Malaysia: Country on alert for HFMD

The Star 17 Jun 16;

PETALING JAYA: Hand, foot and mouth disease (HFMD) has reached outbreak proportions, forcing the authorities to take urgent measures to contain it.

The Health Ministry has placed the country under the “alert level” following last week’s 1,379 cases nationwide with Selangor, Johor and Kuala Lumpur topping the list.

Health director-general Datuk Dr Noor Hisham Abdullah said there was an increase of 83 cases or 6.4% as compared with 1,296 cases the week before.

“The upward trend began in the last week of April with 794 cases.

“A directive was issued in early May to all state health departments to step up monitoring and preventive efforts,” he said.

Selangor has the highest number of cases with 4,441 (32.6%), followed by Johor 1,393 (10.2%), Kuala Lumpur 1,317 (9.7%), Sabah 1,299 (9.5%) and Sarawak 1,108 (8.1%).

In Negri Sembilan, health authorities have closed 12 nurseries and preschools to enable disinfection procedures to be carried out there.

State health director Dr Abdul Rahim Abdullah said the outbreak of the disease was also detected in six houses.

“Up to Sunday, a total of 485 HFMD cases have been reported.

“So far, there is no new outbreak besides the 18 spots,” he said, adding that nurseries and preschools in Taman Seri Pandan, Seremban, were among the first affected areas.

An alert will be put out to warn the public if the number of weekly cases exceeds 20.

Last month, the number of cases shot up to 87 in the fourth week from 28 in the second week.

In Kuala Terengganu, there was a 35% increase in cases as the authorities took prompt action to inspect day care centres, kindergartens and surroundings.

State Health, Women, Family and Community Development Committee chairman Datuk Muhammad Pehimi Yusof said 165 cases were reported in the first five months this year, a surge from 122 cases for the whole of last year.

In Ipoh, the number of cases was dropping, from a peak of 25 cases between February and May.

Perak health director Datuk Dr Juita Ghazalie said it was a cyclical pattern in which the disease would rise every two years.

Dr Juita said useful information on the disease had been disseminated to all parties and a sentinel surveillance laboratory set up at Taiping and Seri Manjung Hospital to monitor the situation closely.

HFMD is highly contagious and caused by enteroviruses, particularly the Coxsackie A16 and Enterovirus 71 strains.

Symptoms include fever, sore throat, rashes on the hands and feet, and mouth ulcers.

In severe cases, patients can come down with other complications such as meningoencephalitis or myocarditis and may even result in death.


Malaysia issues warning as number of HFMD cases spikes
The increasing trend in HFMD cases was seen in Apr 24 to Apr 30, during which 794 were recorded, surpassing the warning level of 644 cases a week, says the country's director-general for health.
Channel NewsAsia 16 Jun 16;

PUTRAJAYA: A total of 1,379 cases of hand, foot and mouth disease (HFMD) were recorded across the country from Jun 5 to 11, an increase of 83 cases (6.4 per cent) compared to the previous week's 1,296.

Director-general for health Noor Hisham Abdullah said the increasing trend in cases of HFMD was seen in Apr 24 to 30, during which 794 cases were recorded, surpassing the warning level of 644 cases a week.

"The Ministry of Health issued a warning letter on the increasing number of HFMD cases in Malaysia on May 9 to all state health departments so that they can improve monitoring efforts to prevent it from spreading,” he said in a statement on Thursday (Jun 16).

Dr Noor Hisham said Selangor recorded the highest number of cases (4,441), followed by Johor (1,393), Kuala Lumpur (1,317), Sabah (1,299), Sarawak (1,108), Perak (892), Melaka (727), Penang (713), Negeri Sembilan (522), Pahang (345), Kedah (265). Other states had less than 200 cases.

He said the three districts in Selangor with the high number of cases were Petaling (1,626), Hulu Langat (1,172) and Klang (618).

Dr Noor Hisham said HFMD is endemic in Malaysia and occurs throughout the year, and has a cyclic trend which peaks every three years.

He said that although the disease is due to several types of viruses which mostly cause a mild to moderate infection only, the infection from Enterovirus 71 (EV71) can be severe and can bring death.

He added that the most HFMD cases were caused by the Coxsackie A16 Virus and EV71, and is spread by contact with saliva, liquid blisters and faeces of infected people. It has an incubation period of between three to five days.

Dr Noor Hisham said most mild infections have symptoms of a high fever followed by rashes at the hand, foot, mouth and tongue. Patients can recover without medical treatment within seven to 10 days.

He further explained that children can also have other symptoms such as vomiting, diarrhoea and poor appetite.

However, Dr Noor Hisham said EV71 infections can cause severe complications such as encephalitis and myocarditis, though it is very rare.

"This disease quickly spreads at the rate of almost 100 per cent among children aged less than 10 years, especially in areas such as nurseries or kindergartens," he said.

Thus, he said, a parent or guardian of a child with signs of infection should adopt preventive measures such as not bringing them to public places, schools, nurseries, kindergartens or care centres because it can spread the infection.

He said children suspected of being infection should be brought to a doctor for treatment, and advised practising good hygiene by washing hands with soap and clean water after using the toilet or changing diapers.

Children’s toys, floors and toilets should also be cleaned, especially with chlorine, in addition to using separate eating and drinking utensils and not sharing items with other children.

- Bernama/ec