Hand, foot, mouth disease hits Bandung

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.