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But the bug responsible is the mild Coxsackie Type A virus
 THE incidence of hand, foot and mouth disease (HFMD) has remained high in the last three months, with the recently ended month-long school holiday failing to break the chain of infection.
This is largely because the epidemic seems to be hitting children aged two to four in childcare centres, which had stayed open during the school break.
More than 13,100 people have come down with the illness in the first half of the year; in the last five years, the number of cases for the period hovered around 9,649.
In two of the last three weeks, the number of cases diagnosed a week shot past 679, the epidemic level. The 721 cases reported last week is more than double the usual number for this time of year.
The number of cases has already exceeded the warning level of 515 cases a week in the last 14 consecutive weeks. Compare this to last year, when the number of cases each week rose above 515 in only six weeks throughout the entire year.
The bright spot in these numbers is that the main strain this time appears to be the Coxsackie Type A virus, which produces mild symptoms in most cases.
However, with all school-going children back in class this week, the numbers look set to surge afresh.
A Health Ministry spokesman said the reason for the high numbers in the current outbreak is unknown.
HFMD, a usually mild childhood disease, causes fever and blister-like eruptions in the mouth, as well as red rashes on the hands and feet, giving it its name. Children down with it are often listless and do not eat well.
It is spread through contact with bodily fluids, so proper hand washing plays an important part in breaking its spread. The disease is caused by a group of about 80 viruses, some more deadly than others. Some cases here have been fatal, usually those caused by the virulent enterovirus 71 (EV71) bug.
In 2008, four children infected with EV71 developed encephalitis, or inflammation of the brain lining. One of them died. In the worst HFMD outbreak here caused by the bug in 2000, four children died.
Although a mild strain seems to be spreading this year, the Health Ministry spokesman nevertheless advised parents to take their children to a doctor if they are unwell.
The ministry also urged parents to keep their infected children out of school, and to avoid taking them to public or crowded places, where the virus could be spread to other children.
The spokesman noted that so far this year, no school, kindergarten or childcare centre has been told to close as a result of the outbreak.
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