Number of new HFMD cases in Singapore soars past epidemic levels

Hoe Yeen Nie, Channel NewsAsia 5 Sep 08;

SINGAPORE : The number of new hand, foot and mouth disease (HFMD) cases in Singapore has reached epidemic levels for the first time since June this year.

This comes at a time when kindergartens are gearing up for a spike in cases when the new school term begins on Monday.

But doctors said that often it is the lack of proper hygiene at home that helps spread the disease.

HFMD is a common childhood infection, which typically sees two peaks each year.

617 new cases were reported last week - breaking the epidemic threshold of 565 cases. But this is below the numbers seen in the previous seasonal epidemic between March and May, which saw 1,466 new cases a week at its height.

Experts differ on how much impact the September holidays will have on infection rates.

The Health Ministry said that the one-week break might provide some relief, but some doctors think the time away from school may be too short to have a large effect. Furthermore, childcare centres continue to operate as usual during this time.

But with classes due to reopen on Monday, the PAP Community Foundation kindergarten in Woodlands Avenue 6 is taking no chances. Aside from increasing the frequency of checks, it also teaches its kids to look out for ulcers and sores on the palms, soles and buttocks.

Veronica Tee, administrator, PCF Sembawang, said: "The children already know that when they do feel unwell during class time, they need to let the teacher know. And we have also put in an added measure recently - by doing another check mid-way during class."

During an outbreak, kindergartens and childcare centres will minimise outdoor excursions and intermingling between children of different age groups.

Cherie Hearts, which operates a chain of 30 childcare centres here, said that it will also rope in healthy adult volunteers to help take care of children should its centres have to shut down.

It said this would help ease the load of those working parents who have difficulty taking leave.

NTUC Childcare said it provides hand sanitisers for visitors throughout the year.

Hand hygiene is also stressed at all centres, but some doctors said that not enough is being done at home.

Dr Thoon Koh Cheng, Department of Paediatric Medicine, KK Women's and Children's Hospital, said: "Strict hand hygiene is probably still overlooked. People let down their guard when the child is well, and when the child becomes sick, people let down their guard again by allowing them to go back to childcare centres and kindergartens when they are just on the brink of recovery."

One factor that could account for the rise in cases is the weather. The theory goes that during rainy weather, people tend to stay indoors, and this makes it easier for viruses to spread. - CNA/ms

HFMD: 617 children infected last week
Ministry tracking situation closely as number crosses epidemic level
Lee Hui Chieh, Straits Times 5 Sep 08;

WHEN school re-opens next week, parents should keep a close eye on their children and avoid sending them to school if they have the tell-tale symptoms of hand, foot and mouth disease (HFMD).

The number of children who came down with the common childhood affliction crossed the epidemic level last week, and looks likely to go up, going by past trends.

Last week, 617 children were diagnosed with the usually mild disease which causes fever and rashes on the hands, feet and buttocks, higher than the official epidemic level of 565 cases a week.

Ten children had to be hospitalised because their illness left them unable to eat properly.

But it is too early to declare that an HFMD outbreak is under way, as numbers fluctuate from week to week, and could come down this week, a spokesman for the Ministry of Health (MOH) said.

In fact, fewer children are expected to catch the disease from other children during this week, as it is the one-week school holiday period.

She added: 'A sustained rise above the epidemic level for two or more consecutive weeks is more significant, especially if there is a rising trend. MOH will continue to monitor the situation closely.'

Still, it is likely that numbers will continue to grow, as traditionally, more children are hit by HFMD between August and October each year.

The total number affected during this peak period tends to be lower than the other traditional peak period of March to May. As many as 1,466 children came down with the disease in a week in April at the height of the first peak this year.

The disease is of great concern to the authorities this year because the current predominant virus is EV71 that causes a deadly form of the disease.

This year, EV71 has caused four children to develop encephalitis, or inflammation of the brain lining.

One of them, a three-year-old boy, died last month - the first HFMD death here since seven children were killed, mostly by the same virus, in a severe outbreak in 2000 and 2001.

Mr James Hou, 36, a manager of an engineering company, is taking no chances after his four- year-old son came down with HFMD last week.

He took his son to KK Women's and Children's Hospital when the boy complained of a headache two days after being diagnosed with HFMD.

He said: 'If it's just fever, it's not unusual. But when other symptoms come, it's better to have a detailed check.'

He said that the family was particular about hygiene and handwashing at home, so his son had probably caught the disease outside.

So even though his son has recovered, he has kept both the boy and his five-year-old daughter away from their childcare centre because other children there came down with HFMD recently.

He has also banned them from going to playgrounds for the time being.