In 2012, Chinese scientists were studying a possible connection to the "failure of polio vaccine efficacy" or ‘take’ and sporadic (Hand, Foot and Mouth Disease) epidemics. This complicated study from China, researchers appeared to indicate polio vaccine triggered hand foot and mouth disease in children due to the connection of the Enterovirus 71 (EV71). According to the CDC the Enterovirus 71 (EV71), a Hand, Foot, Mouth disease-associated serotype that has been linked to polio-like syndrome permanent paralysis and more severe disease outcomes.
Correction:This article has been updated. The original version of this article stated that the polio vaccine is contaminated with EV71, a virus within the same family as the poliovirus, which can cause HFMD. While this is certainly possible, HFI was unable to find evidence of this and was in error making this claim. The second claim, that the polio vaccine could cause outbreaks of HFMD, was based on a misinterpretation of the scientific research. While the polio vaccine may influence outbreaks of HFMD, it is unclear from the literature whether it may impart a positive (protective) or negative impact. More research on this subject is needed.
Hand Foot and Mouth Disease (HFMD)
With the imminent eradication of Polio worldwide (1), non-polio enteroviruses have gained traction as a major public health threat during the recent two decades (2-4), commonly manifesting as the hand, foot and mouth disease (HFMD). Associated with infections by a plethora of human enteroviruses (5-9), HFMD is a highly infectious and common childhood affliction in many countries. Endemic countries, particularly in the Asia-Pacific, experience outbreaks of HFMD every 2 to 3 years or even yearly (9-12). These periodic outbreaks have put a strain on the public healthcare infrastructure with increased patient visitation and inconvenience from childcare facility closures, in a bid to contain localized outbreaks. 5
Viruses from the group called enteroviruses cause HFMD. There are many different types in the group including polioviruses, coxsackieviruses, echoviruses and other enteroviruses. Coxsackievirus A16 is the most common HFMD strain in the US, except Coxsackievirus A6 predominated in 2011-12. Coxsackievirus A6 causes more severe illnesses, sometimes needing hospitalization. Enterovirus 71 (EV71), a HFMD-associated serotype that has been linked to more severe disease outcomes (13,14) this is what concerned researchers in China.
Finding the source of the outbreaks is not as important since according to the Bill Gates Foundation, the Chinese Government Officials have approved two HFMD vaccines for their country's children.2, 4
Hand, foot, and mouth disease (HFMD) is a common viral illness that usually affects infants and children, but can sometimes occur in adults. Coxsackievirus A16 is the most common cause of HFMD, but other viruses, such as Entervoirus 71 (EV71) has also been associated with such cases. Of these two viruses, EV71 infection is associated with a higher death rate and is primarily responsible for fatalities and outbreaks in Southeast Asia. HFMD is typically a benign and self-limiting disease, but a minority of individuals with HFMD may require hospital admission due to rare complications such as inflammation of the brain and the meninges (protective membrane of the brain and spinal cord) or acute flaccid paralysis (weakness or paralysis of the muscle without other apparent cause).
HFMD has recently emerged in the Asia-Pacific region as the most severe epidemic disease affecting children with causes polio-like syndrome permanent paralysis.
Some outbreaks of EV71 HFMD in the Asia-Pacific region have been reported since 1997. Over the years, outbreaks have been reported in Malaysia, Taiwan, mainland China, Australia, and Singapore among other areas in the region, making EV71 a public health threat to children in Asia. According to the statistics from National Health and Family Planning Commission of China from 2008 to 2013, more than 9 million cases of HFMD were reported, resulting in around 2,700 reported deaths. For the period 2008 to 2012, around 80% of the severe cases and over 90% of fatal cases were caused by EV71.2
Hand, foot, and mouth disease (HFMD) is a common viral illness that usually affects infants and children, but can sometimes occur in adults. Coxsackievirus A16 is the most common cause of HFMD, but other viruses, such as Entervoirus 71 (EV71) has also been associated with such cases. Of these two viruses, EV71 infection is associated with a higher death rate and is primarily responsible for fatalities and outbreaks in Southeast Asia. HFMD is typically a benign and self-limiting disease but a minority of individuals with HFMD may require hospital admission due to uncommon complications such as inflammation of the brain and the meninges (protective membrane of the brain and spinal cord) or acute flaccid paralysis (weakness or paralysis of the muscle without other obvious cause).
July 21, 2018 BREAKING NEWS Concerns over China's vaccine manufacturing:
Spread of HFMD
Hand, foot, and mouth is a contagious disease and can easily spread from person to person. The virus spreads through the saliva, nasal discharge, and through the stool. The sick child will be most contagious during the first week and if you’re worried about whether your exposed child is going to get sick, there is a 4-6 day incubation period for the virus. (This means from exposure to a sick person, the child would become sick after the incubation period.) Could the oral polio vaccine used in China contribute to the outbreaks as young children as they are given the Polio vaccine at 2, 3, and 4 months and again at 4 years? 3
Immunity after Infection?
There is only some cross-immunity between different enteroviruses; adults usually have had multiple strains. It is possible to be infected numerous times by various strains. It has also been noted by many adults that infection is more severe in the adult populations.
- Ang LW, Koh BK, Chan KP, Chua LT, James L, Goh KT. Epidemiology and control of hand, foot and mouth disease in Singapore, 2001–2007. Ann Acad Med Singapore. 2009; 38:106–12.
- China FDA http://app1.sfda.gov.cn
- Hand-foot-and-mount disease. Mayo clinic. Available at http://www.mayoclinic.org/diseases-conditions/hand-foot-and-mouth-disease/basics/causes/con-20032747 [Accessed 06 January 2016].
- Ho M, Chen ER, Hsu KH, Twu SJ, Chen KT, Tsai SF, et al. An epidemic of enterovirus 71 infection in Taiwan. Taiwan Enterovirus Epidemic Working Group. N Engl J Med. 1999; 341:929–35.
3. China Vaccine Schedule: https://gumroad.com/l/ynTp