Nur Dianah Suhaimi, Straits Times 20 Apr 08;
The doctor who first identified hand, foot and mouth disease (HFMD) here 36 years ago is shocked at the recent rapid spread of the viral disease.
Since the current outbreak three weeks ago, more than 2,600 cases have been reported.
Dr Tay Chong Hai, 75, now a skin specialist in private practice, said it was 'unusual' to have 1,000 HFMD cases in a week.
A thousand people were infected two weeks ago.
'When the HFMD virus was first identified here in 1972, there were only 104 cases over three months,' he told The Sunday Times.
Dr Tay was first alerted to the HFMD virus in 1972 when his wife, Dr Caroline Gaw, then a polyclinic doctor, told him she was seeing cases of children with mouth ulcers and rashes.
After studying one patient's stool sample, he realised it was HFMD, which had already been found in the United States, Canada and Britain.
So far this year, 7,050 people have caught the disease. The majority are children. Although no one has died this time, one seven-year-old girl is in hospital with brain damage.
This may be the most serious HFMD outbreak since 2000, when an epidemic killed seven children.
Dr Tay said outbreaks can occur when there is a lowering of 'herd immunity' - that is, there are not enough immune individuals in a community to protect the rest from infection.
This year's spike and rapid spread could be due to more children in childcare centres, more air-conditioned spaces like malls and, possibly, a more contagious strain.
HFMD is a common childhood illness like chicken pox and measles. It is caused by intestinal viruses, the more common strains being Coxsackie virus and Enterovirus 71 (EV71).
Adults may get it as well but children, those under five in particular, are most susceptible.
The EV71 strain, which has infected some 16 per cent of HFMD patients here, is also more contagious, Dr Tay said.
Doctors say there will be outbreaks once every few years. Greater hygiene and isolation help in averting it.
Dr Tay said that unlike measles and chicken pox, there is no vaccine for HFMD. But he had some consolation for those hit by it.
'It's like measles and chicken pox. Once you get it, it's unlikely that you'll get it again.'
Worried families grapple with HFMD
Some childcare centres stand empty, while lives of those hit have been turned topsy-turvy
Nur Dianah Suhaimi, Straits Times 20 Apr 08;
Last week, Mr Frankie Loh drove back and forth daily between Malacca, where he had to attend to business, and Singapore so that he could be by the side of his only son.
Two-year-old Kieran, who had contracted hand, foot and mouth disease (HFMD), had been hospitalised.
This meant that Mr Loh, 35, had to spend five hours driving to and fro every day. The marketing executive said: 'Talk about exhaustion. I usually don't return home till my business trip is over.'
Other affected families have found their lives turned topsy-turvy since the current outbreak three weeks ago.
Children are being kept apart in affected households. Some parents have resorted to wearing masks and gloves.
HFMD is usually not fatal, and children make up the majority of the 2,600-plus cases in the recent outbreak.
Housewife Norjannah Mohammed Kamal, 31, and her husband decided to separate their two sons when the younger one came down with HFMD last Friday.
Their elder son is now staying with his grand-aunt in Sembawang while their younger son stays put at the couple's Ang Mo Kio flat.
'I had no choice. I don't want my elder son to get HFMD too,' she said.
In Madam Jessica Tan's case, it was she who came down with HFMD last week. She decided to stay with her parents so as not to infect her two children aged four and one. Her husband is caring for them.
'I burst into tears when I said goodbye to them. I couldn't even hug or kiss them,' said the 32-year-old manager.
IT trainer Zaid Ismail, 38, had to confine his eldest son, Umar Khalid, to his bedroom when the boy fell ill last week. Umar, seven, was also not allowed to play with his two younger brothers.
'His two-year-old brother missed him very much and would stand at the bedroom door asking to play with Umar,' said Mr Zaid, who started wearing a mask and gloves at home.
Despite the precautions, the entire family of five still ended up with HFMD. The youngest, a four-month-old baby boy, has been hospitalised.
Another parent, Ms Cathy Chan, 29, chose to apply for leave to look after both her sons when they came down with HFMD last week. Ms Chan, an administrative assistant, hopes to return to work this week.
Paediatrician Lee Bee Wah said it was a good move to keep young children, especially those below 18 months old, at home for the time being. Younger children fall sick easily, she added.
Meanwhile, some childcare centres, especially those with HFMD cases, are experiencing empty classrooms. At Averbel Child Development Centre in Yishun, the pre-school classes have become quiet since three children got HFMD last week.
Said principal Daphne Lee: 'Parents of the younger kids prefer to keep their children at home because they're afraid of the disease.'
However, Jollies Child Care Centre in Jurong West is optimistic that classrooms will soon be full again. Its classes have been empty after seven children contracted HFMD.
Said its spokesman: 'All the children are expected to turn up this week. The entire centre has been cleaned up.'
Additional reporting by Samatha Eng and Aw Cheng Wei
What is HFMD?
Straits Times 20 Apr 08;
HFMD is an illness caused by intestinal viruses, the more common strains being Coxsackie virus and Enterovirus 71.
The usual symptoms are:
Fever for two to three days
Sore throat and runny nose
Rash (flat or raised red spots, some with blisters) on the palms of hands, soles of feet, or buttocks
Mouth ulcers
Poor appetite
Vomiting and diarrhoea
Tiredness and weakness
Does HFMD affect only children?
No. Both adults and children can be affected, but children, particularly those under the age of five, are most susceptible.
What is the treatment?
No specific treatment is available, except medication to relieve the symptoms of the disease.
Can someone die from HFMD?
Most cases are mild. Occasionally, serious complications involving the nervous system, heart and brain can occur, which may lead to death.
