In recent weeks a serious viral disease has swept across Singapore. Since early October, more than 1,700 children–most under 5 years of age–have been diagnosed with a potentially deadly form of hand, foot and mouth disease (HFMD). Three people are thought to have died from it. The source of the epidemic has confounded the government. Health officials ordered Singapore’s 440 kindergarten classes and 557 day-care centers closed in early October. The schools were slated to reopen Monday, but play areas at shopping malls, public pools and the Singapore Zoo remain shuttered.
The disease worries health officials because it’s not easy to detect. HFMD typically starts with symptoms as mundane as a sore throat or a runny nose. Mouth ulcers, rash, vomiting, diarrhea, fatigue and weakness follow. There is no vaccine for the virus, which spreads through direct contact with bodily fluids such as saliva and urine. Anxious parents have mobbed the emergency departments of Singapore’s hospitals in recent weeks, many ignoring recommendations that they go to family physicians first. Some said they were uncertain their children had the virus, but were willing to wait hours if necessary.
The school closings have disrupted life for many. Last week Jane Lim, a mother of two, drummed her fingers in frustration on a restaurant table. Ordinarily her 5-year-old son would be in kindergarten class tackling reading lessons. Instead, he accompanied his mother grocery shopping. “I want [the schools] to reopen,” Lim said. “It’s been two weeks.” The Singapore government has set up telephone hot lines to help people cope with the crisis. Some have received as many as 2,000 calls a day from parents, many complaining about problems in arranging alternative day care for their children. “A child’s life is much more important than our convenience,” said Singapore President S. R. Nathan, urging employers to extend “special considerations” to workers.
Now it appears the epidemic is spreading to other countries in Southeast Asia. Three Malaysian infants are believed to have died from the disease in recent days. Seventy-nine new cases were reported over a two-day period last week in Johor Baharu, a Malaysian city across the narrow strait from Singapore. Malaysian authorities are scrambling to contain the outbreak. Last week they closed all government-run kindergartens and child-care centers. Johor Baharu is a popular shopping destination for Singaporeans. Dr. Suntok Singh, the city’s Health Department deputy director, said the visitors contribute to the spread of the disease. Johor has long had a problem with other, less lethal strains of HFMD. State Health Committee chairman Halimah Sadique said recent inspections by health officials at 77 day-care centers showed hygiene levels to be below average. That’s one of many challenges officials will have to deal with to stop the disease.
