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Published Date: 2012-03-22 14:01:38
Subject: PRO/EDR> Hand, foot & mouth disease - Malaysia: (SK)
Archive Number: 20120322.1077794

HAND, FOOT AND MOUTH DISEASE - MALAYSIA: (SARAWAK)
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Date: Wed 21 Mar 2012
Source: The Star [edited]
http://thestar.com.my/news/story.asp?file=/2012/3/21/sarawak/10955872&sec=sarawak

The number of hand-foot-mouth disease (HFMD) cases in the state [Sarawak] rose sharply on Monday [19 Mar 2012] to more than double that of Sunday. It went from 44 new cases to 109 new cases on Monday, according to data from the state's Health Department's HFMD Ops Room.

The dramatic increase was believed to be due to cases that were detected with the opening of school after a one-week break. "The increase may be due to the fact that most of the clinics as well as child care centres were closed during the weekend and therefore, the majority of cases were only detected on Monday [19 Mar 2012]," it said.

The rise was observed [in Kuching] as well as in Samarahan, Sri Aman, Betong, Sarikei, Bintulu, Miri, and Limbang. Mukah and Sibu, however, saw a drop in cases, while Kapit had no new cases for the past 3 consecutive days.

As of Monday [19 Mar 2012], the department had detected 3297 cases in the state with 240 admissions. There are no serious cases and no deaths due to HFMD have been reported so far. On Monday 2 schools [in Kuching] and one in Bintulu were served with closure orders. They were Taska Dirumah Mimi Satok and SK Semerah Padi [in Kuching], and Tadika Methodist in Bintulu.

The cumulative number of institutions closed remains at 61. Kuching had 37, Sarikei (9), Betong (6), Samarahan (4), Limbang (3), and Bintulu (2).

To prevent contracting the disease, the Health Department advises the public to:
- practise good cough etiquette (covering mouth and nose with tissue when sneezing or coughing)
- practise good hand hygiene (frequent hand-washing with soaps/sanitisers) before preparing food and after handling diapers/visiting toilet)
- avoid sharing of personal items like toothbrushes, pot-tees, handkerchiefs, towels, forks, and spoons.
- practise good personal hygiene like changing clothes and taking a bath before attending to children.
- frequently disinfect all toys, floors, and surfaces like tables and chairs.
- bring children who have fever to the nearest clinic
- strictly avoid visiting public places like swimming pools, playgrounds, and shopping complexes.

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[The virus responsible for these cases is not given; neither are the ages of the children involved nor the severity of their disease (other than some required hospital admission). EV71 is circulating in continental Southeast Asia and Taiwan currently, and may be the etiological agent of this outbreak.

In the ProMED-mail post of 30 Jul 2006 (archive no 20060730.2103), Dr Jane Cardosa indicated,
"My laboratory has been investigating HFMD outbreaks in Sarawak since the initial enterovirus 71 (EV71) outbreak in Sarawak in 1997, and our data show that in Sarawak, EV71 outbreaks occur in a regular cyclical pattern every 3 years. In an outbreak year, we start seeing cases in early February. The outbreaks have peaked between March and May. In 2000 and in 2003, we did not have many fatal cases, but in this year's [2006] outbreak, we have seen more than in the previous 2 outbreaks [14 000 cases with 13 deaths]. All outbreaks we have documented (1997, 2000, 2003, and 2006) have been predominantly caused by EV71 of genogroup B. Our surveillance findings have recently been published in BMC Public Health (see: Podin Y, et al: Sentinel surveillance for human enterovirus 71 in Sarawak, Malaysia: Lessons from the first 7 years. BMC Public Health. 2006; 6(1):180; Epub ahead of print at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1543637."

Coxsackievirus A16 has also caused significant outbreaks of HFMD worldwide. Fortunately, no deaths have been reported thus far in the current outbreak. One hopes that the preventive measures indicated by the Health Department are put into practice by the populace.

A HealthMap/ProMED-mail map of Malaysia can be seen at http://healthmap.org/r/1mSG. An administrative map of Sarawak can be seen at http://www.sarawak.gov.my/uploads/assets/pictures/testing/geo_division.gif. - Mod.TY]

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