Singapore

HFMD may soon be an epidemic

Measures being taken to contain HFMD as disease on the rise in Singapore

Two weeks ago, Ms Wendy Phng, 28, noticed red spots on her daughter's hands and feet, and ulcers in the toddler's mouth.

Ms Phng, a property officer, said: "She was also running a fever on-and-off. I thought it was chickenpox at first.''

But a visit to the doctor on April 25 confirmed that Ms Phng's daughter had Hand Foot and Mouth Disease (HFMD).

Ms Phng suspects that her only child, who is one-and-a-half, caught the virus at a gathering or the playground.

The Ministry of Health said that there were 1,052 cases two weeks ago.

Last week, there were 1,022.

These are the among the highest figures sinceOctober 2013, when 1,247 weekly cases were reported.

Infectious diseases specialist Leong Hoe Nam told The New Paper that the figures hint that we are at the "cusp of an epidemic" (see report on opposite page).

The virus is highly contagious, and this is made worse because children at childcare centres or kindergartens are in close proximity and share "everything", he added.

Ms Phng said that she and her husband swung into action, and spent a day disinfecting their home. Adults can also contract HFMD.

"Toys, floors and beds - we had to sanitise everything that she came into contact with. Up till now, we still keep the toys away because we heard that she's still contagious," said Ms Phng.

"Her rashes have dried up, but we're still keeping her away from crowds and other children for now," she added.

Administrative assistant Valerie Lim's son goes to a childcare centre in Woodlands which has seen nine cases in just over a week.

Madam Lim, 23, said she checks her son for HFMD symptoms every day. She is worried because if he catches the virus, she and her husband will have to take leave for at least a week to care for him as they do not have a helper.

"It'll be a big inconvenience but we don't have a choice.

"Perhaps we'll take alternate days off, " said Madam Lim.

Childcare centres and kindergartens across the island, with more than 10 HFMD cases, or with more than 13 per cent of students getting HFMD, and with a transmission period of more than 16 days, are put on a watch list on the MOH website.

Yesterday, four centres were on the list: Learning Vision at The Grassroots' Club, Ascension Kindergarten, PAP Community Foundation Sparkletots Preschool at Sembawang and The Little Skool House at Kent Vale.

A spokesman for NTUC First Campus, which manages The Little Skool House at Kent Vale, told TNP that "all necessary precautionary measures" are taken to detect and prevent the spread of HFMD on their campuses.

STEPPING UP MEASURES

TNP also spoke to other childcare centres and kindergartens. They say they are stepping up measures to ensure that the virus doesn't enter or spread at their centres.

These include increasing the frequency of temperature and "visual" checks and regularly disinfecting shared spaces and surfaces.

Childcare centre Acekidz Group has seen five cases in the last two weeks.

Miss Winnie Tan, 34, a teacher there, said they have started taking temperatures thrice a day instead of the usual twice, and do more thorough checks on the children's mouths, hands and feet three times daily.

The centre also washes and sanitises all surfaces the children come into contact with.

She said: "We usually do the cleaning twice a week, but we have been doing it every day since our first case (about two weeks ago)."

According to MOH guidelines, children with HFMD should stay at home and away from school until they are clear of the disease.

Operator of His Little Kingdom Childcare and Development Centre Susie Tan, 49, said her centre sees about two cases a year.

She said: "It's better to be safe than sorry with all these precious ones.

"When a child gets HFMD, not only he or she suffers, the parents are affected, and it also causes the teachers and school problems."

Toys, floors and beds - we had to sanitise everything that she came into contact with. Her rashes have dried up, but we're still keeping her away from crowds and other children for now.

- Ms Wendy Phng


BY THE NUMBERS

1,022 Number of HFMD cases last week, down from 1,052 two weeks ago. These are the among the highest figures since Oct 2013, when 1,247 weekly cases were reported.

Expert says there could be an epidemic

PHOTO: DR LEONG HOE NAM

"We are at the cusp of an epidemic," said infectious diseases expertLeong Hoe Nam (above) of Mount Elizabeth Novena Hospital .

"More than 1,000 cases is really a lot. (The numbers) are going to go up.''

Why?

"The kids who were previously infected have moved on from kindergartens and pre-schools, which means these places are currently filled with kids who are vulnerable to the disease,'' he said.

"When enough people have had the disease, it builds an immunity within the group - essentially, the virus cannot find a toehold to take root.

"But when the kids are blank slates for the virus, they can take hold and spread very quickly.''

The other reason numbers are likely to go up? "Singaporeans have relaxed their infection control,'' said Dr Leong.

HFMD can be caused by different viruses, but EV71 was behind most of the seven deaths during the 2000-2001 outbreak in Singapore.

Dr Leong said: "It's very contagious. It spreads by objects and droplets (which are microscopic fluid droplets that can fly out from your mouth when you sneeze or even talk).

"So, if an infected person touches an object and another person, without immunity, touches it as well, it is likely that the other person will become infected."

"But we will overcome (the outbreak)," he added.

The virus currently circulating is not fatal, he said. However, HFMD is still not to be taken lightly. "It varies from child to child, but they need at least a week to recover.''.

SYMPTOMS OF HFMD

Hand, foot and mouth disease (HFMD) is a viral infection common among children in Singapore.

Dr Clarence Yeo, 43, a physician at Killiney Family and Wellness Clinic, said: "Children usually first develop a fever, after which they tend to develop ulcers in the mouth and blisters on the hand and feet.

  • The fever usually lasts a couple of days. But the blisters can take up to 10 days to clear.
  • Other symptoms include blisters on the buttocks, sore throat, lethargy and poor appetite, as stated on the MOH website.
  • Although it affects both children and adults, children below five years old are particularly susceptible.
  • The disease is spread from person to person by direct contact with nasal discharge, saliva, faeces, and fluids from the rash of an infected person.
  • There is no vaccine available.
Ministry of HealthVirusepidemichealthHFMDSingapore