China reported more than 176,000 cases of hand-foot-mouth disease (HFMD) last month, but the outbreak peaked on May 14, Ministry of Health spokesman Mao Qun'an told reporters in Beijing on Tuesday.

Daily reported cases declined from 11,501 at the peak to 3,922 on June 5, Mao said.

Central Anhui Province, which first reported the outbreak of HFMD, had 10,700 cases in May including four deaths, according to Mao.

The worst-hit provinces and regions were Guangdong, Zhejiang, Hebei, Shandong and Hunan, he said.

The disease was also found in regions hit by the devastating May 12 earthquake but, earlier this month, Mao told the press that it had been brought under control.

"The Ministry of Health required that HFMD cases must be reported since May 2 this year," said Mao, "Any HFMD case in the quake-hit areas will be reported immediately through our reporting system."

Nurseries in Fuyang City, Anhui, the worst-hit city, resumed classes on Children's Day (June 1) as health authorities considered the situation was under control.

Between late March and the end of April, the city reported about 22 death cases of HFMD but, in May alone, it reported 4,444 cases, including one death.

HFMD can be caused by a host of intestinal viruses, but EV71 and the Coxsackievirus are the most common.

HFMD usually starts with a slight fever followed by blisters and ulcers in the mouth and rashes on the hands and feet. Those with EV71 often show serious symptoms. It can also lead to meningitis, encephalitis, pulmonary edema and paralysis in some children. There is no vaccine.

(Xinhua News Agency June 10, 2008)