Update On Hand, Foot And Mouth Disease (HFMD) Situation In Singapore(4)

22 Apr 2008

1 MOH has reviewed its current criteria and thresholds when assessing whether a preschool/childcare centre should be closed.  Given the substantial increase in HFMD activities and the re-emergence of EV71 strain, MOH has decided to tighten the policy, recalibrate the criteria and lower the threshold for recommending or mandating such closure.  The revised policy takes immediate effect.

2 The number of HFMD cases notified to MOH increased by 25% to 1245 cases in the week ending 19 April 2008 from 1000 in the previous week. This brings the total number of notified HFMD cases to 7560. 16 (1.3%) cases required hospitalisation last week mainly because of poor feeding.

3 MOH’s sentinel surveillance continues to show a high circulation of Enterovirus 71 (EV71) virus, with 19% of the samples tested positive for EV71 so far this year.

4 Two preschools and five childcare centres will be ordered to close for a period of 10 days due to the extent of outbreak in these institutions. A further seven preschools and six childcare centres with sustained transmission will be advised to consider voluntary closure for 10 days. Closure of a centre will assist in breaking the transmission of HFMD cases and allow the centre to thoroughly clean the premises.

5 HFMD is generally a mild and self-limiting childhood disease. It is endemic in Singapore and there will be yearly seasonal outbreaks. The continued rise in reported cases is expected as part of the epidemic uptrend, and is also partly caused by increased public awareness of the disease from our public education efforts.

6 MCYS and MOE are in close consultation with MOH to monitor the current HFMD situation. This includes monitoring the number of cases, studying the trends very closely and guiding preschools, childcare centres and schools in terms of how they should manage the HFMD situation. The institutions are exercising very high vigilance in their management of HFMD.

Public advice

7 The Ministry would like to stress the importance of maintaining high standards of personal and environmental hygiene to minimise the risk of HFMD. Parents should ensure that their children adopt the following good practices:

• Wash hands with soap before eating and after going to the toilet;

• Cover mouth and nose when coughing or sneezing;

• Do not share eating utensils.

Parents should also ensure that toys or appliances that are contaminated by nasal or oral secretions should be cleaned before they are used again.

8 Parents should consult a doctor early if their child has fever, mouth ulcers and rashes on the palms, soles or buttocks. Children with HFMD should remain at home until all the blisters have dried up. During this period, contact with other children should be avoided until the child recovers. The child should not be brought to any public or crowded places. Proper hygiene should also be practiced at home so as to prevent transmission to other family members.

9 For more information on HFMD, please see the FAQs on MOH website at http://www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx, or the guideline on Prevention and Control of Infectious Diseases in Child Care Centres / Kindergartens / Pre-School Centres here.

MINISTRY OF HEALTH

22 APRIL 2008