The Centre for Health Protection (CHP) of the Department of Health (DH) is today (December 10) investigating a case of severe enterovirus (EV) 71 infection, and again urged the public and institutions to maintain strict hand, personal and environmental hygiene.
A 2-year-old boy with underlying illness has presented with fever, cough and rash since November 30. He attended the Accident and Emergency Department of Princess Margaret Hospital (PMH) on December 2 and 4, and was admitted to PMH for treatment on December 4. He developed drowsiness on December 7.
Upon laboratory testing, his throat swab specimen tested positive for EV71. The clinical diagnosis was EV71 infection complicated with meningoencephalitis. The patient is now in a stable condition.
Initial enquiries revealed that the patient had no travel history during the incubation period and his home contacts have remained asymptomatic.
The CHP's epidemiological investigations also revealed that there is a hand, foot and mouth disease (HFMD) outbreak in the school, New Territories Women & Juveniles Welfare Association Limited Cheung Fat Estate Nursery School in Tsing Yi, where the patient attended. Apart from the patient, a 2-year-old girl has developed HFMD symptoms since November 29. She sought medical attention and no hospitalisation was required. She is now in a stable condition.
Officers of the CHP have conducted site visits to the school and advised the management on necessary infection control and preventive measures. As a precautionary measure, the school was advised to suspend all classes. The school has been put under medical surveillance.
The CHP's investigations are ongoing.
As of December 9, the CHP recorded a total of 63 cases of EV71 infection in 2018, as compared with 36 to 56 cases recorded during the corresponding period from 2015 to 2017. In addition, zero to four cases of EV71 infection were recorded per week in 2018 but the number of cases increased to five to six in the past two weeks.
"EV71 is one of the causative agents for HFMD. The infection is transmitted from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. Good personal and environmental hygiene are the most important measures to prevent EV71 infection," a spokesman for the CHP said.
"HFMD is common in children while adult cases may also appear. It is usually caused by enteroviruses such as Coxsackie virus and EV71. It is clinically characterised 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 rash on the hands or feet," the spokesman said.
"The local HFMD activity is currently at a high level. The usual peak season for HFMD and EV71 infection is from May to July. A smaller peak may also occur from October to December. 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, 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 with EV71 infection are advised to refrain from going to schools or group activities such as parties, interest classes and swimming until two weeks after fever has subsided and all the vesicular lesions have dried and crusted to prevent the spread of disease;
* Avoid going to overcrowded places; and
* Parents should maintain close communication with schools to let them know the latest situation of the sick children.
The public may visit the CHP's page on HFMD and EV71 infection for more information.
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