A nationwide alert has been issued in a bid to control a virus that has caused 22 deaths in one city and shows signs of spreading to other parts of the country.

The Ministry of Health warned on Saturday that cases of hand-foot-mouth disease (HFMD) will possibly increase in the following months since June and July are the peak seasons for the disease.

Following the 22 children's deaths reportedly caused by enterovirus 71, or EV71, in Fuyang of Anhui province, two other deaths from the same virus have been confirmed in Guangdong province, Xinhua News Agency reported yesterday.

By May 2, 4,529 HFMD cases had been reported in Anhui, including 3,736 cases in worst-hit Fuyang, the provincial health authority said yesterday. Of those in Fuyang, 22 have died and 12 are in critical condition, with more than 600 still in hospital. Some have damaged brains, hearts and lungs.

Several hundred cases have emerged in other places including Henan, Hubei, Shaanxi, Zhejiang, Jiangxi and Guangdong provinces as well as the Hong Kong and Macao special administrative regions.

EV71 has been confirmed to have caused some of the cases, Xinhua reported.

A high-level taskforce headed by Minister of Health Chen Zhu has been set up to curb the spread of the highly contagious disease following the outbreak of EV71.

"Local Party and government officials are on high alert. The authorities are taking urgent measures to prevent the disease and speed up treatment," the ministry said in a statement.

It said special equipment was being installed in children's wards; and the local authorities were strengthening checks on food and water safety to stop the disease from spreading.

HFMD, characterized by fever, sores in the mouth and rashes on hands and feet, is not a new infection and is common among infants and children, experts say. It can be triggered by various viruses and usually does not lead to death.

Of the fatal cases reported this year, severe complications due to EV71 infection including meningitis, encephalitis, pulmonary edema and paralysis were the cause of death.

"While not all the children infected with the virus develop the lethal complications, prevention and early diagnosis and treatment are crucial for recovery" said Liu Xiaolin, a leading doctor at Fuyang No 2 People's Hospital, which has been designated for treatment of the disease.

The MOH said on its website that "HFMD is highly preventable and can be treated".

However, there is no effective vaccine available worldwide to kill the EV71 and "current medical intervention targets the complications from the viral infection", Liu noted.

Under such circumstances, prevention should be a priority, said Liu Qian, vice-minister of health, who heads an expert team in Fuyang.

The ministry issued a circular on Friday requiring hospitals to report the disease within 24 hours, and told local health departments to publicize emergency information and the epidemic situation.

"The move is important for more timely reports and would facilitate research," said a researcher surnamed Ning at the center for disease prevention and control of Fuyang.

To relieve the economic burden on patients, the Fuyang government is set to provide highly subsidized, or even free, treatment.

"Most of the infected children in Fuyang are from the poor countryside," Liu noted. A 10-day hospitalization typically costs 10,000 yuan ($1,420), she added.

The ministry also vowed more training on HFMD diagnosis and treatment for pediatricians across the country.

(China Daily April 5, 2008)