Update On Hand, Foot And Mouth Disease (HFMD) Situation In Singapore(5)

29 Apr 2008

1 The number of HFMD cases notified to MOH increased by 18% to 1466 cases in the week ending 26 April 2008 from 1245 in the previous week. This brings the total number of notified HFMD cases to 9026. 21 (1.4%) cases required hospitalisation last week mainly because of poor feeding. The seven-year-old girl diagnosed with encephalitis (inflammation of the brain) was discharged from KKH on 23 April. There have not been any other cases with serious complications so far.

2 MOH’s sentinel surveillance continues to show a high circulation of Enterovirus 71 (EV71) virus, with 25% of the samples tested positive for EV71 so far this year.

3 MOH has tightened the assessment criteria and lowered the threshold for recommending or mandating closure of institutions with HFMD clusters, so as to stem the spread of HFMD in view of EV71 strain being the main circulating strain. As of 28 April, 11 preschools and childcare centres have been ordered to close for a period of 10 days due to the extent of outbreak in these institutions. A further 34 preschools and childcare centres with sustained transmission are 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. Please see the MOH website http://www.moh.gov.sg for the latest update on daily number of cases and list of childcare centres/preschools that have reached mandatory or voluntary closure.

4 HFMD is generally a mild and self-limiting childhood disease. It is endemic in Singapore and there will be yearly seasonal outbreaks. 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

5 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.

6 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.

7 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

29 APRIL 2008