Hand, foot, mouth disease hits Bandung

Yuli Tri Suwarni, The Jakarta Post, Bandung

A pediatrician in Bandung municipality has warned of an outbreak of hand, foot and mouth disease (HFM), saying he had treated several patients for the disease since early April.

There was a major outbreak of the disease in Singapore and several cities in Indonesia in 2000, but there have been few recorded cases since.

"Almost every day a parent brings in a child with spots on their skin that look like smallpox, accompanied with a high fever. They are worried their children have dengue fever or smallpox, but after further tests, it turns out that in fact they have HFM, commonly known as the Singapore flu," said Azahali, who is also the head of the Childhood Infections and Tropical Diseases unit at Hasan Sadikin General Hospital, the largest hospital in Bandung.

He said he had treated at least 20 children for HFM since April.

Most of the patients treated by Azahali were kindergarten and elementary schoolchildren whose parents said they had been infected by classmates.

Most of the children are unable to eat or drink because of rashes in their mouths and on their tongues. The fluid-filled spots, similar to smallpox, are also found the palms of the children's hand and the soles of their feet.

Azahali said that at first he was confused by the symptoms and had to search through his medical books to discover the cause.

He learned that the symptoms were all common to HFM, which had been a problem in Singapore in 2000. He said this was the first time he had dealt with the disease since he began to practice in 1972.

The virus that causes HFM spreads among humans, entering through the mouth and multiplying in the intestines and the throat.

"Only after the virus reproduces does it attack its target, in this case, the mouth, hands and legs," he said.

The incubation period in the human body is about four to six days, and is marked by a high fever followed by red spots in the mouth and on the tongue, arms and legs.

"If not immediately treated, the fluid-filled spots can grow to four to eight millimeters in size, at which point they can burst and become infected," he said.

He said the virus can survive in dirty water for five to six months, which poses a danger because children frequently play in water, particularly during the rainy season.

Because there is no cure for the disease, Azahali can only treat the symptoms with painkillers and medicine to reduce fevers.

As it is caused by a virus, HFM patients will begin to improve within a week if they improve their hygiene, get plenty of rest and eat and drink properly.

If not treated, the virus can attack internal organs like the brain and enter the blood stream, attacking the heart and lungs.

"As of now, we haven't had any patients that severe. At the worst, they only had difficulty eating and were weak," he said.

Gunadi S. Binekas, head of the Bandung Health Office, said he had not received any reports on the disease.

He said the health office would conduct a field investigation to determine whether there was an HFM outbreak in the city.