Expert: ‘Foolish’ To Report 20-Fold HFMD Case Rise From 2021

Reported HFMD cases in 2022 to date are nearly 100% higher than the same period in 2019, compared to a 2,400% rise in comparison to 2021 figures when Malaysia was under lockdown.

KUALA LUMPUR, May 27 – Reports of a “20-fold increase” in hand, foot, and mouth disease (HFMD) cases this year from 2021 do not reveal the real trend of the infectious disease in Malaysia, says public health specialist Dr Mohd Farhan Rusli.

Dr Farhan, who is Selangor Task Force Operations director, said the rebound in HFMD cases is expected in 2022 as nurseries and schools were closed last year, and people remained largely at home as the country was still under the Movement Control Order (MCO) due to the Covid-19 pandemic.

“We must look back at what happened last year. Last year, the nurseries were closed, people were at home, and we were under MCO, so it’s very foolish if you compare the trend or data from last year to this year.

“If you want to compare 2022, you have to compare it with pre-pandemic times – 2018, 2019 – then you will have a good comparison. If you look at the data from 2018, up until August, it was about 40,000 over HFMD cases. So, then you start looking at what is the real increase in percentage,” Dr Farhan told reporters at the Selangor Saring media briefing on Tuesday.

“We have to make sure that we don’t use fear tactics to tell people, ‘Look there’s a 20-fold increase’ – all of a sudden it’s a 20-fold increase. Malaysia has never reported a 20-fold increase because you’re comparing it with a time when nobody was going to school, so the data doesn’t make sense when you compare it like that. 

“You have to compare it apple to apple, then you can know what the real incidence rate is,” Dr Farhan said.

The Ministry of Health (MOH) yesterday reported a 24-fold, or 2,400 per cent, increase in HFMD cases this year from 2021, with a total of 57,510 cases reported from January 1 to May 25, 2022, compared to 2,333 cases recorded over the same period last year during the Covid-19 pandemic.

Health Minister Khairy Jamaluddin, at a press conference yesterday, acknowledged that it was not useful to compare 2022 figures to 2021 when schools and nurseries were closed last year due to the coronavirus pandemic.

He said when compared to the same period in 2019, the number of HFMD cases this year to date were nearly 100 per cent higher, with an increase of 27,664 cases.

According to MOH’s health indicators data, the number of HFMD cases reported nationwide in Malaysia are as follows (the Covid-19 pandemic hit Malaysia in January 2020):

  • 2021: 4,239 cases
  • 2020: 17,235 cases
  • 2019: 52,176 cases
  • 2018: 76,776 cases
  • 2017: 29,359 cases
  • 2016: 47,008 cases
  • 2015: 22,587 cases

“Whatever trend of communicable disease we had last year, it does not reflect the normal data trend because we were under the MCO,” Dr Farhan said.

“Dengue cases also noted a drop, right? There’s a saying, everything went down during the MCO except Covid. So then how can you say you were controlling your communicable diseases well during the MCO when nothing was moving?

“If people don’t move, you don’t have communicable disease – that’s the whole pretext of communicable disease: movement. If you are in a ‘movement’ control order, HFMD rates will definitely go down and it will surely rebound this year because we’ve reopened schools and everything is open again, so you cannot compare. 

“That’s why I feel we should not report it as a 20-time increase compared to last year because it doesn’t have value, in terms of reporting,” Dr Farhan said.

HFMD is a contagious viral infection that commonly affects children under five years of age, but it can occasionally affect adults. 

Symptoms of HFMD include fever, sore throat, and maculopapular or vesicular rashes on hands, feet, and mouth. Although the disease is generally mild, severe HFMD can lead to fatal neurologic and systemic complications.

State Public Health, Unity, Women and Family Development Committee chairman Dr Siti Mariah Mahmud said the Selangor state government, through its district health offices, will monitor child care centres in the state more closely to control the spread of HFMD.

As of May 21, a total of 13,262 HFMD cases were recorded in Selangor, with the Petaling district reporting the highest number of cases with 4,155 cases, followed by Hulu Langat (2,608 cases) and Gombak (2,112 cases). A total of 419 cases were admitted to wards.

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