Recent outbreaks of hand, foot, and mouth disease (HFMD) in China have highlighted poor health care in the country's vast rural areas -- the weak link in the health care system.

HFMD is not a highly contagious disease, but deaths resulting from it have surged this year in China.

Forty children died from the disease in March alone, double the total of the first three months last year, according to statistics from the Ministry of Health (MOH).

Altogether 192,344 cases had been reported this year as of April 12, up 38 percent from a year earlier, including 94 death cases.

HFMD typically strikes infants and children under the age of five in spring and autumn. Normally it runs its course in seven to ten days. In a few cases, however, infection can lead to high fever, meningitis, encephalitis, pulmonary edema and paralysis, which can be fatal.

It usually starts with a slight fever followed by blisters and ulcers in the mouth and rashes on the hands and feet. It is spread through contact with saliva or feces of the infected.

The disease started to cause alarm in 2008 when it killed 22 children in central China' s Anhui Province from March to May.

However, despite the government's increasing efforts to curb outbreaks, deaths from HFMD have continued to rise. In 2009, 353 children died from the disease, up from 2008's 126. Meanwhile, the number of HFMD cases in 2009 was 1.15 million, up from 480,000 year on year, according to MOH.

Statistics showed rural areas and urban fringe zones were the worst hit regions, which experts said was due to poor hygiene and medical care as well as weak health awareness in those regions.