Update On Hand, Foot And Mouth Disease (HFMD) Situation In Singapore(8)

22 May 2008

1 The number of HFMD cases notified to MOH decreased by 25% to 940 cases in the week ending 17 May 2008 from 1246 in the previous week. This brings the total number of notified HFMD cases in 2008 so far to 12,674. 10 (1.1%) cases required hospitalisation last week mainly because of poor feeding.

2 A thirteen-month-old boy has been hospitalised for suspected encephalitis. The child was in contact with his cousin who had HFMD and attended a kindergarten with an active HFMD cluster. He developed symptoms on 16 May and was seen by a general practitioner who made a diagnosis of HFMD. The child was taken to the Emergency Department on 18 May and admitted for poor feeding. The following day, he developed complications and has since been managed in the intensive care unit. Laboratory investigations were positive for EV71.

3 MOH’s sentinel surveillance continues to show a high circulation of EV71 virus, with 32% of the samples tested positive for EV71 so far this year.

4 Last week, 2 preschools and childcare centres were ordered to close for a period of 10 days due to the extent of outbreak in these institutions, and 12 preschools and childcare centres with sustained transmission were 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.

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

Public advice

6 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.

7 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.

8 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 MAY 2008