1997 Sarawak HFMD outbreak
The 1997 Sarawak HFMD outbreak is a hand, foot, and mouth disease outbreak from April until June caused by the Enterovirus 71 affecting 600 children in the state of Sarawak in Malaysia. An estimate from 28–31 of the infected children died as a result of the outbreak where it is known as the first HFMD cases in the country with high fatalities. The children died within hours of admission to hospitals due to acute congestive heart failure and cardiovascular collapse which was suggestive of acute viral myocarditis.Background
In the midst of simultaneous outbreak, Coxsackie B virus were initially thought to be the causative agent but not detected among the deceased children. Through autopsies performed on the deceased children, their deaths is caused by several symptoms linked to the disease such as poor peripheral perfusion, tachycardia and cardiac failures with earlier developed symptoms such as shock, pallor, cold extremities, delayed capillary refill and weak peripheral pulses.
