Hand, Foot and Mouth Disease: Deadly strain infections up

Judith Tan, Straits Times 28 Mar 08;

Health Ministry tells parents and family doctors to be alert; may close pre-schools if situation worsens

HEALTH officials are warning parents about a rise in the number of cases of Hand, Foot and Mouth Disease (HFMD) caused by a potentially deadly strain of virus.

The strain, called Enterovirus 71 (EV71), was found in a 'higher' number of patients between mid-February and last Saturday, according to the Ministry of Health.

Officials, though, did not say how many people have come down with EV71, which can lead to infections in the brain, heart, and lungs.

A total of 3,721 people have contracted HFMD since the start of the year. A Health Ministry spokesman said a sample study had revealed that about 20 per cent of patients with the ailment tested positive for EV71.

During an outbreak in 2000-2001, the same strain killed more than 70 children in Asia, including seven in Singapore.

While none have died this year, health officials are still on the alert. Family physicians have been told to check for the virus and schools are keeping close tabs on young children, especially those under five who are most susceptible to the disease.

HFMD is a common childhood ailment and actually comes from over 60 different strains of viruses. These include Coxsackie A16, the milder strain that is more common in Singapore.

It causes ulcers, rashes and blisters and can infect adults.

The Health Ministry spokesman said that the spread of EV71 is 'above the normal range' compared with past years and that the ministry would consider closing pre-schools if the situation got worse.

The increase in infections coincides with the reopening of schools after the week-long March break.

During the 2001 outbreak, all kindergartens and childcare centres were closed for 12 days, affecting about 140,000 children.

A check by The Straits Times found that 10 people went to the National University Hospital between mid-February and Wednesday with HFMD.

A hospital spokesman said that out of the 10, only one patient was warded.

There were 14 cases treated at the KK Women's and Children's Hospital this month and the last - 10 of which were caused by the EV71 strain.

But the hospital would not disclose how many of the patients were warded.

Symptoms of infection include a fever lasting two or three days; sore throat; blister-like rashes on the hands, feet and bottom; mouth ulcers, vomiting and diarrhoea.

The virus is spread through contact with blister fluid, saliva, faeces, items used by an infected person and occasionally through the air.

EV71 strain responsible for recent spike in Hand, Foot & Mouth Disease
Tan Hui Leng, Today Online 28 Mar 08;

THE dreaded Enterovirus 71 (EV71) strain has been identified as that responsible for the recent spike in Hand, Foot and Mouth Disease (HFMD) cases.

Up until last Saturday, a total of 3,721 HFMD cases have been reported to the Ministry of Health (MOH) this year — up from 2,480 in the same period last year. The last two weeks, in particular, saw a sharp spike, with last week's figures hitting 585 — crossing the warning level of 565 cases.

Of the cases in the first 12 weeks of the year, 21 per cent of virus isolates tested positive for EV71.

This strain has on occasion been associated with "serious complications", noted the MOH. During the 2000 and 2001 HFMD outbreak, it killed seven children.

However, it is also important to grasp that most EV71 infections are mild in nature, said the MOH. "Many EV71 infections also pass unnoticed as they do not cause any symptoms to appear."

HFMD is a common childhood disease. Symptoms include fever, upper respiratory symptoms, rash with blisters on the palms and soles, and mouth ulcers.

Parents should consult a doctor early if their children exhibit symptoms.

Patients should remain at home and have limited contact with other children until all blisters have dried up.

There has not been any HFMD case involving serious complications this year.

Still, the MOH has asked all doctors to be on high alert. Pre-schools and schools have also been asked to step up hygiene measures. Pre-schools may be closed if necessary.

More HFMD cases reported this year
Channel NewsAsia 27 Mar 08;

SINGAPORE: There has been an increase in the number of Hand, Foot & Mouth Disease (HFMD) cases this year.

The Health Ministry (MOH) has received 3,721 reports so far. It is alerting doctors to be vigilant and to detect new cases early for treatment.

It is also working with the Education Ministry and the Ministry of Community Development, Youth and Sports to alert schools to step up measures against HFMD.

If necessary, the Health Ministry may require the closure of pre-schools under the Infectious Diseases Act.

HFMD is spread through direct contact with respiratory droplets. This includes saliva, faeces and blister fluid of an infected person.

Symptoms include fever, mouth ulcers and rashes with blisters on the palms and soles.

Children five years old and younger are the most vulnerable.

MOH has discovered high circulation of the Enterovirus 71 among infected persons since mid-February.

The re-emergence of the virus is of concern as there could be serious health complications.- CNA/so