Sunday, August 19, 2018

PRO/EDR> Hand, foot & mouth disease update (07): Southeast Asia (Singapore) USA (VA)

HAND, FOOT AND MOUTH DISEASE UPDATE (07): SOUTHEAST ASIA (SINGAPORE),
USA (VIRGINIA)
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In this posting:
[1] Southeast Asia (Singapore)
[2] USA (Virginia)

******
[1] Southeast Asia (Singapore)
Date: Wed 15 Aug 2018 06:00 AM SGT
Source: The New Paper [edited]
<https://www.tnp.sg/news/singapore/hfmd-clusters-reported-eight-pre-schools>


Six childcare centres and 2 kindergartens in Singapore have been
identified as hand-foot-mouth disease (HFMD) clusters.

The 1249 cases of HFMD from [29 Jul-4 Aug 2018] is also the highest
reported in a week this year, almost 1.5 times the 868 cases at the
same time last year [2017], according to Ministry of Health figures.
There have also been slightly more cases caused by the enterovirus A71
(EV-A71), a more virulent strain behind the recent deaths of 2
children in Malaysia.

In an update on its website last [Fri 10 Aug 2018] MOH [listed] the 6
childcare centres and 2 kindergartens with HFMD clusters [see source
URL above]. None of them has been closed due to the outbreak.

A cluster occurs when a pre-school reports more than 10 HFMD cases or
an "attack rate" higher than 13 per cent and a transmission period of
more than 16 days. The attack rate refers to the proportion of
children enrolled who are infected.

Replying to queries by The New Paper last [Fri 10 Aug 2018], MOH said
the HFMD coxsackievirus type A remains the predominant strain in
Singapore, as in previous years.

But its spokesman also said there has been a "slight increase" in the
proportion of cases from the EV-A71 strain.

The spokesman also said the ministry is monitoring the HFMD situation
in Malaysia.

The Early Childhood Development Agency (ECDA) also issued an advisory
on [1 Aug 2018] to remind all pre-schools to exercise vigilance and
maintain good hygiene practices.

There is currently no cure for HFMD, with doctors treating only its
symptoms such as fever and mouth ulcers.

Fatal infections are rare, with 8 reported cases since 2000, all
caused by EV-A71, The Straits Times reported earlier this year
[2018].

Dr Asok Kurup from the Infectious Disease Care clinic said that while
EV-A71 can cause neurological disease, it is not a new strain and is
not more infectious than other strains.

Dr Jacqueline Chung, senior principal of St James' Church
Kindergarten, said: "We send out an advisory whenever a case occurs
reminding parents to check their children for symptoms of HFMD.

"We also step up the cleaning of our premises. Teachers play their
part by raising the children's awareness of their personal hygiene. We
are thankful that parents have been understanding and cooperative."

"It is really tough and almost impossible to avoid cross infections in
such environments.

"Simple things like washing of hands, not putting their fingers into
the mouth, carrying hand sanitisers around is important in maintaining
good hygiene."

[Byline: Adeline Tan, Gilaine Ng]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[HealthMap/ProMED-mail map of Singapore:
<http://healthmap.org/promed/p/150>

Enterovirus 71 (EV-A71) is a genotype within the species enterovirus
A, genus _Enterovirus_, family Picornaviridae. The virus is one of the
most common etiologies of hand-foot-mouth disease (HFMD) in children.
EV-A71 associated disease is usually mild with children typically
recovering within 4-6 days. However, the virus has been associated
with fulminant disease during large outbreaks in many parts of the
world.

Excerpted from Silvia M and Sanna G. Enterovirus 71 in Europe: A
briefing. Developments in Clinical & Medical Pathology. 2018.
<http://crimsonpublishers.com/dcmp/pdf/DCMP.000503.pdf>

Abstract
--------
"Enterovirus A71 (EV-A71) was first identified in California in 1969
and described in 1974 by Schmidt et al. Since then it has been
implicated in more than 10 small and large outbreaks worldwide. Wide
epidemic of hand-foot-mouth disease (HFMD), generally benign, occurred
in Japan in 1973 and 1978. Important outbreaks with brain stem
encephalitis and high mortality rates have been described in Europe in
the 1970s (Bulgaria and Hungary in 1975 and 1978 respectively), in
Malaysia in 1997 and Taiwan in 1998 and in Asia-Pacific region,
including China and Korea. Recently, EV-A71 epidemics have been
reported in European countries, such as the Netherlands, France,
Spain. EV-A71 infection causes hand-foot-mouth disease, herpangina,
fever, and usually resolves spontaneously and do not need specific
treatment, however, can sometimes induces a variety of neurological
complications, including encephalitis, aseptic meningitis, pulmonary
edema, and acute flaccid paralysis that can be fatal. In this review
we focus on enterovirus A71 infections, summarizing that one's
occurred in Europe which have raised particular concern about the
potential emergence of EV-A71 as a worldwide health threat." -
Mod.LK]

******
[2] USA (Virginia}
Date: Sun 19 Aug 2018
Source: Daily Broccoli [edited]
<https://www.dailybroccoli.com/article/psa-hand-foot-and-mouth-disease-is-spreading-like-wildfire-in-kids-under-5>


Hospitals across the country are reporting outbreaks of
hand-foot-mouth disease, a contagious disease caused by a group of
viruses. Symptoms of this highly contagious viral disease include
fever, red sores of the hands, mouth, and feet, and sore throat.

Children under the age of 5 that attend daycare or preschool are
especially susceptible to hand-foot-mouth disease.

Hand-foot-mouth disease is more of a concern in the summer. Sore
throats and blisters in the mouth could prevent kids from eating and
drinking. Dehydration is the most commonly reported complication of
the disease.

Adults can contract hand-foot-mouth disease, but it is more common in
children who have not yet developed an immunity to common viruses.
There is no treatment for hand-foot-mouth disease. Symptoms can be
managed with acetaminophen or ibuprofen.

Hand-foot-mouth disease typically runs its course within less than a
week. Keep your child away from other children if they develop a fever
or blisters. The disease spreads easily, resulting in localized
outbreaks.

Virginia is seeing a rise in hand-foot-mouth disease this summer
[2018], with as many as 10 cases a night being reported in one
emergency room.

Hand-foot-mouth disease is spread through nose and throat secretions,
feces, and blister fluid. According to the Center for Disease Control,
parents should wash their hands thoroughly after changing diapers,
avoid touching your face, avoid sharing utensils with sick children,
and refrain from hugging or kissing sick children.

[Byline: Julie Harris]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[HealthMap/ProMED-mail map of Virginia, United States:
<http://healthmap.org/promed/p/247>]

Hand-foot-and-mouth disease (HFMD) is a very common ailment that
affects hundred of thousands of people every single year.

Part of the reason it's so very common is that it is highly
contagious, and can spread easily from contact with saliva or mucus.
Though the symptoms of the virus are usually mild, there can be
serious side effects, especially in people with weakened immune
systems from another illness or from age.

In some rare cases, HFMD can lead to serious brain infections like
meningitis and encephalitis.

More commonly, kids who don't shake the symptoms for a few weeks may
lose some of their fingernails or toenails.
(excerpted from
<https://www.littlethings.com/hand-food-and-mouth-disease/>)
- Mod.LK]

[See Also:
Hand, foot & mouth disease update (06): USA
http://promedmail.org/post/20180729.5934295
Hand, foot & mouth disease update (05): China (HK) EV71
http://promedmail.org/post/20180529.5821814
Hand, foot & mouth disease update (04): China
http://promedmail.org/post/20180518.5804254
Hand, foot & mouth disease update (03): China
http://promedmail.org/post/20180430.5774368
Hand, foot & mouth disease update (02): Caribbean (Cayman Islands)
http://promedmail.org/post/20180221.5641051
Hand, foot & mouth disease update (01): Japan, research
http://promedmail.org/post/20180130.5594550
2017
----
Hand, foot & mouth disease update (10): Caribbean, WHO (Western
Pacific), USA (midwest) http://promedmail.org/post/20171103.5423054
Hand, foot & mouth disease update (09): comment
http://promedmail.org/post/20170906.5299733
Hand, foot & mouth disease update (08): Thailand (BT)
http://promedmail.org/post/20170904.5294390
Hand, foot & mouth disease update (07) - Mexico
http://promedmail.org/post/20170704.5150139
Hand, foot & mouth disease update (06): Thailand
http://promedmail.org/post/20170701.5144249
Hand, foot, & mouth disease update (05): Thailand (SK)
http://promedmail.org/post/20170623.5125187
Hand, foot & mouth disease update (04): Australia (VI)
http://promedmail.org/post/20170520.5050110
Hand, foot & mouth disease update (03): Pakistan (PB), comment
http://promedmail.org/post/20170316.4905767
Hand, foot & mouth disease update (02): Thailand, Viet Nam
http://promedmail.org/post/20170303.4875744
Hand, foot & mouth disease update (01): Southeast Asia, UK, USA,
Domin. Rep. RFI http://promedmail.org/post/20170218.4847712
2016
----
Hand, foot & mouth disease - China (03): (HK):
http://promedmail.org/post/20161007.4543101
Hand, foot & mouth disease - China (02): (HK)
http://promedmail.org/post/20160522.4237221
Hand, foot & mouth disease - China: (BJ, GX) vaccine
http://promedmail.org/post/20160329.4124126]
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