7 June 2004

Dear Doctor,

Hand-foot-mouth Disease and Enterovirus 71 Infection in Hong Kong

I would like to update you on the current situation of hand-foot-mouth disease (HFMD) and enterovirus 71 (EV-71) infections in Hong Kong. As at 7 June 2004, eleven cases of EV71 infection were reported this year: 1 case in February, 2 cases in April, 6 cases in May, 2 cases up to 7 June. All cases were young children aged between one and five, they all recovered without complication. Some were associated with hand-foot-mouth disease (HFMD) outbreaks in the nurseries or kindergartens they attended. According to our laboratory surveillance data on enterovirus (2004), Coxsackie A16 is the commonest enterovirus isolated, which is also a common cause of HFMD.

In view of the increasing trend this summer season, your support is sought in providing the following health advice to parents whose children suffer from HFMD:

• Do not let children attend nurseries/kindergartens/schools until all vesicles have dried up.
• Keep children at home while symptomatic and do not let them attend activities that mix with other children, e.g. birthday party, interest classes, swimming pool.
• Wash hands thoroughly after changing diapers or handling respiratory secretions of their children
• Clean thoroughly toys or appliances which are contaminated by the child's secretions with 1:49 diluted household bleach.

As an extra precaution, a child who has HFMD with suspicion to be caused by EV71 infection should be excluded from attending nurseries/kindergartens/schools for 2 weeks after all symptoms have subsided.