Nearly 71 percent of China's fatal hand-foot-mouth disease (HFMD) cases were reported in rural areas, giving a clear sign of the huge rural-urban medical gap, the Ministry of Health said on Thursday.

The ministry vowed to further enhance medical responses, particularly in vast countryside areas, to curb the raging epidemic.

As of June 22, the common viral epidemic among children has sickened nearly 987,779 on the Chinese mainland. Of that total, 537 died. The majority of those who have gotten ill are younger than 3, said Wang Zijun, deputy director of the emergency response office under the Chinese Center for Disease Control and Prevention, at a press conference.

The epidemic control situation is grave in the country as the number of deaths caused by the disease stood at only 186 in the same period last year, Wang said.

"Rural doctors, who are less experienced than their urban counterparts in treating the infection, are finding it difficult to make timely diagnoses of the infection, with no lab screening capacity at grassroots-level facilities," said Lu Lianhe, veteran infectious disease doctor of the Beijing Ditan Hospital.

A late diagnosis might delay the effective treatment for the disease, which, in rare cases, can cause deadly complications like encephalitis, he said.

Usually, the infected person recovers without medication in seven to 10 days, experts said.

Relatively poor awareness of public hygiene and medical care among the rural population is also to blame for the higher fatality rate there, Wang said, urging parents there to practice better hygiene.

Among the fatal cases, about 92 percent were caused by entero virus 71 or EV71, which, like other strains such as the polio viruses, coxsackie viruses and echo viruses, can cause the disease, Wang said.

To address that, the CDC planned to introduce a quick test kit for EV71 among rural doctors to help facilitate early detection, according to Wang.

"Early detection and treatment is the key to averting death," he said.

Also, the ministry has been busy training all rural doctors in the nation for better HFMD response, said Yang Jinrui, deputy director of the ministry's information office.

The task will be completed by the end of June, according to Yang.

Previously, treatment guidelines for HFMD had been distributed to all medical facilities across the country.

In truth, apart from an unbalanced outbreak response between rural and urban areas in China, the long-existing gap in health conditions of minors is also widening, experts warned.

The prevalence of stunted growth among rural children younger than 5 is 17.3 percent, nearly four times that of urban children, official statistics show.

"And the gap shows no signs of shrinking," said Song Wenxiu, division director of the National Working Committee on Children and Women under the State Council.

Also, they are more susceptible to incidents such as the fake milk powder, she said.

(China Daily June 25, 2010)