Hand Foot and Mouth Disease - What will it be for Singapore in 2009?

From MOH report

There was a convergence of 2 news items yesterday. Firstly there was a short report about a law suit between the El-Amin Education child care centre and the Straits Times; and then there was a report about the rising HFMD cases in Hong Kong/China.

This is a grim reminder of what is to come in Singapore as we move into the time of year when the HFMD epidemic hits. The chart below shows the incidence last week moving into the warning zone. I am actually quite surprised why MOH has not started its public programmes to warn the public of the impending epidemic.

In Singapore the potentially deadly EV71 virus was found in 33.2% of cases as compared to about 13% in Hong Kong. The MOH published a report about the 2008 epidemic here. I tried to find some information about mortality figures related to HFMD in Singapore but could not find anything very much. Only thing I could dredge up was that in the 2000/2001 epidemic there were 7 HFMD related deaths, out of which had EV71. At that time ~66% of samples were EV71 positive.

So what are we to expect this year? Likely the epidemic will hit in some way or other. Current figures are almost identical to last year's data. We can however, mitigate the risks by following good hygienic practices in schools especially:

• Wash hands with soap before eating and after going to the toilet;
• Cover mouth and nose when coughing or sneezing;
• Maintain good air circulation;
• Clean thoroughly toys or appliances which are contaminated by nasal or oral secretions; and
• Do not share eating utensils

Last year a number of schools were closed during the epidemic. I don't know what will happen this year. But I do know it will come with signifcant disruptions to family life. We have not found solutions to the closure of schools and child care centres. What do we do with infected children? How to quarantine them? What do we do with children whose child care centres are closed down? How do working families cope?