HFMD, Not everything with "research" is worth believing

Every time an infectious epidemic/endemic breaks loose, there will be a whole barrage of "cures" or wonder ailments making waves on social media. Everything from traditional cures to so-called "latest" or cutting edge technology will claim to be the saviour you have been looking for.

This year (2018), HFMD is on the mouths and minds of every school child, parent and teacher. It has reached an all time high with fatalities starting to reported, and everyone fears for the worst. With everybody in this state of mind, telling people to use conventional preventive measures like keeping your hands clean doesn't sound as good as a miracle product that can guarantee continuous protection

The issue with all these new products is the lack of regulation. There isn't any strong regulatory bodies in Malaysia currently that governs these products, some with preposterous claims. The MDA or Medical Device Act was setup to handle this problem, but sadly when we tried contacting them, they still weren't sure if sanitizers and disinfectants are under their jurisdiction. The result is, ANYBODY, with ANY product can make ANY claim, and nobody will be able to tell if they are genuine or not. 

You may think "Well, at least some protection is better than nothing right?"

Wrong!

If the product is bogus (doesn't work as it should), parents will use these products on their children, under the false belief that they are now protected. This might actually INCREASE the rate of transmission due to the misleading information spread by these parties.

"But they have research!" is the most common protest we see when we try to educate our public. And sadly, this is the most commonly seen modus operandi right now in trying to market an unverified ailment.

Whenever somebody throws big words and lengthy scientific paper at you, 99% of our population will be impressed, and never bother to look through the papers AS LONG AS YOU HAVE PAPERS. Even the 20% of the scientific intellectuals of our population are most of the time convinced just by browsing the titles of the papers, never bothered to think one layer deeper.

Example 1

One product has claimed that they can create an ionic protective shield that can shield a child from HFMD if you sprayed it on the child's shirt. It has studies and research papers from many labs showing that it can kill viruses, bacteria and fungi.

While most people will say "oh, since you have studies, your product should be ok lah", we beg you to think again.

All the studies provided have been studies of direct antimicrobial effect on viruses. There are NO studies showing the prevention of transmission by spraying on clothes.

It is like to saying smoke is proven to repel mosquitos. Therefore if you smoke, you will be protected from Aedes mosquitos, and will not get dengue.

The rational of this claim is hard to be accepted because if it did work as claimed, no hazard suit, no N95 masks, no goggles will be needed in any viral outbreak anymore.

Perhaps they should carry out with a study where the researchers made mice wear small shirts, and split the mice into 2 groups. One group of mice will have the shirts sprayed on this product, and the other one nothing. Then expose these mice to enterovirus 71, and compare the infection rates between these 2 groups. I've practically designed the study for them, and hopefully they will pick this up and carry it out before claiming such methods.

If they did this study, then their claims will be much more accepted in the scientific community.

Example 2

A product has claimed to be ionic in nature, and has even better antiviral profile than alcohol. This product claims to be alcohol free, therefore they promote it to be halal, and safe for infants.

Problem: What they have is antiviral data, albeit from very peculiar sources. What they DON'T have, is patient safety data. They do not have any health authority sanctioning them, making the safety of this particular spray dubious. 

There are many many agents that can kill viruses, including ultraviolet light. But we don't go sanctioning using portable ultraviolet light for every school kid. Reason being we know how harmful UV light can be to our body if exposed for long periods of time. 

But imagine we didn't study these agents well enough and used them just because they are effective. We would be repeating mistakes done in the past, i.e. mercury being used to treat everything from syphilis and typhoid fever, to parasites. Paracelsus, a world renowned physician used mercury too, and it wasn't until 150 years later that people realised that mercury caused other problems, and at times worsened the original condition. 

This is where modern medicine differs. In order to be accepted as a viable treatment, modern medicine is subject to vigorous testing, and post marketing surveillance. That's why you hear about market recalls of certain drugs whenever something bad is reported.

So back to our topic of the day. Many of these marketed agents have certain test, verified by certain labs, to be effective to kill bacteria/viruses/fungi. But are they safe to be used on the human body, especially for infants? A rather disturbing thing happening I've noticed is that almost 90% of the marketed "latest technology" or "nano-ion" or "alcohol free" sanitisers will claim to be "safe for infants!" without any medical body certifying it. Meaning no one knows for sure what these agents do to our bodies, yet they are claiming that it is safe.

So what should we do? Whom do we trust?

For a lay person like you and I, we would not have the resources to carry out clinical experiments for every product that comes our way. Therefore, the only people we can trust is our governing bodies, notably being WHO, CDC, and FDA. These bodies do the research for us, and they are not out there to find ways to get rich quick. We need to also look closely at the certification granted by these bodies, for example if a product is licensed to be used as an disinfectant, IT DOES NOT MEAN THAT IT CAN SAFELY BE USED AS A SANITIZER AS WELL!

You can read what the CDC says about HFMD and how to prevent it here. The only thing CDC recommends apart from frequent hand washing is Alcohol hand sanitisers containing no less than 60% alcohol. Any brand will do, but the content of alcohol needs to be higher than 60%.

The following video teaches us the correct way of washing hands to ensure that they are clean:

 

When in doubt, think this way: 

If a product is as godly as they claim it is, why wouldn't the WHO and CDC use it to curb dangerous outbreaks like Ebola, Bird Flu etc? Why does the WHO and CDC still advocate the trusted old methods? If you ask these questions before buying into any claims, you will most likely be safe.