Singapore: Hand Foot Mouth Disease

[Shiloh]

Source: http://www.todayonline.com/articles/248662.asp

Hot News // Wednesday, April 16, 2008
1,000 HFMD cases last week
Girl recovering from encephalitis, cause still unknown

Neo Chai Chin
chaichin@mediacorp.com.sg

A seven-year-old girl admitted into hospital with encephalitis, or inflammation of the brain, is being tested to determine if her condition resulted from the highly-contagious Hand, Foot and Mouth Disease (HFMD).
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Diagnosed with HFMD by a general practitioner on April 3, the girl was admitted to KK Women's and Children's Hospital (KKH) six days later for encephalitis, the Ministry of Health (MOH) announced yesterday.
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According to a KKH spokes-person, her condition has improved and she is recovering in a general ward at the hospital.
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The number of HFMD cases hit 1,000 last week, reaching epidemic levels not seen since 2001. Seven children died in the 2000-2001 HFMD outbreak, which led to the closure of childcare centres and nurseries in October 2000.
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An epidemic is declared when more than 500 cases are recorded in a week ? a threshold Singapore crossed about four weeks ago. A total of 6,315 HFMD cases have been reported so far this year.
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The MOH has detected a rise in the incidence of the deadly enterovirus-71 (EV71) strain of HFMD that caused at least four of the seven deaths in 2000-2001. EV71 can cause complications such as encephalitis and myocarditis, or the inflammation of the heart muscle.
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Mortality rates for encephalitis are high, doctors told Today.
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"About one-third of patients die, one-third suffer brain damage and one-third recover," said Dr Ang Poon Liat of Thomson Medical Centre's Paediatric Clinic.
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Symptoms of encephalitis include fever, severe headaches, drowsiness, fits, as well as HFMD symptoms such as mouth ulcers and rashes on the palms and buttocks, he said.
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What could account for the recent spike in HFMD cases?
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Doctors said it could be a number of factors, such as more children attending enrichment centres at a younger age, a possible mutation of the EV71 strain, as well as its interplay with the flu virus.
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"A lot of kids are going to school much earlier. Kids over a year old are being put in infant care," said paediatrician Ang Ai Tin. "And viruses have an incubation period where the kid is ill but no one knows about it. Meanwhile, the virus would spread within a group of children."
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The Influenza A virus could also be working "hand in glove" with the HFMD virus, "strengthening each other and having a greater impact on children", said Thomson Medical's Dr Ang.
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The MOH is working with the Ministry of Community, Youth and Sports and the Ministry of Education to monitor the situation as it steps up hygiene measures and checks. It has asked doctors to be more vigilant in spotting children with the symptoms.
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"HFMD is a well-known adversary. It is seasonal and most doctors will be watching out for it," said general practitioner Chong Yeh Woei.
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Parents should also ensure that their sick children avoid crowded places, including schools and childcare centres, until they recover, advised the MOH.

 

[Oracle]

Re: Singapore: Hand Foot Mouth Disease

"The Influenza A virus could also be working "hand in glove" with the HFMD virus, "strengthening each other and having a greater impact on children", said Thomson Medical's Dr Ang."

Nope. Not a bad medical guess; they co-occur for similar reasons, just as influenza A may co-occur in an outbreak area with Newcastle virus disease (NVD).

 

[Shiloh]

Re: Singapore: Hand Foot Mouth Disease

Source: http://www.iol.co.za/index.php?set_id=1&click_id=31&art_id=nw20080420090914355C845178

Hand, foot and mouth disease rapidly spreading in Singapore
Posted : Sun, 20 Apr 2008 02:34:02 GMT
Author : DPA

Hand, foot and mouth spreading rapidly

April 20 2008 at 12:44PM

Singapore - An outbreak of hand, foot and mouth disease (HFMD) has affected more than 2 600 people in three weeks, potentially the most serious spread of the virus in eight years, doctors said in a published report on Sunday.

The majority of those afflicted in Singapore are children. Although no one has died, a seven-year-old girl was in a hospital with brain damage.

"When the HFMD virus was first identified here in 1972, there were only 104 cases over three months," The Sunday Times quoted Dr Tay Chong Hai as saying.

Tai, the doctor who first identified HFMD in the city-state, said outbreaks can occur when there is a lowering of "herd immunity" or not enough immune individuals in a community to protect the rest from infection.

This year's spike and rapid spread could be due to more children in childcare centres, more air-conditioned spaces like malls, and possibly a more contagious strain, he said.

HFMD is caused by intestinal viruses. The most common strains are the Coxsackie virus and Enterovirus 71.

Adults may get the illness, but children under five are most susceptible.

The EV71 strain, which has infected 16 per cent of the patients, is also more contagious, Tay said.

There is no vaccine for HFMD.

Symptons include a fever, sore throat and runny nose, rash, mouth ulcers, vomiting, diarrhoea and weakness.

Some childcare centres have empty classrooms.

"Parents of the younger kids prefer to keep their children at home because they're afraid of the disease," said Daphne Lee, the principal at one such centre. - Sapa-dpa

 

[Shiloh]

Re: Singapore: Hand Foot Mouth Disease

Source: http://news.monstersandcritics.com/...eschools_childcare_centres_shut_amid_outbreak

Some preschools, childcare centres shut amid outbreak

Apr 23, 2008, 1:11 GMT

Singapore - Two preschools and five childcare centres have been told to temporarily shut down starting Thursday following outbreaks of hand, foot and mouth disease (HFMD).

Another seven preschools and six childcare centres in Singapore have been asked to voluntarily close for 10 days as the number of cases soars, health official said Wednesday.

Nearly 1,250 people caught the disease last week, a 25-per-cent jump over the preceding seven days, said Health Ministry data reported in The Straits Times. Of these, 16 were children who had to be hospitalized.

The new cases sent the total number afflicted to 7,560 since the beginning of the year. The last time schools were closed because of HFMD was in 2006.

The ailment causes ulcers, rashes and blisters.

The virus is transmitted through saliva, blister fluid and faeces. There is no vaccine.

Citing the re-emergence of the potentially deadly EV71 strain, a spokesman said that the Health Ministry was lowering its threshold for closing schools.

Officials said that closures will give schools and centres time to disinfect their toys and thoroughly clean their premises.