Suspected Hand, Foot And Mouth Disease (HFMD) Death Of 3-Year-Old Boy In Singapore

07 Aug 2008

1 The Ministry of Health (MOH) has been notified of a suspected Hand, Foot and Mouth Disease (HFMD) death.  The patient was a 3-year-old Malay boy who developed fever, oral ulcers and rash on 3 August 2008. He was seen by a general practitioner on the same day who diagnosed HFMD. The boy subsequently developed vomiting on 4 August 2008 and was admitted to the KK Women’s and Children’s Hospital (KKH) on 6 August 2008. At KKH, he was found to be dehydrated with high fever and was admitted to the Intensive Care Unit (ICU) for management.  His condition deteriorated and he passed away on the same evening. Investigations into the cause of death are ongoing.

2 The patient was attending Elias Kindergarten (Woodlands) which currently has an active HFMD cluster.  In view of the on-going transmission of HFMD and the suspected HFMD death of a child attending the kindergarten, we have informed the Ministry of Education to close this kindergarten for a period of 10 days, with immediate effect till 17 August 2008.  This closure will allow a break in the chain of transmission and will allow the Kindergarten to carry out the necessary cleaning and disinfection.

Situation of HFMD in Singapore

3 The number of HFMD cases notified in the week ending 2 August 2008 is 392 cases, below the warning threshold level. This brings the total number of cases to 17,435 for the first 31 weeks of this year.

Ministry’s Advice

4 The Ministry would like to stress the importance of maintaining high standards of personal and environmental hygiene to minimise the risk of HFMD. Parents should ensure that their children adopt the following good practices:

• Wash hands with soap before eating and after going to the toilet;

• Cover mouth and nose when coughing or sneezing;

• Do not share eating utensils.

5 Parents should also ensure that toys or appliances that are contaminated by nasal or oral secretions should be cleaned before they are used again.

6 Parents should consult a doctor early if their child has fever, mouth ulcers and rashes on the palms, soles or buttocks. Children with HFMD should remain at home until all the blisters have dried up. During this period, contact with siblings and other children should be avoided as HFMD is infectious.  As other children living in the same household may also get infected, parents should check these children daily before they are allowed to go to school, child care centre or other pre-school centres.  The affected child should not be brought to any public or crowded places. Proper hygiene should also be practiced at home so as to prevent transmission to other family members.

7 For more information on HFMD, please see the FAQs on MOH website at http://www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx, or the guideline on Prevention and Control of Infectious Diseases in Child Care Centres / Kindergartens / Pre-School Centres here.

MINISTRY OF HEALTH

7 AUGUST 2008