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CDC - Outbreak Notice - HFMD in Asia

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  • CDC - Outbreak Notice - HFMD in Asia

    Outbreak Notice
    Hand, foot, and mouth disease in Asia
    This information is current as of today, July 03, 2008 at 17:33

    Updated: July 03, 2008

    Situation Information

    Since March 2008, a growing number of cases of hand, foot, and mouth disease (HFMD) have been reported in parts of Asia, mainly affecting children. HFMD is common among infants and children. It is very contagious and is spread through direct contact with the nose and throat secretions, saliva, blister fluid, or stool of an infected person. A large number of cases in the current outbreaks of HFMD in Asia are reportedly caused by enterovirus 71 (EV71). However, other strains of enterovirus can also cause HFMD.
    In addition to the countries listed below, other countries in the Western Pacific have also increased surveillance for HFMD.

    On June 16, 2008, the Chinese Center for Disease Control and Prevention (China CDC) posted a notice confirming that the HFMD outbreak peaked on May 14, 2008, and is now in decline. According to Ministry of Health spokesman Mao Qun?an, although over 176,000 cases were reported last month, the number of daily reported cases decreased from 11,501 during the outbreak?s peak to 3,922 by June 5, 2008. The provinces which have been most affected by this outbreak are Guangdong, Zhejiang, Hebei, Shandong, and Hunan. A joint report from China CDC and the Office of the World Health Organization in China, released May 19, 2008, states that cases have also occurred in other provinces, including Anhui, Hebei, Hubei, Henan, Jiangsu, Jiangxi, Shaanxi, Sichuan, and Yunnan, and in the municipalities of Beijing and Chongqing. As of June 16, 2008, over 370 cases have also been reported in Macau, according to China CDC.
    Of the HFMD cases reported in China, most were in children 5 years of age and younger, and of those tested in laboratories, the majority were caused by EV71.
    The Chinese government has enhanced its surveillance, prevention, and control activities, including implementing a public awareness campaign and monitoring water quality.
    Hong Kong

    As of July 2, 2008, a total of 100 cases of HFMD have been reported in Hong Kong, with 66 (66%) of the cases caused by EV71.

    As of July 2, 2008, the Ministry of Health in Singapore has reported a total of 15,776 cases. Since the end of May the number of cases reported each week has been decreasing. Of these, none had serious complications and none were fatal. As of June 3, 2008, 32% of cases tested this year in the Ministry?s sentinel surveillance system were positive for EV71. The Ministry is working closely with preschools and child-care centers to help limit the spread of HFMD and stresses the importance of good personal and environmental hygiene, especially for children.

    On June 30, 2008, the Central News Agency reported that the Taiwan Centers for Disease Control (Taiwan CDC) had confirmed a total of 272 cases this year, including 9 deaths. Due to the decreasing numbers of cases reported each week, Taiwan CDC is reporting that the outbreak is waning. The importance of good hygiene and prompt medical attention for children showing severe symptoms has been encouraged.
    Prevention Measures for Travelers

    No vaccine is available to prevent HFMD. There is no specific treatment for people who are sick with this disease other than treating symptoms, such as fever.
    Travelers can take steps to prevent getting HFMD by practicing good personal hygiene and following safe food and water practices. If you are traveling in general, and especially to areas where HFMD has been reported, follow these tips to help make healthy choices:
    • Wash your hands frequently with soap and water for 20 seconds, especially before you eat, after you cough or sneeze, and after you go to the bathroom. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol). Consider packing alcohol-based hand gel in your luggage to ensure you have it when needed.
    • Eat foods that are fully cooked and served hot.
    • Drink beverages that have been properly bottled and sealed (water, carbonated drinks, or sports drinks).
    • Do not put ice in drinks.
    • Eat only fruits and vegetables that you can wash (with boiled or bottled water) and peel yourself.
    • Do not share eating utensils, such as forks, spoons, and cups.
    Adults should help child travelers to follow these recommendations. Infants, children, and adolescents are more susceptible to infection and illness because they are less likely than adults to have cells that fight infection from previous exposures to the enteroviruses that cause HFMD. Infection results in immunity to the specific virus that caused HFMD. A second episode of HFMD may occur following infection with a different member of the enterovirus group.
    Additional Information

    Hand, foot, and mouth disease

    HFMD is an illness caused by certain strains of enterovirus, including EV71, which are common worldwide. Outbreaks of HFMD caused by EV71 are not uncommon and have been reported by countries throughout the Asia-Pacific region in recent years. EV71 can be spread from person to person by direct contact with nose and throat secretions (e.g., by coughing or sneezing), saliva, fluid from blisters, or the stool of infected persons. People sick with HFMD often experience symptoms such as fever, sores in the mouth, and a rash, occasionally with blisters. HFMD caused by EV71 may sometimes lead to serious complications, including swelling of the brain (encephalitis). Most cases of HFMD occur in children under 10 years of age, but adults can also become infected.
    For more information, see:Disease situation in Asia

    Hong Kong

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