The Centre for Health Protection (CHP) of the Department of Health (DH) today (November 5) reported the latest investigation progress of an outbreak of hand, foot and mouth disease (HFMD) in a child care centre (CCC) announced last week and confirmed that the outbreak was attributable to enterovirus (EV) 71 infection. The CHP again urged the public and institutions to maintain strict hand, personal and environmental hygiene.
The officers of the CHP visited the CCC twice last week to evaluate and request improvements in childcare procedures and infection control measures. In addition to health education for the staff of the CCC on October 31, an online health seminar was held on the evening of November 1 to remind parents of precautions for EV71 and preventive measures for their children. The seminar was attended by about 30 parents.
The CHP's medical surveillance of the CCC revealed that there were two more patients, namely a 17-month-old girl and a 29-month-old boy. The outbreak has involved a total of eight children so far. All have sought medical consultation and are stable with no hospitalisation required. Clinical samples from three of the patients tested positive for EV71. The CHP continues to test clinical specimens from the other symptomatic children.
The CHP has advised the CCC to suspend its services for 14 days from November 1. Since the two new patients had their symptoms onset at home after the service suspension, this indicates that the measure could be effective in preventing further spread of EV71 in the CCC. Medical surveillance of all children in the CCC is still ongoing.
"EV71 is one of the causative agents for HFMD. The infection is transmitted by direct contact with an infected person's nose or throat discharges, saliva, fluid from blisters or stool. Good personal and environmental hygiene are the most important measures to prevent EV71 infection," a spokesman for the CHP said.
The local HFMD activity is still at a high level currently. According to the CHP's latest surveillance data, the number of HFMD outbreaks in institutions recorded has increased from 11 (affecting 52 persons) in the week ending September 21, to both 23 (affecting 59 and 54 persons) recorded in the weeks ending October 26 and November 2 respectively. As of yesterday (November 4), four outbreaks involving nine persons had been reported in the past two days of this week. The outbreaks were mainly recorded in kindergartens, CCCs and primary schools. The CHP will issue letter to schools again, urging them to be more vigilant and take corresponding measures to tackle HFMD.
"In Hong Kong, 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 condition. Institutional outbreaks may occur where HFMD can easily spread among young children with close contact," the spokesman added.
The spokesman reminded that alcohol-based handrub should not substitute hand hygiene with liquid soap and water, as alcohol does not effectively kill some viruses causing HFMD, for example, EV71. 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 household 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;
- 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;
- 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 sick children.
The CHP's weekly publication, EV SCAN (www.chp.gov.hk/en/view_content/21639.html), is issued every Friday to report the latest local situation of HFMD. Members of the public may also visit the CHP's page on HFMD and EV71 infection for more information.
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