HFMD

13 August 2012

Question No. 245

Name of person: Dr Lam Pin Min

Question

To ask the Minister for Health (a) if the Ministry is monitoring the EV71 epidemic situation in Cambodia; (b) if he will provide updates on (i) the current hand, foot and mouth disease (HFMD) situation in Singapore; and (ii) whether there have been local cases of EV71 infection in the last three months; and (c) whether there is any surveillance system in place to monitor any importation of the deadly EV71 strain.

Answer

1          MOH is closely monitoring the Enterovirus 71 (EV-71) situation in Cambodia, and has been in contact with its Cambodian counterparts and the World Health Organisation. All hospitals in Singapore which provide medical services for children have been alerted to look out for similar cases who had come from, or travelled to, Cambodia. There have been no reports of such cases thus far.  To date, there have also been no reports to suggest that the EV-71 strain in Cambodia is a new, more virulent strain.

2          EV-71 is one of the causes of Hand, Foot and Mouth Disease (HFMD), together with other enteroviruses such as Coxsackieviruses. EV-71 and other enteroviruses circulate continuously in Singapore at varying levels throughout the year.

3          HFMD is a common childhood disease which is endemic in Singapore and the region. Yearly seasonal outbreaks of HFMD are thus expected. The number of HFMD cases in Singapore this year rose above the epidemic level in the week of 12 Feb 2012 and reached a peak of 1,686 cases in the week of 13 May 2012. However, the number of cases has since decreased to 871 cases in the week of 22 July 2012. Less than 3% of notified cases of HFMD required hospital admission because of poor food intake, and there were no severe local cases among those hospitalized. In the last 3 months, 4.1% of the samples collected for MOH’s HFMD surveillance programme were positive for EV-71. The current main circulating strains are a mixture of Coxsackieviruses, which are the most common cause of HFMD, and are generally milder than EV-71.

4        As EV-71 is endemic in Singapore, MOH does not monitor specifically for the importation of EV-71. Nevertheless, MOH has established local surveillance systems to monitor the prevalence of HFMD due to EV-71 and to detect new and emerging infections which could be imported through international trade and travel.