SINGAPORE: Number of new HFMD cases soars past epidemic levels

[Giuseppe]

Number of new HFMD cases soars past epidemic levels

By Hoe Yeen Nie, Channel NewsAsia | Posted: 05 September 2008 2352 hrs

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
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http://www.channelnewsasia.com/stories/singaporelocalnews/view/374009/1/.html
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[Shiloh]

Re: SINGAPORE: Number of new HFMD cases soars past epidemic levels

Source: http://www.straitstimes.com/Breaking+News/Singapore/Story/STIStory_309471.html

Dec 2, 2008
Boy with HFMD dies
By Esther Tan

MADAM Roslinda Mohamad Ali thought that her son had developed a fever from fretting over his Primary School Leaving Examination (PSLE) results.

He was later diagnosed with Hand, foot and mouth disease (HFMD) but she never thought that he would die as she had seen the children of friends and relatives recover from the disease over the past two years.

But 12-year-old Muhammad Shahril Izhar Kamarudin died in hospital on Sunday, a week after he was diagnosed with the disease.

While it is not clear if the disease caused the boy's death, it will take several months for an autopsy to determine if he is the second person to die of the disease since 2001.

Singapore registered its first death from HFMD in August, since a severe outbreak from 2000 to 2001 which killed seven children. Most of the victims who died suffered from a severe form of HFMD caused by a virus called EV71.

The total number of HFMD cases is about 17,400 for the first 31 weeks of this year. Two preschools and four childcare centres were temporarily shut by the Health Ministry in April following outbreaks of HFMD.

Shahril first developed fever and red spots on his cheeks in the first week of November.

'I thought he might be having a fever because he was worried about getting back his Primary School Leaving Examination (PSLE) results,' said Madam Roslinda.

The former student of Jurong West Primary School appeared to recover after two visits to different general practitioners and he asked to be allowed to join his classmates on a two-day school trip to Malacca.

'His fever had subsided, so we relented and let him go on the trip,' recalled Madam Roslinda.

But after he got back, his fever returned and he developed rashes on his palms.

After he collected his PSLE results his condition worsened.

'His fever went as high as 40 degrees celsius. He had ulcers in his mouth and on his lips,' said the boy's stepfather Mohamed Afandi Ahwan, 38.

The boy also complained of difficulty in swallowing food, he added.

He was diagnosed as having HFMD and given paracetamol after a seeing a doctor at Jurong Polyclinic on Nov 23.

On Sunday morning, he fainted after being helped to the toilet by his mother.

Although he later regained consciousness and was no longer having a fever, his breathing became heavy.

While on the way to the hospital, he passed out in Mr Afandi's car and was revived by staff at the hospital.

Mr Afandi said they were told by doctors that Shahril was breathing but not on his own and his heartbeat was weak.

'That was when we realised the situation was very serious,' he said.

The boy died at 1.30pm on Sunday - which was also his birthday.