監 測 及 流 行 病 學 處
Surveillance Epidemiology And
Branch
香港九龍亞皆老街147C 號 3 樓 3/F, 147C Argyle Street, Kowloon, Hong Kong 衞生防護中心乃衞生署
轄下執行疾病預防 及控制的專業架構 The Centre for Health
Protection is a professional arm of the Department of Health for
disease prevention and control 衞生防護中心乃衞生署
轄下執行疾病預防 及控制的專業架構 The Centre for Health
Protection is a professional arm of the Department of Health for
disease prevention and control
本 署 檔 號 Our Ref. : (3) in DH SEB CD/8/22/1 IV
電 話 Tel. :
傳 真 Fax No. : 25 May 2018
Dear Principal / Person-in-charge,
Vigilance against Hand, Foot and Mouth Disease (HFMD) and Enterovirus 71 (EV71) Infection
I would like to draw your attention to the recent increase in activity of hand, foot and mouth disease (HFMD) and enterovirus 71 (EV71) infection and urge schools and institutions to be vigilant against the diseases.
The Centre for Health Protection (CHP) of the Department of Health recorded an increasing number of institutional outbreaks of HFMD in the past two weeks, from five in week 19 (ending May 12) to 14 last week. Fifteen institutional HFMD outbreaks have already been recorded in the first five days of this week. Besides, surveillance of HFMD based at sentinel private medical practitioners and sentinel child care centres/kindergartens also showed a corresponding increase of HFMD activity recently.
In addition, the number of cases of EV71 infection recorded has increased from zero to one case per month during the period from January to April to seven cases in May. As of 24 May, a total of nine cases of EV71 infection were recorded in 2018.
HFMD is a viral infection commonly seen in children. The infection can occur throughout the year in Hong Kong but the disease activity usually peaks from May to July. Common symptoms include fever, sore throat and skin rash over the hands and feet. Although the illness is self-limiting in most cases, some cases especially those caused by EV71 may be associated with complications like myocarditis, encephalitis or poliomyelitis-like paralysis.
Maintaining good hygiene practice is the most important measure to prevent HFMD and EV71 infection. Schools and institutions are recommended to take the following measures to prevent outbreak:
Maintain good communication with parents and advise them to keep their children at
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home for rest when they develop fever or rash. People who develop symptoms suggestive of HFMD should seek medical advice promptly.
Encourage staff to screen children for signs and symptoms of HFMD before they enter the school. Children with HFMD should be excluded from school until fever has subsided and all the vesicles have dried and crusted. As an extra precaution, children with EV71 infection are advised not to go to school for another two weeks after all symptoms subsided, since the virus may be excreted in stool for some weeks and the infection is associated with a higher risk of complications.
Supervise children on personal hygiene practices, especially on how to wash the hands properly with liquid soap before meals and after going to toilet, cover nose and mouth while sneezing or coughing, and proper disposal of nasal and mouth discharge.
Avoid high risk play facilities such as ball pools. Clean and disinfect frequently touched surface, furniture and toilets regularly with diluted bleach of 1:99 concentration (mixing one part of household bleach containing 5.25% sodium hypochlorite to 99 parts of water). Disinfect toys/places which are contaminated by secretions or excreta with diluted household bleach of 1:49 concentration.
Remind staff to wash hands thoroughly with liquid soap and water after changing diapers for each child, to disinfect diaper-change area by diluted bleach, and to dispose soiled diapers properly.
Keep the environment clean and hygienic, and follow the “Guidelines on Prevention of Communicable Diseases in Schools /Kindergartens /Kindergartens-cum-Child Care Centres /Child Care Centres” which is available at http://www.chp.gov.hk/files/pdf/guidelines_on_prevention_of_communicable_disea ses_in_schools_kindergartens_kindergartens_cum_child_care-centres_child_are_ce ntres.pdf.
Incorporate in your health education to children that when they are having holidays outside Hong Kong, they should still remember to keep their hands clean and avoid touching vesicles on hands of other sick children.
If there is a suspected HFMD outbreak (e.g. two or more students in the same class or in the same setting in case of kindergartens or child care centres develop symptoms of HFMD in succession within a short time), please inform the Central Notification Office of the CHP as early as possible by fax (2477 2770) or phone (2477 2772). The CHP
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will give advice on the management of such cases and take appropriate control measures.
We may consider advising schools to suspend classes for a period of 14 days when situation warrants. Examples of such scenarios include occurrence of further cases in an institution attended by a confirmed EV71 case after stepping up control measures, OR occurrence of a HFMD outbreak in an institution with an EV71 case who is suffering from severe complication. For more information, please visit the website of CHP at http://www.chp.gov.hk/en/view_content/16354.html.
Yours faithfully,
(Dr SK CHUANG)
for Controller, Centre for Health Protection Department of Health
