手口足症近四千病例

到底是
　手口足症，
　　或手足口症，
　　　還是口足手症？

　　學校放假了，孩童不高興，父母也憂心，砂州教育部指示所有小學取消在三月11-19日學校假期內進行的課外活動。孩童們要過一個提心吊膽的假期了。

　　3月12日的報導砂手足口症已達4,121宗病例，這三天的新病例是10日251宗，11日213宗，12日251宗，因此新病例有下降之趨。
　　國際時報http://www.intimes.com.my/news/gnews.htm
　　聯合日報http://www.uniteddaily.com.my/20060313/
　　
　　3月10止，共3,984宗，死亡病例6宗，
　　詳情瀏覽衛生局網頁www.sarawak.health.gov.my，
　　若欲知更多手口足症資料可以到下列網站參閱：

1.Medical Encyclopedia　
　http://www.nlm.nih.gov/medlineplus/ency/article/000965.htm#visualContent
2.Dr Green
　 http://www.drgreene.com/21_1103.html
3.美國的Centers for Disease Control and Prevention
　 http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm
http://www.edcp.org/factsheets/handfoot.html　

　　名稱混淆
　　最近因為手口足症的流行，報章也出現名詞上的爭執，到底是手口足症，還是手足口症，是手後的口先還是足先？按照一般英的名稱是Hand, foot, and mouth disease (HFMD)應該是手足口症，不過按照華文從英文翻譯則應該是口足手症才對。
　　不過無論如何，手口足症，手足口症或口足手症，大家都知道指的就是現在這種發生在孩童身上的腸胃症由腸病毒enterovirus所引起的病症，目前砂州情況就是En71型病毒所引起的。

　　詩巫登上國際舞台
　　詩巫人因為有了1997年的經驗，一般統稱柯沙奇或柯萨奇病症，當然就是由柯沙奇病毒： coxsackieviruses所引起的。這種病毒是當時純粹Made in Sibu所以引起了聯合國衛生組織(WHO)的注意，詩巫很少會登上國際舞台，卻因為柯沙奇舉世關注，該文如下：

聯合國衛生組織網頁http://www.who.int/

聯合國衛生組有關詩巫柯沙奇相關報導
http://www.who.int/csr/don/1997_07_03/en/
1997 - Fatal myocarditis in Malaysia
03 July 1997 Disease Outbreak Reported
Report from the Ministry of Health, Malaysia, dated 28 June 1997 regarding the cluster of deaths among infants and young children during an outbreak of hand, foot and mouth disease in Sarawak, Malaysia.
　　On 14 April 1997, a 19-month old boy was admitted to the Sibu Hospital Sibu, Sarawak, Malaysia, with a 3-day history of fever and oral ulcers. On examination, he showed poor peripheral perfusion and tachycardia, subsequently developed cardiac failure, and died on 15 April 1997. Since then, 26 more children in several cities in Sarawak have died of heart failure, and 2 others who were brought in dead are suspected to have died of similar cause. Eighteen (62%) of the 29 children were male. Their mean age was 1.6 years (range 7 months to 6 years); 23 (79.3%) of 29 were less than 2 years old.
　　The 27 children who were admitted alive presented with or soon thereafter developed signs of shock, including pallor, cold extremities, delayed capillary refill, and weak peripheral pulses. Pulmonary oedema was present in many cases; intravenous fluids often exacerbated the oedema. Nearly all the children had sinus tachycardia on electrocardiogram; no rhythm disturbances were noted. Echocardiograms obtained on most patients uniformly showed a poorly contractile globular left ventricle with low output (ejection fraction <60%).>Update 30 June: The Sarawak Health Department informed of an additional fatal case in a 2-year-old boy from Sarikei Division who died from viral myocarditis in Sarawak General Hospital on 30 June. Update posted on the web site of Sarawak Health Department at http://www.jaring.my/jkns/outbreak/virus1.htm
　　Epidemiological and laboratory investigations are underway. Several enteroviruses have been isolated from clinical specimens obtained both from children who died and those with uncomplicated hand, foot and mouth disease. Two isolates have been identified as enterovirus 71; further identification of the remaining isolates is in progress.