Urbanization also behind outbreak

Experts said outbreaks of HFMD were also related to China's fast pace of urbanization as urban fringe zones, where a lot of migrants live, had been hard-hit by the disease.

China has seen a leap in urbanization in the past half century, with urban population increasing to 46 percent of the country's total from the 7 percent in 1949.

The fast urbanization has increased environmental degradation and pollution which poses a severe threat to people's health, especially in migrant suburbs with poor access to local health care.

Four of the HFMD deaths reported in Dongguan this year, Guangdong Province, were all from suburban migrant families, said Wangbo, vice director of the province's HFMD expert panel.

Dongguan has the largest floating population in the province as the pillar industry of the city, manufacturing business, has absorbed masses of migrants.

A survey showed that from January 2008 to the middle of 2009, HFMD cases from the three urban fringe zones accounted for 78 percent of the city's total for that period.

"Poor living conditions and hygiene, low economic status as well as substandard nutrition among kids are the reasons for the outbreak in urban fringe zones," said Wang Quanyi, an official with the Beijing Disease Control Center.

Migrant parents usually do not pay enough attention to their children as they are too busy earning money to support the family, so they are unlike to pickup early symptoms of some diseases, said Wang.

According to a survey among residents in urban fringe zone conducted by Shandong University of Traditional Chinese Medicine, 83.7 percent of those surveyed said they had never considered having health checks and only 9.2 percent of them had not received any treatment when sick.