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But hand, foot and mouth disease is still at epidemic levels with 1,060 new cases detected in the week before last. APRIL CHONG reports
 The hand, foot and mouth disease (HFMD) outbreak may be on the wane here. There were 1,060 new cases in the week before last compared to the peak of 1,261 new cases a month ago.
However, the disease, which started spreading rapidly in June, is still at epidemic levels.
More than 22,000 children have been infected this year.
HFMD is usually mild with symptoms such as fever, mouth ulcers and blisters on the palms and soles. It resolves after five to seven days.
Usually, less than 2 to 3 per cent of infected children would need to be warded, estimated Dr Thoon Koh Cheng, head of the infectious disease service at KK Women's and Children's Hospital.
Children who are warded usually suffer from dehydration, as the mouth ulcers they get make it difficult for them to eat and drink. Dehydration can be fatal if not treated, said Dr Thoon.
A few may be hospitalised for the rare case of infection of the brain, lung or heart when the virus migrates. This can be fatal too, with children below the age of five at a higher risk.
Symptoms of an infection include fits, drowsiness, disorientation, irritability, vomiting, chest pain, breathing difficulty and headaches.
About 1.3 per cent of infected children have been warded this year. The number of hospital admissions have also been stable atabout 13 children each week for the past few weeks, said the Health Ministry. Most of those who were hospitalised had eating difficulties.
As of early this week, no child has been reported to be severely ill or has died from this outbreak, which is caused by a group of about 70 viruses known as the
enteroviruses.
In the severe 2000 and 2001 outbreak, seven children died. They were infected with the more deadly enterovirus 71 (EV71) strain, which can lead to infections of the
brain and heart.
While the EV71 strain has been responsible for most of the HFMD-related deaths, it is still not known why some children are more susceptible to these serious complications, said Dr Chan Poh Chong, a senior consultant at the University Children’s Medical Institute at National University Hospital.
About 11 per cent of the patients tested here were found to have the EV71 strain. However, doctors said that the number of children infected with this deadly strain has not been increasing and neither have there been seriously ill patients.
As of Tuesday, no child-care centre was closed.
Adults can also contract HFMD but the disease is usually mild in them, probably due to their higher immunity, said Dr Chan.
Vaccination or anti-viral medication for HFMD are not available but trials for a vaccine are currently underway.
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