Close to 12,000 Chinese kids with HFMD

Experts expect more cases as weather warms; no link with other cases in region
Tracy Quek, Straits Times 6 May 08;

FUYANG (ANHUI PROVINCE) - THE number of children stricken with hand, foot and mouth disease (HFMD) in China has hit 11,905, resulting in 26 deaths. Health experts expect the numbers to rise as the weather warms.

Olympic host city Beijing, neighbouring northern Hebei province and the south-western Chongqing municipality were the latest to report cases yesterday, adding to the growing list of areas hit by China's most severe outbreak of HFMD in recent years.

The health authorities in Beijing said 1,482 children have taken ill, according to state media yesterday.

But the outbreak in the Chinese capital is not a threat to the August Games as it affects mostly young children, the World Health Organisation's (WHO) China representative, Dr Hans Troedsson, told reporters on Sunday.

Elsewhere in China, children - most under the age of six - have fallen ill in Anhui, Guangdong, Jiangsu, Hunan, Zhejiang and Hubei provinces.

Eastern Anhui province and southern Guangdong province are the worst hit. State media reported that 26 children have died.

Enterovirus 71, or EV-71 - the most vicious strain of the viruses which cause HFMD - has been blamed for the deaths of 22 children in Fuyang city in Anhui, three children in Guangdong and one in eastern Zhejiang province.

Around Asia, the virus has affected children in Hong Kong, Singapore, Taiwan and Vietnam.

HFMD, which could be caused by more than 60 viruses, is a common illness among children. It often starts with a fever, followed by blisters and ulcers in the mouth, and rashes on the hands and feet. Although highly contagious, the disease is usually mild and children recover within four to six days.

Dr Jeffery Cutter from the Communicable Diseases Division of Singapore's Ministry of Health said EV-71 seems to rear its head every two to three years.

'It is uncertain why certain viruses are more dominant in one year rather than another,' he said, but said it could be due to a build- up in the number of non- immune children in the interim period.

Singapore has seen more than 9,000 cases. EV-71 is responsible for one in five of the HFMD cases.

China this year also saw many more cases triggered by EV-71. In some cases, children infected with EV-71 can develop viral meningitis, encephalitis, pulmonary edema and paralysis. There is no vaccine.

Mr Peter Cordingley, WHO's spokesman for the Western Pacific region, said there is no connection between the various HFMD outbreaks across Asia.

'These are all localised infections inside the affected countries,' he told The Straits Times.

Dr Troedsson told The Straits Times the disease is prevalent during warmer weather.

Referring to Anhui, he said: 'From my discussions with the (Chinese) Ministry of Health, one thing was that this province was affected by snow storm..but after that, it had an unusual warm spell early this year - the question is if it was a bit warmer. But that's speculation, we don't know.'

HK can expect to see a spike
Caryn Yeo, Straits Times 6 May 08;

WITH thousands expected to travel across the border for the long weekend, Hong Kong could see a spike in cases of hand, foot and mouth disease in the coming weeks, an infectious disease expert warned yesterday. The city marks Buddha's birthday on May 12.

Dr Lo Wing Lok said that there was now a higher risk of travellers carrying the virus back to Hong Kong as the outbreak had spread to neighbouring Guangdong province.

'The problem is that there is no way to detect a carrier of the virus at the border,' Dr Lo told The Straits Times.

'The only thing the government can do is to be prepared for an increase in the number of cases, especially in establishments where there are a lot of children.'

He added that the number of cases is expected to rise between May and July - the traditional peak season for the virus.

Hong Kong has recorded 10 cases of the deadly EV-71 strain of the virus since the start of the year, with no fatalities so far. There were 12 cases for the whole of last year.

A kindergarten was ordered to close last week after 23 children developed symptoms of HFMD. One of them was infected with EV-71.

Mrs Luk Wai Kin, mother of a six-year-old girl, said her family had decided to cancel their monthly shopping trip to Shenzhen.

'After the experience with Sars, I think it's better to be safe than sorry,' she told The Straits Times.

60 severe cases in Taiwan
Ong Hwee Hwee, Straits Times 6 may 08;

TWO children, aged one and three, have died in Taiwan this year after being infected by enterovirus-71, or EV-71.

As of yesterday, there were 60 severe cases of intestinal virus infection, compared to 12 in the whole of last year. All but two of this year's cases were caused by EV-71.

The Taiwan health authorities are expecting the numbers to climb, peaking next month.

'We have seen a huge jump in severe cases this year,' said Dr Chou Jih-haw, deputy director of Taiwan's Centre for Disease Control.

'Many Taiwanese children below five years old have never been infected with intestinal virus, hence they have no resistance against it,' he told The Straits Times.

But officials said that they do not expect a repeat of a major outbreak in 1998 when 78 children died and 405 others were left with severe neurological complications.

Dr Chou said that there was no evidence to suggest that the cases in Taiwan were related to the outbreak in China and other Asian countries. 'The patients have no record of travelling overseas,' he said.

So far, media coverage on the EV-71 outbreak has been relatively muted.

'I will still send my children to the childcare centre,' said Ms Du Juan, 41, who has two children aged three and six. 'But I will make sure that they stay at home if they are unwell.'