An ongoing outbreak of the hand-foot-mouth disease (HFMD) in China this year has caused nearly 200,000 infections, including 94 deaths, mostly under the age of 3, the Ministry of Health (MOH) announced on Tuesday.

The number of infections was up 38 percent over the same period last year and the disease is expected to spread, the ministry said.

Nearly 80 percent of current infections were detected in southern or eastern regions, including Guangdong, Zhejiang and Anhui provinces, according to MOH spokesman Deng Haihua, who said deaths were reported in 14 provinces and regions.

In a typical case, at least 13 toddlers, all under the age of 3, have died of the disease in Quanzhou county of Guangxi Zhuang Autonomous Region, Xinhua News Agency reported on Monday.

"The disease will continue to spread across the country in the spring and summer seasons, posing a great challenge to contain the epidemic," Deng said.

Parents, particularly those in rural areas, are urged to practice good hygiene to help prevent the infection, which only strikes children.

In response to the outbreak, training sessions have been organized for health care workers and a clinical guideline on HFMD treatment will soon be distributed nationally among doctors, said Zhao Minggang, deputy director of the medical administration department under the MOH.

To help ward off further infections, regular hand washing is required in hospitals, especially at those designated for the treatment of HFMD, he added.

Feng Zijian, director of the emergency response department of the Chinese Center for Disease Prevention and Control, said most of the more than 2,100 severe cases and deaths reported so far have happened in rural areas, where awareness of public hygiene and medical care is relatively poor compared to cities.

The HFMD is a common viral illness of infants and children, which causes fever and blister-like eruptions in the mouth and/or a skin rash. It spreads easily through contact with mucus, saliva and feces.

Adults infected with the disease pass it on to others, particularly children, without showing any symptoms themselves.

Most sufferers of the disease develop mild symptoms, which can clear up without treatment, experts said. In a few cases, however, an infection can lead to high fever, meningitis, encephalitis, pulmonary edema and paralysis, which can be fatal.

According to Feng, almost all of the deaths were caused by enterovirus 71 or EV71. Other strains, which also lead to HFMD, all belong to the enterovirus group like the polioviruses, coxsackieviruses and echoviruses.

Given a high death rate among children ill with the disease and a lack of vaccine worldwide, "prevention is top priority", Zhao said.

The first application for a clinical trial of a HFMD vaccine was submitted to the State Food and Drug Administration by the Beijing-based Sinovac Biotech Ltd at the end of last year.

(China Daily April 14, 2010)