2018 Malaysia HFMD outbreak

The 2018 Malaysia HFMD outbreak is a hand, foot, and mouth disease (HFMD) outbreak happened among children in the country nationwide. More than 50,000 cases has been reported until August,[1] increasing from only 38,000 cases recorded in early January.[3] Among the states and federal territories affected by the outbreak, Selangor recorded the highest cases with 11,349, Kuala Lumpur with 4,428 and Sarawak with 4,412 cases as reported in July.[3] Two children in Sarawak and Penang are among the fatalities in the year as a result of complications caused by the virus.[4][5]

2018 Malaysia HFMD outbreak
DiseaseCoxsackievirus A16[1] and Enterovirus 71[2]
First caseJanuary 2018
Deaths2
Confirmed casesmore than 50,000[1]

Background and history
Main article: 1997 Sarawak HFMD outbreak

The background of HFMD transmission outbreak in Malaysia were firstly reported in the state of Sarawak in 1997 where a total from 28–31 children died as a result of infection by the Enterovirus 71 (EV-A71) virus.[6][7] Since then, the recurrent cyclical epidemics of HFMD in the country occurs every two to three years. Another factor that increases the spread of HFMD among children is through travelling to neighbouring countries with high HFMD infection despite the main root causes of the recurring disease still remain a mystery in the country.[7] Through autopsies performed on the deceased children, their deaths is caused by several symptoms linked to the disease such as poor peripheral perfusion, tachycardia and cardiac failures.[7] The children also had earlier developed symptoms such as shock, pallor, cold extremities, delayed capillary refill and weak peripheral pulses.[7] In 1998, the Ministry of Health acknowledged the disease was endemic in the country with periodic outbreaks among young children. Since the first outbreak, the Ministry of Health has periodically ordered the closure of every affected kindergartens and schools where it is likely to be the source area of the disease. Further outbreak with 1,178 cases where it is mostly occurred in kindergarten and nursery was reported in the state of Johor in 2000 following an outbreak in neighbouring Singapore a month before.[7]

Authorities response

In July, Malaysian Health Ministry Disease Control Division director Chong Chee Keong said toys are among the cause of immediate spread of the virus to other children.[8] The Health Ministry further reported that the HFMD disease cases has exceeded the warning levels and urged every parents must act as "gate-keepers" to make sure their children that was infected by the disease did not go to school to prevent the spread and seek immediate treatment if there is signs of infection with the Education Ministry issuing a letter to every schools to monitor the health of their students.[9][10][11] The Health Ministry also considering the use of vaccine from other countries although extensive research on the vaccine need to be carried out before it could be approved for local use.[12] With the increasing infection among children, all supermarkets and shopping complexes in Penang have been ordered by local health department to disinfect their trolleys, toys and benches on their premises.[13] Disinfection also been carried out in all villages, schools and preschools in a district in Sarawak.[14]

See also
  • Enterovirus

Further reading
  • L. G. Chan; Umesh D. Parashar; M. S. Lye; F. G. L. Ong; Sherif R. Zaki; James P. Alexander; K. K. Ho; Linda L. Han; Mark A. Pallansch; Abu Bakar Suleiman; M. Jegathesan; Larry J. Anderson (2000). "Deaths of Children during an Outbreak of Hand, Foot, and Mouth Disease in Sarawak, Malaysia: Clinical and Pathological Characteristics of the Disease". Clinical Infectious Diseases. 31 (3). doi:10.1086/314032 – via Oxford Academic.
  • "Hand Foot and Mouth Disease (HFMD) Guidelines" (PDF). Ministry of Health, Malaysia. Archived (PDF) from the original on 29 August 2019. Retrieved 29 August 2019.

References
  1. Martin Carvalho; Hemananthani Sivanandam; Rahimy Rahim; Loshana K Shagar (16 August 2018). "Over 50,000 cases of HFMD recorded, virus strain relatively benign". The Star. Retrieved 29 August 2019. Over 50,000 cases of hand, foot and mouth disease (HFMD) stemming from the Coxsackie virus have been reported since the outbreak of the disease.
  2. "Malaysia reports increase in Hand, Foot and Mouth Disease". Outbreak News Today. 10 June 2018. Retrieved 29 August 2019. For the year 2018, up to 316 nurseries/kindergartens/pre-schools reported HFMD clusters at their premises, which is 52% of the total epidemic reported. HFMD virus surveillance also found an increase in enterovirus-71 (EV71) activity in the environment since March 2018.
  3. "HFMD cases near 38,000 nationwide since January [NSTTV]". Bernama/NSTP. New Straits Times. 28 July 2018. Retrieved 29 August 2019.
  4. Katrina Khairul Azman (29 July 2018). "A 2-Year-Old Boy In Sarawak Suffering From HFMD Has Died". Says.com. Archived from the original on 29 August 2019. Retrieved 29 August 2019.
  5. "17-month-old boy's death in Penang due to HFMD". The Star. 30 July 2018. Retrieved 29 August 2019.
  6. Yoke Fun-Chan; I-Ching Sam; Kai-Li Wee; Sazaly Abu Bakar (2011). "Enterovirus 71 in Malaysia: A decade later" (PDF). Neurology Asia. 16 (1). Archived (PDF) from the original on 29 August 2019. Retrieved 29 August 2019 – via University of Malaya.
  7. Nur Najihah Hasan (2017). "Assessing the Prevalence of Hand, Foot and Mouth Disease (HFMD) Using Geospatial Density and Distribution Techniques" (PDF). Faculty of Geoinformation and Real Estate: 2–3 [18–35]. Archived (PDF) from the original on 29 August 2019. Retrieved 29 August 2019 – via Universiti Teknologi Malaysia.
  8. "Toys among agent causing spread of HFMD between children: Health Ministry". Bernama. New Straits Times. 11 July 2018. Retrieved 29 August 2019.
  9. "HFMD cases exceed warning levels, says ministry". The Star. 12 July 2018. Retrieved 29 August 2019.
  10. "HFMD can cause death if not immediately treated: Malaysian health ministry". Bernama. Channel NewsAsia. 27 July 2018. Archived from the original on 29 August 2019. Retrieved 29 August 2019.
  11. "Situasi Semasa Kejadian Penyakit Tangan, Kaki Dan Mulut (HFMD) Di Malaysia" [Current Situation of Hand, Foot and Mouth Disease (HFMD) In Malaysia] (Press release) (in Malay). Ministry of Education, Malaysia. 12 July 2018. Archived from the original on 29 August 2019. Retrieved 29 August 2019.
  12. Farhana Syed Nokman (31 July 2018). "HFMD outbreak: Health Ministry considering use of vaccine from other countries". New Straits Times. Retrieved 29 August 2019.
  13. "Penang supermarkets, shopping malls ordered to carry out disinfection as HFMD cases rise". Bernama. Channel NewsAsia. 24 July 2018. Archived from the original on 29 August 2019. Retrieved 29 August 2019.
  14. Peter Boon (3 August 2018). "All-out effort to curb HFMD". The Borneo Post. Archived from the original on 29 August 2019. Retrieved 29 August 2019.
  • HFMD outbreak – Data on the outbreak from the Ministry of Health, Malaysia
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