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8 July 2013
Question No. 556
Name of Person: Mr Muhamad Faisal Abdul Manap
Question
To ask the Minister for Health (a) if he can provide a breakdown of cases of HFMD, chicken pox and dengue from 2010-2012 according to children of (i) less than 2 years old; (ii) 2 years old; (iii) 3 years old, (iv) 4 years old; (v) 5 years old and (vi) 6 years old; (b) how many of these cases involve children who are (i) in full-day childcare and (ii) infected by their siblings; and (c) how many days on average does a child have to stay away from childcare if he/she contracts (i) HFMD (ii) chicken pox and (iii) dengue.
Answer
1 Hand, Foot and Mouth Disease (HFMD) is a common childhood disease. Children aged six years and under accounted for over 70% of the notified cases between 2010 and 2012. Table 1 shows the number and proportion of all HFMD cases who are children aged six years and under. HFMD can be transmitted from person to person directly through the faecal-oral route or contact with respiratory droplets, saliva, or vesicular fluid, or indirectly by articles contaminated by secretions.
Table caption
Age (years) | 2010 | 2011 | 2012 | |||
|---|---|---|---|---|---|---|
No of cases | Percentage among all cases | No of cases | Percentage among all cases | No of cases | Percentage among all cases | |
0-1 | 5921 | 19.2% | 3317 | 16.0% | 6772 | 18.2% |
2 | 5566 | 18.0% | 3679 | 17.8% | 6588 | 17.8% |
3 | 4755 | 15.4% | 3412 | 16.5% | 5595 | 15.1% |
4 | 3326 | 10.8% | 2292 | 11.1% | 3944 | 10.6% |
5 | 2367 | 7.7% | 1637 | 7.9% | 2753 | 7.4% |
6 | 1469 | 4.8% | 1202 | 5.8% | 1905 | 5.1% |
Total | 23,404 | 75.9% | 15,539 | 75.1% | 27,557 | 74.2% |
Table 1: Number and proportion of all HFMD cases who are children aged six years and under, 2010-2012
2 As children can acquire the infection from various modes of transmission, it is not possible to determine the specific source of their infection, whether from their siblings or from pre-school centres. Of the HFMD cases notified among children below six, about half were in pre-school centres. The key to controlling the spread of HFMD is to maintain high standards of personal and environmental hygiene. The Ministry of Health (MOH) also works closely with the Early Childhood Development Agency and the Ministry of Education to ensure that educational institutions, including childcare centres, remain vigilant and take measures to minimise the spread of this disease.
3 Dengue is a mosquito-borne disease that is endemic in Singapore. The vast majority of dengue cases are adults. From 2010 to 2012, children aged six years and under accounted for 1.5% to 2% of all notified dengue cases. Table 2 shows the number and proportion of all dengue cases who are children aged six and under.
Table caption
Age (years) | 2010 | 2011 | 2012 | |||
|---|---|---|---|---|---|---|
No of cases | Percentage among all cases | No of cases | Percentage among all cases | No of cases | Percentage among all cases | |
0-1 | 30 | 0.56% | 36 | 0.68% | 19 | 0.41% |
2 | 12 | 0.22% | 17 | 0.32% | 10 | 0.22% |
3 | 10 | 0.19% | 12 | 0.23% | 7 | 0.15% |
4 | 18 | 0.34% | 7 | 0.13% | 12 | 0.26% |
5 | 16 | 0.30% | 14 | 0.26% | 12 | 0.26% |
6 | 22 | 0.41% | 15 | 0.28% | 9 | 0.19% |
Total | 108 | 2.02% | 101 | 1.90% | 69 | 1.49% |
Table 2: Number and proportion of all dengue cases who are children aged six years and under, 2010-2012
4 As dengue infections are transmitted through the bite of infective female Aedes mosquitoes, it is not possible to conclusively determine the source of infection. MOH does not have data on the proportion of children with dengue who are in pre-school centres.
5 As for chickenpox, MOH is also unable to provide an age breakdown of the chickenpox cases as it is not a legally notifiable disease.
6 Based on the nature of the disease and the clinical status of the child, doctors will make an assessment as to the appropriate number of days of medical leave to grant the child. A child who is diagnosed to have an infectious disease should only return to the pre-school centre when the medical leave has expired and symptoms have resolved. This can take up to 1-2 weeks for dengue, chickenpox and HFMD.