NewsDesk @bactiman63

Hong Kong health officials report investigating  two outbreaks of hand, foot and mouth disease (HFMD) at two child care centers.

Ulcerous herpangina on soft palate and oropharynx from Hand Foot and Mouth Disease (HFMD)
Public domain image/shawn c

The first outbreak involves 21 toddlers (including 11 boys and 10 girls) aged 8 to 26 months at a child care center in Kowloon City. They developed fever, oral ulcers and rash on their hands or feet since May 11. All patients sought medical attention and one of them required hospitalisation, who has been discharged after treatment. All patients are in stable condition. The respiratory specimen of one affected boy tested positive for enterovirus (EV) upon laboratory testing.

The second outbreak involves 23 children (including 12 boys and 11 girls) aged 2 to 4 at a residential child care center in Wan Chai. They developed oral ulcers and rash on their hands or feet since May 18. All patients sought medical attention and none required hospitalization. They are in stable condition.

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“HFMD is common in children, while adult cases may also appear. It is usually caused by EVs such as Coxsackie virus and EV71. It is clinically characterized by maculopapular rashes or vesicular lesions occurring on the palms, soles and other parts of the body such as the buttocks and thighs. Vesicular lesions and ulcers may also be found in the oral cavity. Sometimes patients present mainly with painful ulcers at the back of the mouth, namely herpangina, without a rash on the hands or feet,” a spokesman for the Centre for Health Protection (CHP) said.

“HFMD occurs throughout the year with the usual peak occurring from May to July. A smaller peak may also occur from October to December. According to the CHP’s latest surveillance data, the local activity of HFMD has increased. As young children are more susceptible, parents should stay alert to their health. Institutional outbreaks may occur where HFMD can easily spread among young children with close contact,” the spokesman added.

To prevent HFMD, members of the public, and especially the management of institutions, should take heed of the following preventive measures:

  • Maintain good air circulation;
  • Wash hands before meals and after going to the toilet or handling diapers or other stool-soiled materials;
  • Keep hands clean and wash hands properly, especially when they are dirtied by respiratory secretions, such as after sneezing;
  • Cover the nose and mouth while sneezing or coughing and dispose of nasal and oral discharges properly;
  • Regularly clean and disinfect frequently touched surfaces such as furniture, toys and commonly shared items with 1:99 diluted household bleach (mixing one part of bleach containing 5.25 per cent sodium hypochlorite with 99 parts of water), leave for 15 to 30 minutes, and then rinse with water and keep dry. For metallic surfaces, disinfect with 70 per cent alcohol;
  • Use absorbent disposable towels to wipe away obvious contaminants such as respiratory secretions, vomitus or excreta, and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach (mixing one part of bleach containing 5.25 per cent sodium hypochlorite with 49 parts of water), leave for 15 to 30 minutes and then rinse with water and keep dry. For metallic surfaces, disinfect with 70 per cent alcohol;
  • Children who are ill should be kept out of school until their fever and rash have subsided and all vesicles have dried and crusted;
  • Avoid going to overcrowded places; and
  • Parents should maintain close communication with schools to let them know the latest situation of the sick children.

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