The number of Chinese children infected with hand-foot-mouth disease (HFMD) continues to rise, with reported cases exceeding 8,531 on Monday.

All were aged below six, with the majority being under two.

Altogether 25 children have died of the disease. Tests have confirmed 24 of the deaths were triggered by the virus known as enterovirus 71 or EV71.

According to the Guidelines Regarding Prevention and Control of HFMD published on the Ministry of Health website, HFMD can be caused by a host of intestinal viruses, but EV71 and the Coxsackievirus (Cox A 16) were the most common.

Anhui Province, in east China, and Guangdong Province, south China were the worst hit areas. Twenty-two of the deaths occurred in Fuyang, a city in northwestern Anhui, and the rest happened in Guangdong.

The two regions were followed by Beijing, Jiangsu, Hunan and Hubei, according to statistics released by local health departments.

In Anhui alone, 622 new cases were reported on Saturday, including 362 in Fuyang, driving up the number of children with HFMD to 5,151 in Anhui.

Beijing has recorded at least 1,010 cases of the disease, while Guangdong registered 925 cases as of Sunday.

Both EV71 and Cox A16 can cause HFMD, which usually starts witha slight fever followed by blisters and ulcers in the mouth and rashes on the hands and feet.

Those sickened by EV71 often show serious symptoms. It can also lead to meningitis, encephalitis, pulmonary edema and paralysis in some children. There is no vaccine.

Saying reports of HFMD could increase in the next few months, the Health Ministry issued a circular late last month requiring better management and surveillance of the disease.

The ministry asked hospitals for daily reports on the disease, and for local health departments to report emergencies promptly and increase investment in research into the disease.

(Xinhua News Agency May 5, 2008)