THE EPIDEMIOLOGY AND CONTROL OF HAND, FOOT AND MOUTH DISEASE

Abstract

Policies to control hand, foot and mouth disease (HFMD) in Singapore resembles control measures for severe diseases, such as SARS. Daily temperature screening, isolation of feverish children, 10 days mandatory school closures (for schools with large outbreaks), mandatory reporting of cases, etc., are some of the policies currently implemented in Singapore. Perhaps rightly so, as EV-A71 has the potential to cause death, but it comes at a socioeconomic cost. Today, 17 years after the first school closures were implemented for HFMD, we revisit the literature and collected surveillance data to investigate how these policies stood the test of time, and what gaps remain in the literature through a rigourous systematic review; a modeling study about HFMD disease burden; and an econometric modeling paper of the population’s utility and perceptions towards HFMD control policies. Our findings will help affected jurisdictions on the optimization of their control efforts in the future.