Published Date: 1998-06-28 23:50:00
Subject: PRO/EDR> Hand, foot & mouth disease, fatal - Singapore
Archive Number: 19980628.1200

HAND, FOOT & MOUTH DISEASE, FATAL - SINGAPORE
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See Also

Enterovirus 71 epidemic, children - Taiwan (13) 980625193748
EV-71 & HFMD-linked child deaths - Japan (Osaka) 1997 980623221208
Date: Sat, 27 Jun 1998 12:20:21 +0800
From: Dr. M. Vadivale <vale@pop.jaring.my>
Source: Straits Times <http://straitstimes.asia1.com/pages/sin6_0627.html>
[edited - ES

A 2-1/2-year-old Singapore boy has died of severe complications from hand,
foot and mouth disease, the first death of its kind here since 1993.
The disease is caused by a virus that is from the same family as
enterovirus 71, which is linked to the deaths of 50 children in Taiwan.
However, the boy and his family have not travelled to Taiwan recently, so
health authorities believe the death may be a sporadic case of hand, foot
and mouth disease with severe complications.
The Health (MOH) and Environment (ENV) ministries said in a joint statement
yesterday that it will take one to four weeks for laboratory tests to
confirm which virus was responsible for the infection. In the meantime,
they have taken several steps: Doctors have been alerted to look out for
such cases, refer serious ones to a hospital and notify ENV's Quarantine
and Epidemiology Department. All hospitals have been alerted and are
prepared to handle patients with severe hand, foot and mouth disease.
Guidelines for collecting and handling specimens for laboratory testing
have been issued to all hospitals and paediatricians. Child-care centres
and kindergartens have been told to maintain high hygiene and health
standards.
While the World Health Organisation has not called for travel restrictions
to Taiwan, health authorities here suggest taking precautions, such as
practising a high standard of hygiene and avoiding crowded places and the
sharing of personal items.
Touching on the case of the dead boy, Dr Phua Kong Boo, clinical head,
paediatric medicine at the KK Women's and Children's Hospital, said that
the boy suffered from a fever, mouth ulcers and was vomiting on June 16.
By June 18, he became very drowsy. A day later he was breathless and taken
to a hospital. He went into a fit, collapsed and was taken to KK in a
critical condition, later the same day.
He was diagnosed to have enterovirus infection with complications of
encephalitis and myocarditis. His condition did not improve and he died on
Thursday. Investigations showed that two cousins and an elder sister had
recovered from similar but mild infections, several days to about six weeks
before the boy came down with the symptoms.
Dr Phua added that the disease in its mild form is very common. According
to MOH, there were 358 cases last year and 290 so far this year. MOH added
that it has not detected any case of enterovirus 71 infection here so far
this year.
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