Boy with mystery illness improves . Child stricken with virus in serious condition but still in intensive care

2008.08.22 – South China Morning Post

A three-year-old boy stricken with an unknown viral infection was improving with treatment, Kwong Wah Hospital said last night.
His condition has been upgraded to serious – from critical – although he remains in intensive care.

“He has normal blood pressure. His fever is coming down,” a hospital spokesman said.

The boy is the fourth child in two weeks to fall seriously ill with suspected viral infections.

The boy, who lives in Mong Kok, had no recent travel history and was not attending kindergarten when he was taken ill, a spokesman for the Centre for Health Protection said.

The boy was feverish and vomiting when he was taken to the Yau Ma Tei hospital’s accident and emergency department on Tuesday.

He suffered convulsions and went into a coma. Doctors said he had symptoms of blood poisoning and of encephalopathy, inflammation of the brain.

The Education Bureau said it had sought the advice of the Centre for Health Protection about precautions schools need to take against the spread of infections.

A bureau spokesman said: “A letter has been issued to all schools reminding them to clean up and disinfect school premises before the start of the new school year [on September 1]. Parents are also reminded to continue to record the body temperature of their children for schools’ inspection every day.”

Two girls died last week and a seven-year-old girl remains critically ill in the intensive-care unit of Prince of Wales Hospital in Sha Tin with symptoms of encephalitis.

Investigators strongly suspected the children were infected by viruses, a medical source said.

Laboratory tests were being conducted at the University of Hong Kong, Chinese University and the Centre for Health Protection.

For a viral infection, there was not much in the way of specific treatment, the source said.

“Most of the time, the children will be given supportive treatment, such as monitoring vital signs,” he said. “If the child has breathing difficulty, they will be given oxygen or be aided with a breathing machine. Then they have to make sure the fluids are OK, the renal function is OK and hopefully the immune defence mechanism will take over so that the child will recover.”

He said it was important to monitor the frequency of cases.

“If these come in an outbreak situation, then it is cause for alarm as it might be like Sars,” he said, referring to the outbreak of severe acute respiratory syndrome in 2003. “Thus far this does not seem to be happening, but we must not be complacent.”

The cases were recorded under a paediatric surveillance programme launched in mid-March to monitor the trend of complications due to influenza-like illnesses and enterovirus infections in children.

Primary schools and kindergartens closed early for the Easter holiday to halt a rapidly spreading flu outbreak. So far, 78 cases of enterovirus 71 have been recorded this year, after severe outbreaks on the mainland.