; 
therefore, only outbreaks (classified as the occurrence of more than 
three cases), not sporadic cases, were reported.   Because of this, 
reports are now more regular, while statistical data on past 
outbreaks is sparse.  In 2006, Guangdong province reported 670 cases 
and Fujian province reported 240 cases; statistical data for 2007 is 
still unavailable.  The Guangdong Department of Health's Foreign 
Affairs Division Chief Feng Shaomin told us that inconsistent 
reporting has made it difficult to compare this year's outbreak to 
long-term trends, but it does represent a significant increase over 
¶2006. 
 
¶7. (U) Beijing Embassy ESTH has cleared this cable. 
 
GOLDBERG