Treatment played key role in killer Cambodian children's disease

The doctor who first alerted the government to Cambodia’s “mystery illness” remains convinced that incorrect treatment in private clinics has played a critical role in the deaths of 64 children. 

“What was killing the children was in the last four hours of their lives. All of these children have had total destruction of their lungs,” Kantha Bopha Children’s Hospital founder Beat Richner said.

While the World Health Organization and the Ministry of Health put the case tally at 59 with 52 deaths, Richner says there have been 64 cases and 62 deaths in his hospitals alone.

Richner alerted the Ministry of Health on June 20 to a number of dramatic deaths in his hospitals since April where children mostly under 3 years old had died within 24 hours of being admitted.

Virology testing by Institut Pasteur Cambodia has since identified EV71 – an enterovirus that causes serious complications with Hand, Foot and Mouth disease – as being a common affliction in the children who have died.

WHO epidemiologist Dr Nima Asgari, who is working with the government in investigating the deaths, said the UN-agency had found a number of other pathogens, including dengue, were also implicated in the deaths and advised medical practitioners to stop the use of steroids in treating patients who may have EV71.

“Our investigation found that steroids had been used … and there have been studies of the treatment of patients [with EV71] that if you give steroids, those patients die,” Asgari said.

However, Richner, who is awaiting the results of his own toxicology testing being performed in Australia, said that to blame steroids for the deaths of the children was “nonsense”.

“All of the 62 children who died, were treated in private clinics first,” he pointed out. “I think there are wrong [blood transfusions], wrong treatment causing intoxication.

“Lots of medicines in Cambodia are fake or [faulty], and there is no controls over the private clinics buying these medicines,” Richner said. “We still do not know absolutely the reason that these children have died.”