In 2012 in Cambodia, 52 of 59 reviewed cases of children reportedly dead (as of July 9, 2012) due to a mysterious disease were diagnosed to be caused by a virulent form of HFMD. Although a significant degree of uncertainty exists with reference to the diagnosis, the WHO report states, "Based on the latest laboratory results, a significant proportion of the samples tested positive for enterovirus 71 (EV-71), which causes hand foot and mouth disease (HFMD). The EV-71 virus has been known to generally cause severe complications amongst some patients." HFMD infected 1,520,274 people with up to 431 deaths reported at the end of July in 2012 in China. In 2018, more than 50,000 cases have occurred through a nationwide outbreak in Malaysia with two deaths also reported. India 2022
An outbreak of an illness referred to as tomato fever or tomato flu was identified in the Kollam district on May 6, 2022. The illness is endemic to Kerala, India and gets its name because of the red and round blisters it causes, which look like tomatoes. The disease may be a new variant of the viral HFMD or an effect of chikungunya or dengue fever. Flu may be a misnomer.The condition mainly affects children under the age of five. An article in The Lancet states that the appearance of the blisters is similar to that seen in monkey pox, and the illness is not thought to be related to SARS-CoV-2. Symptoms, treatment and prevention are similar to HFMD.
Treatments / countermeasures
There has been a great deal of research into potential methods to relieve the effects of sleep inertia. The demand for remedies is driven by the occupational hazards of sleep inertia for employees who work extended shifts such as medical professionals, emergency responders, or military personnel. The motor functioning and cognitive ability of these professionals who must immediately respond to a call can pose a safety hazard in the workplace. Below are some of the various methods that have been suggested to combat sleep inertia. Napping
When a person is sleep deprived, re-entering sleep may provide a viable route to reduce mental and physical fatigue but it can also induce sleep inertia. In order to limit sleep inertia, one should avoid waking from the deeper stages of slow-wave sleep. The onset of slow-wave sleep occurs approximately 30 minutes after falling asleep, therefore a nap should be limited to under 30 minutes to prevent waking during slow-wave sleep and enhancing sleep inertia. Furthermore, self-awakening from a short nap was shown to relieve disorientation of sleep inertia as opposed to a forced awakening, but these results may warrant more research into the nature of arousal after sleep periods. Caffeine
Caffeine is a xanthine derivative that can cross the blood-brain barrier. The caffeine present in coffee or tea exerts its stimulating action by blocking adenosine receptors in the brain. By antagonizing the adenosine receptors caffeine limits the effects of adenosine buildup in the brain and increases alertness and attentiveness.