HAND, FOOT AND MOUTH DISEASE

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HAND, FOOT AND MOUTH DISEASE:

(Update): 9.

Mdm Halimah Yacob asked the Minister for Health (a) if he will give an update on the hand, foot and mouth disease (HFMD) situation in view of the recent death of a three-year-old suspected of dying from the disease; and (b) whether there are sufficient measures in place to protect children from contracting HFMD, especially the more deadly EV71 strain of the disease.

The Minister for Health (Mr Khaw Boon Wan): Sir, Hand, Foot and Mouth Disease (HFMD) is a common childhood infection. The infections are usually mild. Nevertheless, when the virus involved is the EV71 strain, it can affect the brain or even result in death, although such a complication, fortunately, is rare.

This year, we experienced a surge of HFMD cases involving EV71 as the predominant circulating strain from late March to early July. The total number of HFMD cases this year has already exceeded 18,000 cases. The number of cases peaked in April, with more than 1,400 cases a week, and thereafter it declined steadily to around 500 cases a week now. But, then, there is usually a second though much smaller peak outbreak in September, which is just around the corner. So we have to be careful.

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During the April outbreak period, a total of 35 preschools and childcare centres were ordered to close while 95 were advised to close so that the premises could be cleaned thoroughly and the chain of transmission within these centres broken.

The way to reduce the transmission of HFMD, including EV71, is to continuously maintain a very high standard of personal and environmental hygiene and also to seek medical treatment early when the child is unwell. Parents should also ensure that their children with HFMD have adequate rest and, very important, to remain at home for the duration of the illness as advised by the doctors. We have worked closely with MCYS and MOE in educating all childcare, kindergarten and preschool operators on hygiene measures. My Ministry has also alerted doctors to be vigilant for complications from HFMD as the predominant strain this year is the EV71 strain.

Mdm Halimah Yacob: Sir, I would like to ask the Minister:

(1) What is the official epidemic level for the disease and have we reached it in Singapore? and

(2) Have we done an analysis as to why we have a sudden spike of this disease, particularly the EV71 strain, and what measures are we taking to deal with it?

Mr Khaw Boon Wan: Sir, the epidemic level and where it is pegged is a technical exercise. We would look at past records, and this is done by the experts. We exceeded that level in April, during the recent outbreak. Currently, we are close to that level. So, let us be careful.

The solution to it, which is in reply to the second question, remains the same.

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Until a vaccine is found, we have to rely on basic grandmother advice, which is frequent hand washing, thorough handwashing with soap, and maintain high personal and environmental hygiene standard. The solution is well-known, easy to explain, but execution is a problem.

When I first had to deal with this public health issue years ago, I was naively ambitious. I thought in modern Singapore we should be able to eliminate this. We know the Japanese are legendary in their personal hygiene standard – how to wash hands, and they teach their kids from young. So I told my colleagues in the Ministry of Health, "You go and check. I am sure in Japan they do not have Hand, Foot and Mouth disease, given their high standard of personal hygiene." I was personally quite disappointed when I found that even Japan has HFMD outbreaks, not throughout the year, but during the hot season. Unfortunately, we have hot seasons throughout the year, so we have a problem.