Five more Chinese children have died of hand-foot-mouth disease (HFMD), officials said, taking the national toll to 39, but the epidemic is said to have been brought under control with more children being discharged from hospitals.

Health authorities in east China's Anhui Province on Saturday confirmed that a girl, surnamed Huang from Lixin County of Anhui, had died of HFMD caused by the enterovirus 71 (EV71).

Huang was reportedly admitted to a local hospital last Wednesday. Her condition quickly worsened, and she was transferred to Fuyang City Hospital later that day but died early Thursday.

Another death was reported in Hainan and three others in Guangdong. No further details about these four cases are available.

According to the Guidelines Regarding Prevention and Control of HFMD published on the Ministry of Health website, HFMD can be caused by a host of intestinal viruses, but EV71 and the Coxsackievirus (Cox A16) were the most common.

HFMD usually starts with a slight fever followed by blisters and ulcers in the mouth and rashes on the hands and feet.

Those sickened by EV71 often show serious symptoms. It can also lead to meningitis, encephalitis, pulmonary edema and paralysis in some children. There is no vaccine.

HFMD has sickened more than 24,934 children on the Chinese mainland, of whom 39 have died in six provinces: Anhui, Guangdong, Guangxi, Hainan, Hunan and Zhejiang.

The Guangdong Health Department on Monday confirmed 14,793 cases of childhood infections province-wide so far, including seven deaths.

Reported infections in Guangdong peaked on May 8, with 2,226 new cases on that day. Since then, the incidence began to decline, and there were 1,604 cases on Sunday, Huang Fei, deputy chief of the Guangdong Health Department, said at a news briefing on Monday.

In Fuyang, the worst-hit city in east China's Anhui Province, the HFMD epidemic is under control, China's Health Ministry said on Sunday. No fatalities were reported from May 2-10 in Fuyang, said an official surnamed Yang with the Ministry of Health.

The city reported the country's initial HFMD outbreak and 22 deaths caused by the disease as of May 10.

"The incidence of HFMD in Fuyang is on the decline. The majority of patients who were in critical condition have recovered," he said.

The ministry said on Thursday that patients discharged in Fuyang had outnumbered those admitted to hospitals for the first time. As of that day, 4,927 infected children in Anhui had been discharged.

(Xinhua News Agency May 13, 2008)