Hand, Foot and Mouth Disease: New outbreak looming here

Cases last week just 12 short of epidemic level; numbers likely to rise
Lee Hui Chieh & Ang Yiying, Straits Times 23 Aug 08;

SINGAPORE is on the verge of a hand, foot and mouth disease (HFMD) outbreak, health officials revealed yesterday.

Last week, 553 people came down with the normally mild childhood disease that usually causes fever and rashes on the hands, feet and buttocks. That is just 12 fewer than the Health Ministry's official 'epidemic level'.

The tally last week was up from 415 over the previous seven days, and health officials warn the numbers are likely to rise between now and October, traditionally a peak period for HFMD.

This peak, though, usually affects fewer people than the first one from March to May, said Dr Lyn James, director of the Health Ministry's communicable diseases division. The reasons for the peaks are not known.

Still, the latest surge has already proven deadly. On Aug 6, Singapore registered its first death from HFMD since a severe outbreak from 2000 to 2001 killed seven children. Like most of those victims, three-year-old Marzuk Adi died from a severe form of HFMD caused by a virus called EV71.

This virus has been of particular concern to countries in Asia, which have been battling outbreaks of HFMD in recent years. This year, it has killed 44 in China, 10 in Taiwan and 11 in Vietnam.

The Health Ministry and the Regional Emerging Disease Intervention (Redi) Centre organised a two-day regional forum on HFMD, which was attended by more than 80 scientists and public health officers from 12 countries.

At the forum's last day yesterday, local vaccine company SingVax, Chinese vaccine company Sinovac Biotech and Taiwan's Centres for Disease Control gave updates on their progress in developing the world's first HFMD vaccine.

Both SingVax and Taiwan's CDC said they have seen good results in the laboratories and hope to start clinical trials next year.

In the absence of a vaccine, parents should ensure their children wash their hands, because the disease is often spread through saliva and faecal matter.

They should also take their children to the doctor at the first sign of symptoms, and keep them away from schools and crowded places, Dr James said.

Meanwhile, the school that Marzuk attended, Elias Kindergarten in Woodlands, reopened earlier this week after a 10-day closure to clean up.

When The Straits Times visited yesterday, about 20 to 30 children were in a queue waiting to have their teachers check their temperatures as well as hands and mouths to look for signs of HFMD.

The mother of one pupil, who wanted to be known only as Madam Hafizah, 29, said: 'The school has done its best to check. The school...and parents must know what to do.'