According to BS.CK2 Do Chau Viet, Head of the Department of Intensive Care and Infectious Diseases, Children's Hospital 2, the first case was a boy P.D. K. (born in 2025, Ho Chi Minh City). Two days before being admitted to the hospital, the child had a fever and was diagnosed with sore throat at a nearby clinic. After that, the child appeared with a discreet rash and was diagnosed with hand, foot and mouth disease. Although admitted to a lower-level hospital, the patient's condition quickly worsened with symptoms of sweating in the head area, shortness of breath, and respiratory failure.
The patient was intubated and urgently transferred to Children's Hospital 2. Here, the child was diagnosed with grade 4 hand, foot and mouth disease, strain EV71, which is the agent causing the disease to worsen rapidly, the child was immediately ventilated, blood filtered and used cardiotonie. After more than 3 days of intensive treatment, the baby was out of danger, discharged from the ventilator, switched to CPAP breathing and continued to monitor the risk of neurological sequelae.
The second case is baby boy D. H. T. (born in 2023, Khanh Hoa province). The child had a fever, pink rash appeared, so the family took him to the doctor early. However, after that, the child showed signs of startling, staggering gait. Although IVIg was given and monitored in the resuscitation room, the condition continued to worsen with a high fever of 39 degrees Celsius, breathing tired, pulmonary edema, heart rate increasing to 230 beats/minute, and abnormal blood pressure fluctuating.
When transferred to Children's Hospital 2, the child was in a state of respiratory and cardiac failure, SpO2 was only 75%. Determining that this was also a case of EV71 strain attack, doctors immediately prescribed mechanical ventilation, blood filtration and vasopressors. After 6 hours of intensive treatment, the cardiovascular condition improved; after 3 days, the child was discontinued blood filtration and continued to monitor neurological sequelae.
According to Dr. Do Chau Viet, grade 4 hand, foot and mouth disease often leaves neurological sequelae with different degrees. In particular, the Ho Chi Minh City Center for Disease Control recorded that EV71 strain currently accounts for about 56% of specimens from the beginning of 2026. This virus is mainly transmitted through the digestive tract and direct contact with patient secretions.
The worrying point is that children infected with EV71 often have very little or discreet rash. Many cases are hospitalized in a state of respiratory failure, heart shock without obvious symptoms of rash or mouth ulcers. The virus can directly attack the central nervous system, causing acute brain damage and leading to rapid death within 12–24 hours.
Doctors recommend that parents take their children to a medical facility immediately when the following warning signs appear, even if they have not seen a rash or mouth ulcers:
Startle repeatedly, especially ≥2 times in 30 minutes.
High fever above 39 degrees, prolonged and difficult to lower.
Walking erratically, trembling limbs, loss of balance.
Frequent vomiting, prolonged fussiness, lethargy or abnormal restlessness.
Doctors emphasize that when hand, foot and mouth disease begins to affect the nervous system, every minute of delay can threaten children's lives. Early detection and timely hospitalization are decisive factors to help reduce the risk of severe complications.
