Cybermed Update December 2000

"If you believe everything you read, better not read." -- Japanese proverb


Enterovirus 71 updates

Two recent postings (Joint Press Release) by Ministries of The Environment; Health; Community Development and Sports; and Education, Singapore on Thu 4 Jan 2001 <Press Release> . The source of this case could have either been from Singapore or Pontian, Johore, Malaysia. I feel as HFM is endemic, we have to be always vigilant particularly among children attending nursery, kindergarten and primary school. I have enclosed their latest update report below.

"The Department of Pathology, Singapore General Hospital, has identified enterovirus 71 (EV71), one of the several viruses associated with Hand, Foot and Mouth Disease (HFMD), in postmortem samples taken from the four-year old boy who died on 3 Jan 01. Full postmortem investigations are underway.

The HFMD Taskforce's investigations revealed that three families had travelled together to Pontian, Johor to visit the deceased's grandmother, between 23rd and 26th December 00. One of the children developed HFMD-like illness on the 26 December upon return to Singapore. At the same time, a baby who was in the care of the grandmother in Pontian also developed a viral illness.

The deceased developed symptoms later on 31 December and subsequent to this, four other children, including one who is resident in Pontian, also developed HFMD-like illness.

The HFMD Taskforce considered the following two scenarios in tracing the source of possible infection.

(a) the children went to Pontian in good health and were exposed to the virus there; or

(b) some of the children in the Singapore group were already infected before they went to Pontian, infected the children there, and came back and fell ill.

Based on the pattern of the incubation period of HFMD, the Taskforce is of the opinion that either of the two scenarios above is possible.

As part of our close cooperation with the regional health authorities, Singapore's public health authorities have alerted their counterparts in Johor Bahru of the situation.

Update on the cases in hospital

Altogether, eight children ranging from 3 months to 7- years old were warded in KKH on 3 Jan. Two of them were residents of Pontian who sought medical treatment here after attending the funeral of the deceased. Six of the children have since been discharged from hospital, including the two children from Pontian. The remaining two continue to be in stable condition. As a precautionary measure, the children's parents have been advised to keep them at home for another week.

HFMD Situation in Singapore

There has been no sudden increases in the number of HFMD cases in Singapore. Over the last eight weeks, there was an average of 50 cases a week. In the last two weeks of December 2000, there were 45 and 29 cases respectively. And in the first three days of this year, there was an average of 10 cases a day.

Officers from the Quarantine and Epidemiology Department, Ministry of the Environment have visited the pre-school centres the children attend. All observe good hygiene and no children were found to show any signs of possible HFMD infection.

The Taskforce would like to remind all pre-school centres to observe proper hygiene and sanitation in their premises and isolate any child who is unwell. Parents are reminded not to send their child who is unwell to school but to seek medical attention and let the child rest at home. "

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Wishing all MMA members a Very Happy New Year 2001!

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