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CHP investigates case of severe enterovirus 71 infection
     The Centre for Health Protection (CHP) of the Department of Health (DH) is today (November 7) investigating a case of severe enterovirus (EV) 71 infection, and again urged the public and institutions to maintain strict hand, personal and environmental hygiene.

     A boy, aged 11 with good past health, has presented with fever, cough and runny nose since October 30. He was admitted to Tuen Mun Hospital for treatment on November 3. He developed convulsion and upper limbs weakness on November 4 and was subsequently transferred to the Paediatric Intensive Care Unit for further management on the same day. The patient is now in a critical condition.
     His rectal swab specimen tested positive for EV71 upon laboratory testing. The clinical diagnoses were EV71 infection and encephalomyelitis.

     Initial enquiries revealed that the patient had no travel history during the incubation period. His father has upper respiratory tract infection symptoms recently and is in a stable condition. His other home contacts have remained asymptomatic.
     The CHP's epidemiological investigations also revealed that there is a hand, foot and mouth disease (HFMD) outbreak in the school, Po Leung Kuk Fong Wong Kam Chuen Primary School in Tuen Mun, where the patient attended. Apart from the patient, eight boys aged 11 to 12 have developed HFMD symptoms since October 28. They all sought medical attention and no hospitalisation was required. They are now in a stable condition.
     Officers of the CHP have conducted a site visit to the school and advised the management on necessary infection control and preventive measures. As a precautionary measure, the school was advised to suspend classes in Primary 5 and Primary 6. The school has been put under medical surveillance.

     The CHP's investigations are ongoing.

     "EV71 is one of the causative agents for HFMD. The infection is transmitted from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. Good personal and environmental hygiene are the most important measures to prevent EV71 infection," a spokesman for the CHP said.
     "HFMD is common in children while adult cases may also appear. It is usually caused by enteroviruses such as Coxsackie virus and EV71. It is clinically characterised by maculopapular rashes or vesicular lesions occurring on the palms, soles and other parts of the body such as the buttocks and thighs. Vesicular lesions and ulcers may also be found in the oral cavity. Sometimes patients present mainly with painful ulcers at the back of the mouth, namely herpangina, without rash on the hands or feet," the spokesman said.
     "The local HFMD activity is currently at high level. The usual peak season for HFMD and EV71 infection is from May to July. A smaller peak may also occur from October to December. As young children are more susceptible, parents should stay alert to their health. Institutional outbreaks may occur where HFMD can easily spread among young children with close contact," the spokesman added.

     To prevent HFMD, members of the public, especially the management of institutions, should take heed of the following preventive measures:

* Maintain good air circulation;
* Wash hands before meals and after going to the toilet or handling diapers or other stool-soiled materials;
* Keep hands clean and wash hands properly, especially when they are dirtied by respiratory secretions, such as after sneezing;
* Cover the nose and mouth while sneezing or coughing and dispose of nasal and oral discharges properly;
* Regularly clean and disinfect frequently touched surfaces such as furniture, toys and commonly shared items with 1:99 diluted household bleach (mixing one part of bleach containing 5.25 per cent sodium hypochlorite with 99 parts of water), leave for 15 to 30 minutes, and then rinse with water and keep dry. For metallic surfaces, disinfect with 70 per cent alcohol;
* Use absorbent disposable towels to wipe away obvious contaminants such as respiratory secretions, vomitus or excreta, and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach (mixing one part of bleach containing 5.25 per cent sodium hypochlorite with 49 parts of water), leave for 15 to 30 minutes and then rinse with water and keep dry. For metallic surfaces, disinfect with 70 per cent alcohol;
* Children with EV71 infection are advised to refrain from going to schools or group activities such as parties, interest classes and swimming until two weeks after fever has subsided and all the vesicular lesions have dried and crusted to prevent the spread of disease;
* Avoid going to overcrowded places; and
* Parents should maintain close communication with schools to let them know the latest situation of the sick children.

     The public may visit the CHP's page on HFMD and EV71 infection for more information.
Ends/Wednesday, November 7, 2018
Issued at HKT 19:55
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