THE number of hand, foot and mouth disease (HFMD) cases continues to rise, with another 702 noted last week, bringing the total number of cases to 4,423 this year.

Of these cases, about 60 per cent or 2,654 are children under five years old.

While the majority of the cases were mild infections, 57 children were hospitalised because they were not eating well.

HFMD is generally a mild and self-limiting childhood disease but a Health Ministry (MOH) surveillance found that Enterovirus 71 (EV71), a potentially deadly strain, was in a higher number of patients.

EV71 has been known to cause complications such as infections in the brain, heart and lungs.

In view of this, MOH is working with the Education Ministry (MOE) and the Ministry of Community Development, Youth and Sports (MCYS) to step up efforts to limit the spread of the disease.

All primary schools, kindergartens and childcare centres have been alerted to step up hygiene measures and check for sick children.

Doctors have been asked to be more vigilant in looking out for children with HFMD symptoms and to send patients with signs and symptoms of pneumonia, myocarditis, meningitis and encephalitis to the hospitals.

Also, parents should consult a doctor early if their child has fever, mouth ulcers and rashes on the palms, soles or buttocks.

In an earlier interview with The Straits Times, Dr Chan Kwai Peng, head virologist at the Singapore General Hospital, said that HFMD viruses are spread through blister fluid, saliva, faeces and, occasionally, by droplets from one's breath.

She said as there is no vaccine against HFMD viruses, preventing the spread lies in interrupting the transmission.

MOH advised parents to keep children with HFMD at home until all the blisters have dried up. During this period, infected children should not come into contact with other children and should avoid going to public or crowded places.

Proper hygiene should also be practised at home to prevent transmission to other family members.