Singapore - HFMD

[Commonground]

April 24, 2008
Closed schools begin disinfecting premises
By Judith Tan , Lee Pei Qi and Sumathi V Selvaretnam
AS preschools and childcare centres across Singapore close their doors amid an outbreak of hand, foot and mouth disease (HFMD), the Health Ministry has begun providing daily updates on new cases, breaking from its routine of weekly bulletins.

Between Saturday and 3pm on Thursday, 880 new cases of the common childhood virus were reported, bringing the year's total to 8,440.

While the weekly trend is still rising, there are signs the virus could be slowing. The number of patients falling sick has dropped in each of the last four days, bottoming out at 46 on Thursday.

In the wake of the outbreak, at least 16 schools have, or will, close.

Another nine have been asked to voluntarily pull down the shutters, including six that were added to the list on Thursday.

CENTRES ORDERED CLOSED BY MOH
Centres ordered closed by MOH

Ramakrishna Mission Sarada Kindergarten
... more
Meanwhile, Thursday was also the first day of spring cleaning at the shuttered schools.

Teachers, principals, caregivers and administrative staff rolled up their sleeves to swab the centres from top to bottom. The disinfection is designed to halt the transmission of HFMD, which is spread through saliva, blister fluid, faeces and occasionally droplets in the air.

At PCF Tampines East, which was asked to voluntarily close, professionals were called in to service airconditioners and fumigate.

'We are making sure that every single corner of the centre is clean,' said general manager Mr Benny Yeo.

While the side effects of HFMD are normally mild, the emergence of a potentially lethal strain of the virus has worried health officials.

CENTRES ORDERED CLOSED BY MOH
Centres ordered closed by MOH

Ramakrishna Mission Sarada Kindergarten
St Andrew's Cathedral Child Development Centre
Al-Istiqamah Mosque Kindergarten
Just Kids@Jurong
NTUC Childcare Co-operative (Compassvale)
Pat's Schoolhouse (Halifax Road)
Learning Vision@Work (KKH)
PCS Jurong West Centre
Centres that will heed a request to voluntarily shut their doors

Cherrybrook Kindergarten
Holy Trinity Kindergarten
PCF Sengkang West
PCF Tampines East
PCF Punggol East
NTUC Childcare Co-operative (Anchorvale)
St James Church Kindergarten
Kinderland Preschool (Yio Chu Kang)
PCF Moulmein - Tai Pei Childcare & Development Centre
Centres planning to stay open despite being asked to voluntarily close

NTUC Childcare Co-operative (Toa Payoh)
Brighton Montessori (Frankel Avenue)
Learning Vision@Work (TTSH)

http://www.straitstimes.com/Latest+News/Singapore/STIStory_230691.html

 

[Shiloh]

Re: Singapore - HFMD

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

Health News
Singapore teachers join cleaners as outbreak toll rises

Apr 25, 2008, 6:00 GMT

Singapore - Teachers, administrative staff and cleaners scrubbed Singapore preschools and child-care centres Friday to curb an outbreak of hand, foot and mouth disease after 880 new cases were reported in four days.

With the latest Health Ministry data showing this year's total infections at 8,400, officials were now providing daily updates instead of weekly ones.

At least 16 schools have been closed because of the outbreak. Another nine have been urged to voluntarily shut down for 10 days.

The disinfection is aimed at halting the transmission of the disease, which is spread through saliva, blister fluid, faeces and droplets in the air. Professionals have been called to service air-conditioners and fumigate.

The symptoms of the disease are usually mild and include ulcers, rashes and blisters, health officials said, but the emergence of a potentially lethal strain of the virus has added a frightening dimension to the outbreak. Called enterovirus 71, it killed seven youngsters in Singapore in 2000 and 2001, the Health Ministry said.

The strain has caused 19 per cent of the cases so far this year. There is no vaccine.

Wendy Sinnathamby, a paediatrician with the Children's Medical Institute, told The Straits Times that youngsters will develop immunity only to the strain they contract.

'The child can still catch HFMD caused by another strain,' she was quoted as saying, noting there are more than 60 strains.

 

[Shiloh]

Re: Singapore - HFMD

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

Eight Singapore preschools urged to close due to virus

Apr 29, 2008, 4:44 GMT
Singapore - Eight more preschools have been urged to temporarily close after another 540 cases of hand, foot and mouth disease were reported in a four-day period, health officials said on Tuesday.

So far, 11 childcare centres and preschools have been forced to shut down for 10 days while teachers, administrative staff and cleaners scrub the facilities to stem the outbreak.

Others were asked to voluntarily do so. The latest recommendations for closure bring the total to 34.

So far 9,262 people, primarily children, have been affected.

The disinfection is aimed at halting the transmission of the disease, which is spread through saliva, blister fluid, faeces and droplets in the air.

The symptoms are usually mild and include ulcers, rashes and blisters, health officials said, but the emergence of a potentially lethal strain of the virus has added a frightening dimension to the outbreak.

Called enterovirus 71, the strain has caused 19 per cent of the cases so far this year. There is no vaccine.

 

[Shiloh]

Re: Singapore - HFMD

Source: http://www.todayonline.com/articles/252408.asp

EV71 strain positive-ly higher
Tan Hui Leng
huileng@mediacorp.com.sg

WHILE the number of Hand, Foot and Mouth Disease (HFMD) cases may have stabilised right now, the proportion of samples testing positive for dreaded Enterovirus 71 (EV 71) strain is still higher than in the last outbreak.
.
This year, 26 per cent of HFMD samples tested positive for EV71 ? up from the 21 per cent in the March and April 2006 outbreak.
.
As of last Saturday, a weekly total of 1,465 HFMD cases were reported to the Ministry of Health (MOH) ? similar to 1,466 in the week before.
.
From Sunday to 3pm yesterday, another 507 cases were detected. This brings the total number of notified HFMD cases this year to 10,997.
.
Last week, 17 of the cases required hospitalisation but none of the patients had serious complications.
.
The EV71 strain worries parents as it killed seven children during a 2000 and 2001 HFMD outbreak.
.
The MOH, however, told Today that most EV71 cases "are mild and self-limiting". Thus, any increase in EV71 cases will not affect its current control strategy. This includes advising the closures of preschools and childcare centres once the number of cases in a premise reaches certain trigger points.
.
Last week, four preschools and childcare centres were ordered to close for a period of 10 days and 18 others were advised to consider voluntary closure.
.
As of May 5, a cumulative total number of 17 preschools and childcare centres have been ordered to close and another 48 have been advised to consider voluntary closure.

Tan Hui Leng
huileng@mediacorp.com.sg

WHILE the number of Hand, Foot and Mouth Disease (HFMD) cases may have stabilised right now, the proportion of samples testing positive for dreaded Enterovirus 71 (EV 71) strain is still higher than in the last outbreak.
.
This year, 26 per cent of HFMD samples tested positive for EV71 ? up from the 21 per cent in the March and April 2006 outbreak.
.
As of last Saturday, a weekly total of 1,465 HFMD cases were reported to the Ministry of Health (MOH) ? similar to 1,466 in the week before.
.
From Sunday to 3pm yesterday, another 507 cases were detected. This brings the total number of notified HFMD cases this year to 10,997.
.
Last week, 17 of the cases required hospitalisation but none of the patients had serious complications.
.
The EV71 strain worries parents as it killed seven children during a 2000 and 2001 HFMD outbreak.
.
The MOH, however, told Today that most EV71 cases "are mild and self-limiting". Thus, any increase in EV71 cases will not affect its current control strategy. This includes advising the closures of preschools and childcare centres once the number of cases in a premise reaches certain trigger points.
.
Last week, four preschools and childcare centres were ordered to close for a period of 10 days and 18 others were advised to consider voluntary closure.
.
As of May 5, a cumulative total number of 17 preschools and childcare centres have been ordered to close and another 48 have been advised to consider voluntary closure.
Tan Hui Leng
huileng@mediacorp.com.sg

WHILE the number of Hand, Foot and Mouth Disease (HFMD) cases may have stabilised right now, the proportion of samples testing positive for dreaded Enterovirus 71 (EV 71) strain is still higher than in the last outbreak.
.
This year, 26 per cent of HFMD samples tested positive for EV71 ? up from the 21 per cent in the March and April 2006 outbreak.
.
As of last Saturday, a weekly total of 1,465 HFMD cases were reported to the Ministry of Health (MOH) ? similar to 1,466 in the week before.
.
From Sunday to 3pm yesterday, another 507 cases were detected. This brings the total number of notified HFMD cases this year to 10,997.
.
Last week, 17 of the cases required hospitalisation but none of the patients had serious complications.
.
The EV71 strain worries parents as it killed seven children during a 2000 and 2001 HFMD outbreak.
.
The MOH, however, told Today that most EV71 cases "are mild and self-limiting". Thus, any increase in EV71 cases will not affect its current control strategy. This includes advising the closures of preschools and childcare centres once the number of cases in a premise reaches certain trigger points.
.
Last week, four preschools and childcare centres were ordered to close for a period of 10 days and 18 others were advised to consider voluntary closure.
.
As of May 5, a cumulative total number of 17 preschools and childcare centres have been ordered to close and another 48 have been advised to consider voluntary closure.
Tan Hui Leng
huileng@mediacorp.com.sg

WHILE the number of Hand, Foot and Mouth Disease (HFMD) cases may have stabilised right now, the proportion of samples testing positive for dreaded Enterovirus 71 (EV 71) strain is still higher than in the last outbreak.
.
This year, 26 per cent of HFMD samples tested positive for EV71 ? up from the 21 per cent in the March and April 2006 outbreak.
.
As of last Saturday, a weekly total of 1,465 HFMD cases were reported to the Ministry of Health (MOH) ? similar to 1,466 in the week before.
.
From Sunday to 3pm yesterday, another 507 cases were detected. This brings the total number of notified HFMD cases this year to 10,997.
.
Last week, 17 of the cases required hospitalisation but none of the patients had serious complications.
.
The EV71 strain worries parents as it killed seven children during a 2000 and 2001 HFMD outbreak.
.
The MOH, however, told Today that most EV71 cases "are mild and self-limiting". Thus, any increase in EV71 cases will not affect its current control strategy. This includes advising the closures of preschools and childcare centres once the number of cases in a premise reaches certain trigger points.
.
Last week, four preschools and childcare centres were ordered to close for a period of 10 days and 18 others were advised to consider voluntary closure.
.
As of May 5, a cumulative total number of 17 preschools and childcare centres have been ordered to close and another 48 have been advised to consider voluntary closure.

 

[Shiloh]

Re: Singapore - HFMD

Source: http://www.todayonline.com/articles/253723.asp

Singapore News // Wednesday, May 14, 2008

HFMD cases down, EV71 up
Proportion of HFMD cases with the deadly virus increases

Alicia Wong
alicia@mediacorp.com.sg

The hand, foot and mouth disease (HFMD) epidemic may be showing signs of subsiding, but the health authorities are concerned about the rising rate of infection from the potentially-fatal EV71 virus.
.
The Ministry of Health (MOH) said yesterday that the number of HFMD cases had declined to 1,246 in the week ending May 10, a 15-per-cent drop from the previous week's 1,465 cases. The dip followed a steady rise in the weekly reported cases since the middle of March. This brings the total number of reported HFMD cases this year to 11,736.
.
However, 29 per cent of HFMD patients have tested positive for the EV71 virus this year as of last Friday, a significant jump from the 26 per cent rate of infection for the year-to-date reported in the previous week. The EV71 virus is feared because it was blamed for the seven HFMD deaths during the 2000-2001 outbreak here.
.
Of the 1,246 HFMD cases reported last week, 18 required hospitalisation but there have been no serious complications.
.
The MOH has continued to order or advise the closure of childcare centres to "assist in breaking the transmission of HFMD".
.
"While last week saw the first respite since the surge of HFMD cases, we still need to monitor the situation closely," said an MOH spokesperson, advising parents to ensure children adopt good hygiene practices, and for those with HFMD to remain at home until they are fully recovered.
.
Last week, six pre-schools and childcare centres were ordered to close for 10 days, and 19 preschools and childcare centres were advised to consider voluntary closure.
.
The latest school to suspend operations is Learning Vision@Work, at Kent Vale Staff Housing at Clementi Road, which starts its 10-day closure today.
.
Two others, NTUC Childcare Co-operative at Haig Road and Al-Iman Mosque Kindergarten, ended their closures on May 12 and May 13 respectively. NTUC Childcare said 63 of the 83 children at its Haig Road nursery were present yesterday and that "stringent measures and standard operating procedures remained in place."

 

[Shiloh]

Re: Singapore - HFMD

Source: http://newpaper.asia1.com.sg/news/story/0,4136,166239,00.html

School's out, but some parents with infectious HFMD kids...
WHY SO IRRESPONSIBLE?
# LET THEM PLAY IN CONDO POOL
# ASK DOCS FOR CLEARANCE TO TRAVEL
# HOLIDAY IN HK DISNEYLAND
By Maureen Koh
June 01, 2008

ONE mother allowed her son to play in a condo swimming pool.

Another took her daughter to Malaysia on holiday.

Both could have been suffering from Hand, Foot and Mouth Disease (HFMD) at the time.

Some parents have been bochap (Hokkien for don't care) in allowing kids with HFMD into places where they can spread the highly contagious disease.

A check with six doctors revealed that some parents had approached them to seek 'clearance' to allow children with HFMD to travel.

And all this even as the Ministry of Health (MOH) continues to caution parents to keep their infected children away from public or crowded places.

An MOH spokesman told The New Paper: 'There is no law that penalises the parents but they should be more socially responsible.' (See report on facing page.)

Administrative executive Rachel Koh, 39, said she was upset when she saw her 6-year-old son's classmate at their condominium's swimming pool last week.

It was a day after her son had returned home with the news that the classmate was down with HFMD.

Said Madam Koh, who also has a 3-year-old daughter: 'The boy was playing in the pool with four others.

'I learned from the maid later that the child's mother had organised a party to cheer her son up.

'It's really ridiculous and there's nothing we can do about it, except keep our own kids away.'

The 6-year-old girl who travelled to Malaysia with her mother was given medical leave and told to stay home after the preschool centre suspected she could have HFMD.

A teacher said: 'During our regular checks (on 23 May), we noticed that the student had rashes on the palms of her hands.

'While there were no other symptoms, we chose to send her home as a precautionary measure.'

The centre was among those that had earlier closed voluntarily for 10 days because of HFMD. It also extended its school term by another three days.

TOLD TO STAY HOME

The girl was given two days' medical leave and advised to stay home for observation.

She also had to return to the doctor for a review.
Click to see larger image

Said the teacher: 'On Monday, when the girl did not come to school, we called her home to check on her condition.'

It was then she found out that the girl was in Malaysia with her mother.

'When we questioned her father (who did not travel with them), he said they were quite sure their daughter was not down with HFMD,' said the teacher.

But the father also admitted that they did not obtain any confirmation from the doctor.

When the school holidays started a week ago, some parents approached doctors to seek clearance for their infected children so the family could travel.

General practitioner C P Tan said: 'They plead and say things like they don't want to disappoint their child or how it would be a waste of money for them to drop their holiday plans.

'However, unless the child's illness has completely resolved, I will turn them down.'

Another GP, Dr L H Wong, said her clinic assistant had called a sick boy's home for an update on his condition.

Dr Wong said: 'The assistant was shocked when the maid told her the family had gone to Disneyland (in Hong Kong).

'When I called the mother, she told me she was sure her son had recovered, before adding that he still had some ulcers in the mouth.'

Dr Wong said that HFMD is spread from person to person by direct contact with nasal discharge, saliva, faeces and fluid from the rash of an infected person.

The disease can also be spread through the air.

Paediatrician Benjamin Lim advised parents of sick children to postpone or cancel holiday plans.

'It's a question of responsibility. The incubation period of HFMD is three to five days.[/B]

CONTAGIOUS

'A child infected with HFMD is contagious throughout the duration of the illness,' he said.

Housewife Yeo Bee Geok, 44, who has a 7-year-old daughter, said: 'Now that it's the school holidays, there'll be no one (like teachers) to monitor the situation.

'What happens if irresponsible parents allow their children to go out?'

Dr Tan said: 'As it is, other children living in the same household may also get infected.

'Parents should check these children daily before they are allowed to go to school or childcare centres.'

And while the child remains at home, proper hygiene should be practised to prevent transmission to other family members.

Dr Lim said: 'Despite the Ministry's efforts and constant reminders, some parents still choose to ignore the advice that contact with other children should be avoided until the child recovers.'

This year so far, a total of 13,401 HFMD cases have been notified to MOH.

In the week ending 24 May, the number of notified cases came down by 22 per cent to 729 from 940 in the previous week.

Emergency measures

# Parliament in April gave Health Minister sweeping powers if country faces disastrous health threat.

# This includes authority to close shopping centres, take over private hospitals and arrest suspects without warrant.

# Powers are for use only when the country faces health threat with potential to kill many people.

# In 2003 Sars outbreak, when some disobeyed quarantine orders, surveillance cameras were used in their homes and wrist-tags slapped on repeat offenders.

 

[Shiloh]

Re: Singapore - HFMD

SOurce:

Source: http://health.asiaone.com/Health/News/Story/A1Story20080603-68725.html

HFMD cases fall for fourth week
Lee Hui Chieh
Tue, Jun 03, 2008
The Straits Times

THE number of hand, foot and mouth disease (HFMD) cases continues to fall for the fourth week running. Last week, 665 people caught it - a 9 per cent drop from 729 in the previous week, the Health Ministry said on Tuesday.

In the three preceding weeks, the numbers had dropped by 15 to 25 per cent each week. But a Health Ministry spokesman cautioned against complacency, as last week's patient count still exceeded the epidemic level of 565.

'While the number of HFMD cases has been declining in recent weeks, it is still high,' she said.

At the peak of the epidemic in April, 1,466 cases of this usually mild illness - which causes fever, mouth ulcers and rashes on the palms, soles and buttocks - surfaced in a week.

To stop the disease from spreading, the ministry ordered 28 schools to close, and urged another 81 to consider doing so.

Last week marked the first week in which schools closed for a month-long break, which could have cut down on children passing the bug on to others.

Nine of the newly diagnosed patients last week had to be hospitalised, mainly because they had feeding problems caused by the disease.

This brings the total tally of HFMD patients this year to 14,063, of whom 177 had to be admitted to hospital.

EV71, the virus that causes the most severe form of the illness, was behind 32 per cent of the patients' illnesses. It also caused three children to develop encephalitis, or inflammation of the brain lining, this year.

The only one who is still hospitalised, three-month-old Muhammad Hafiz Badrulhisham, is in a stable condition, said the Health Ministry.

He was transferred last Wednesday from the intensive care unit to the high dependency ward in KK Women's and Children's Hospital (KKH).

A 10-year-old boy was discharged from KKH last Thursday. The first to fall severely ill from the virus this year, seven-year-old Sharmaine Lee, has fully recovered.

 

[Shiloh]

Re: Singapore - HFMD

Source: http://www.straitstimes.com/Breaking+News/Singapore/Story/STIStory_270805.html

HFMD cases up again
By Lee Hui Chieh

THE number of children coming down with hand, foot and mouth disease (HFMD) is on the rise again.

The weekly count crossed the warning level of 402 two weeks ago and continues to grow.

Last week, 553 people were diagnosed with the disease, up from 415 in the previous week.

While these figures still fall short of the epidemic level of 565 for now, they are expected to keep increasing because traditionally, more HFMD cases crop up during Aug to Oct every year.

But this peak - the second one in the year - usually affects fewer people than the first peak from March to May, said Dr Lyn James, director of the Health Ministry's communicable diseases division.

Still, it was during last week that Singapore registered its first death from HFMD since a severe outbreak in 2000-2001 killed seven children here.

Three-year-old Marzuk Adi died on Aug 6, probably from encephalitis or inflammation of the brain, brought on by a severe form of HFMD caused by a virus called enterovirus 71, or EV71.

Elias Kindergarten in Woodlands, which Marzuk attended, has reopened on Monday after a 10-day closure to clean up.

Dr James was speaking on the sidelines of a regional forum on HFMD, organised jointly by the Health Ministry and the Regional Emerging Disease Intervention (Redi) Centre.

At the forum, Singapore vaccine company SingVax, Chinese vaccine company Sinovac Biotech and Taiwan's Centers for Disease Control - which are all racing to be the first to come up with a HFMD vaccine - also gave updates on their progress.