Hand Foot and Mouth Disease

There is a bunch of funny picorna viruses which tend to infect babies and young children. They produce a febrile illness accompanied headaches and characteristic rashes over the body with ulcers on the palms, soles and the insides of the mouth. Although usually mild and self limiting, the illness does rarely affect the brain and produce fatalities. Locally apparently the virulent and more dangerous EV71 virus is quite prevalent.

I became interested because there was a recent apparent fatality due to Hand Foot and Mouth Disease (HFMD). He was only 12 years of age. This was apparently only our second HFMD death since 2001.

The incidence of HFMD in Singapore has been increasing. The figures in 2008 are alarmingly higher than 2007. There was a large spike earlier in April-May this year, and another smallish one extending from November through into December. Both these periods had numbers which brought the disease into epidemic proportions

.Graph from MOH site. Click picture for a larger view.

Although understandng the Ministry of Health's reluctance to create any sort of public panic about what essentially is a relatively mild childhood disease, the single reported death last Sunday is a cause of concern.

I tried to find out more from the MOH website but couldn't get much other than the figures displayed here.

Some missing information which should be of public interest include:

a] How many of these numbers reported were actually HFMD? Were they all lab diagnosed with specific HFMD serlogical tests? Were they specifically examined for the virus type...were they all EV71?

b] What is the frequency of EV71 infections as compared to other milder versions of the picorna virus.

c] Was the recent death examined for EV71? Was it clear that this was HFMD? Why does it take so long to do a PCR virus analysis.

For an infectious disease of this sort, I found it quite discomforting that these info were not readily available to the public. For parents to be reassured, and for them to be able to make sensible and rational decisions about their children, the Ministry of Health really needs to be more upfront about telling us what's going on.

Just like the AVA, the people in MOH tend to treat the public as if they were morons or immature children who cannot deal with information other than highly sanitized ones, and are totally incapable of making rational decisions.