By Lindsay Beck
BEIJING (Reuters) - China should expect more cases of hand,foot and mouth disease, but there is no sign it is facing a newor more virulent strain despite an unusually high number ofchild deaths, officials said on Wednesday.
Hand, foot and mouth is a common childhood illness, but thecurrent outbreak has led to 28 fatalities in China, mostly whenlinked with enterovirus 71 (EV71), which can cause a severeform of the disease characterised by high fever, paralysis andmeningitis.
"There is no indication of a change or a more virulentvirus," World Health Organisation China representative HansTroedsson told a news conference.
But he said there were still questions about why there wereso many cases in Fuyang, in the eastern province of Anhui, andwhy they presented unusual symptoms that made it difficult toidentify the virus -- a delay that may have cost lives.
"We usually don't see a cluster like this ... so we have toinvestigate that further together with the government," hesaid.
China's official Xinhua news agency put the number of casesof hand, foot and mouth disease at 15,799, up from about 12,000cases reported on Tuesday, but the rise was due to morethorough reporting, not the disease's spread, a health officialsaid.
"As we just started the web-based surveillance effort andreporting system, it is quite natural to see a rapid increasein numbers in the first few days of such reporting," saidHealth Ministry spokesman Mao Qunan.
The ministry recently made it mandatory for local healthauthorities to notify the government of cases.
HIGH NUMBERS
But around Asia, cases of the disease, which mostly affectschildren under five, were at higher than usual levels.
Singapore reported a 75 percent surge in hand, food andmouth to 10,490 so far this year compared with last year, whileVietnam's health ministry said the country had about 3,000cases in the first four months of the year, more than the totalnumber of reported cases for 2007.
Ten children had died from the disease in Vietnam.
Hong Kong was also on alert.
"The cases are higher than previous years and could evenhit record levels," said Thomas Tsang, Hong Kong's Controllerof the Centre for Health Protection.
There is no vaccine or antiviral agent available to treator prevent EV71. Enteroviruses spread mostly through contactwith infected blisters or faeces and can cause high fever,paralysis and swelling of the brain.
In China, a 2-year-old girl in the central province ofHunan and a 3-year-old boy in the south-western region ofGuangxi have become the latest to die of the EV71 strain,Xinhua reported. They were the first deaths reported in thoseareas.
Health officials say the disease's high season is usuallyJune and July and caution that it has yet to peak.
BEIJING STABLE
But the Health Ministry's Mao said Fuyang had reported nofatalities for the past six or seven days and said that now thevirus had been identified, doctors were better able to treatsymptoms and control the situation.
Still, Anhui, a poor, inland province, was facing problemsof proper treatment and unscrupulous doctors, the China Dailyreported, saying 10 doctors there had been punished formalpractice relating to the outbreak.
In one of the cases, doctors were given demerits fordelaying the transfer of a patient to a larger, countyhospital. In another, a doctor was fined for giving 17 childrenan injection he claimed could prevent EV71.
But the WHO's Troedsson said public health measures werebeginning to take effect and that there were no signs that thedisease had been covered up.
The sentiment was repeated by Zhong Nanshan, a prominentChinese doctor, who said the outbreak was not a repeat of theSARS virus, whose reporting Chinese authorities muzzled in2003, leading to the sacking of the health minister and Beijingmayor.
In Beijing, host city of the August Olympics, twokindergartens were suspended after children showed symptoms ofhand, foot and mouth, but Mao said the number of cases in thecity was in line with that of previous years.
"We are confident the potential outbreak will not affectthe Beijing Olympic Games," he said.
(Additional reporting by Nguyen Nhat Lam in Hanoi, DarylLoo in Singapore and James Pomfret in Hong Kong; Editing byAlex Richardson)