... ] A Guide to Clinical Management and Public Health Responsefor Hand, Foot and Mouth Disease (HFMD)transmission; pathogenesis; laboratory diagnosis; clinical features and management; andpreventionandcontrol.In ... prevalence of EV71 subgenogroups in the Asia-Pacific regionAreaYear1970’s 1980 ’s 1990’s 2000 -2004 2005 -2009MalaysiaTaiwanAustralia JapanSingaporeChinaVietnamKorea MongoliaThailandNew ... samples,including a samplefromthefatalcase(32). A nationwidequestionnairesurveyfound272complicatedcaseswithHFMDduringtheperiod2000-2002.Ofthese,226casesoccurredin2000,32in2001,and14in2002.Therewerefourcasesinvolvingsequelaeandonefatalcasereportedin2000(52).MalaysiaInSarawak,Malaysia, a widespreadcommunityoutbreakofHFMD,primarilycausedbyEV71infection,beganinearlyApril1997.From1June to 30August1997, a totalof2628caseswerereported to theSarawakStateDepartmentofHealth.Duringtheoutbreak,889childrenwerehospitalized,including39patientswithasepticmeningitisoracuteflaccidparalysis. A totalof29previouslyhealthychildrenyoungerthansixyearsofage(median,1.5years;range,0.5–5.9years;male -to- femaleratioof1.9:1)diedofrapidlyprogressivecardiorespiratoryfailure.EV71wasisolatedinsamplesfromsixofthefatalcases(22).Laterin1997,anoutbreakinvolving4625hospitaladmissionsoccurredinpeninsularMalaysia,resultingin11fatalcases(35). A sentinelsurveillanceprogrammeforHFMDwassubsequentlyestablishedinSarawakinMarch1998.BetweenMarch1998andJune2005,4290specimenswerecollectedfrom...