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Hand, foot and Mouth, HFM disease is not uncommon. Usually, children have rash on the hands, feet and in the mouth with sore throat. Within a week, the disease disappears. However, in 1997 and 1998, there was epidemic of Enterovirus 71 in Sarawak, Malaysia and Taiwan respectively. Some children died because EV71 affected the heart.

Since last month, Singapore has had HFM epidemic, spreading to Johore and other states in Malaysia. Anyway, epidemic does not recognize national borders. This is more so between Malaysia and Singapore.

Why should HFM suddenly become serious, claiming four lives in Singapore and possibly one in Johor Baru. One was found to have EV71. We hope the other four can reveal the strain of virus.

It is reported that there are 273 cases of HFM in Johor. There are suspected cases in Malacca, Kedah and Kelantan. On the other hand, there are fewer cases in Singapore.

Malaysia has experience in dealing with Enterovirus epidemic. The 1997
epidemic in Sarawak was due to EV71, not Coxsackievirus. Similarly, the same strain struck Taiwan in 1998.

Although the Federal and State governments are taking measures to contain the epidemic, the people have to cooperate. Emergency measures such as a special unit in hospital to handle HFM cases are scarcely enough. We need to know the strain of the virus. Is it EV71? Whereas Coxsackievirus does not affect the heart or the brain, EV71 does.

The Health Minister Datuk Chua Jui Meng has commented on the current epidemic. As there are so many strains of Coxsackieviruses A and B, Echoviruses and Enteroviruses, we hope that the minister can let us know the strain causing the epidemic.

The Health Ministry must show that it is able to tackle epidemics in the modern world. It has to instil confidence among the people. In 1997 it handled the Sarawak epidemic unconvincingly, the people were misled with what the Health Minister Datuk Chua called Coxsackievirus.

Although the minister has attributed the current epidemic as due to Coxsackievirus, we hope he will let us know the strain. The virulence or viciousness of the strain determines the types of measures taken.

 Dr Tan Seng Giaw 11 October 2000