Published Date: 2010-03-24 20:02:42
Subject: PRO/MBDS> Hand, foot & mouth disease - Singapore: RFI
Archive Number: 20100324.0937
HAND, FOOT AND MOUTH DISEASE - SINGAPORE: REQUEST FOR INFORMATION
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Tue 23 Mar 2010
Source: Xinhua News Agency [edited]
Singapore reported 4269 hand-foot-mouth disease (HFMD) cases in the
1st 3 months of this year , a 15 percent increase compared with
3705 cases in the same period last year , local media reported
on Tuesday [23 Mar 2010].
According to local TV Channel News Asia, 496 cases were recorded in
the week ending [20 Mar 2010], just 4 short of the warning level of 500.
The Singapore government said that currently no child care center has
been closed due to HFMD.
HFMD usually infects children and infants. Symptoms include fever,
ulcers in the throat and rashes on the hands and feet. HFMD is spread
from person to person by direct contact through the nasal discharge,
saliva, feces and fluid from the rash of an infected person.
[Although Singapore is not a member of the MBDS region, PRO/MBDS has
been reporting HFMD cases from Singapore as it is geographically
close to the region and HFMD contributes an important disease burden
in the region. The most recent prior HFMD outbreaks in MBDS region
occurred in Ho Chi Minh City, Viet Nam, with early onset of outbreak
in 2010 while peak season was between April and May in previous years
(see prior PRO/MBDS posting Hand, foot & mouth disease - Viet Nam:
The number of reported cases of HFMD in Singapore has increased by 15
percent when compared to those reported in 2009. According to data
from the Singapore Ministry of Health weekly publication of
statistics on the local infectious disease situation, there were 496
cases of HFMD reported for week 11 (14-20 Mar 2010) compared to 403
cases reported for the same week in 2009. The number of cumulative
cases of HFMD from week 1 to week 11 in 2010 was 4269 cases, compared
to 3705 during the same period in 2009. More detailed information for
these statistics is available at
In Singapore, the largest HFMD epidemic of Human Enterovirus71
(HEV71) occurred in September and October 2000, an epidemic that
involved mainly young children less than or equal to 4 years of age.
5 deaths occurred, and HEV71 was isolated from 4 case-patients.
Autopsies of 4 case-patients showed encephalitis, interstitial
pneumonitis and myocarditis (see
According to the press release from Singapore's Ministry of Health
dated 7 Aug 2008, available at
3-year-old child had died from a severe form of HFMD caused by a
virus called EV71. This death case was the 1st death of HFMD since a
severe outbreak from 2000 to 2001 which killed total 7 children (see
prior PRO/MBDS posting Hand, foot & mouth disease - Singapore,
Malaysia (02) 20080825.2644).
The above newswire does not mention etiologic agent of this current
HFMD outbreak. Given the absence of fatalities, it is likely that
this continuing outbreak includes cases attributable to milder
infections caused by coxsackieviruses rather than a severe form of
HFMD caused by enterovirus 71 (EV71). Information on the virus
responsible for the current outbreak in Singapore would be greatly appreciated.
For a map of Singapore and its geographic relation to the MBDS
For the interactive HealthMap/ProMED map of China with links to other
ProMED-mail and PRO/MBDS postings in China and surrounding areas, see