Children are examined in a kindergarten in Zhengzhou, capital of central China's Henan Province, May 5, 2008. In order to ensure children's health and prevent diseases transmitted by hand, foot or mouth, lots of kindergartens in Zhengzhou started to practice morning examination after the May Day Holidays to promote health habits as washing hands, basking and eating well-cooked food. (Xinhua Photo)

The number of hand-foot-mouth disease (HFMD) cases reported in China this year has risen to 11,905 by Monday, resulting in 26 deaths, according to Xinhua counting of local official figures.

Tang Xiaoping, an epidemic expert and deputy head of the health bureau of Guangzhou, said the drastic rise is a result of an order by the Ministry of Health on Friday, which classifies HFMD as a C class epidemic that must be reported to the ministry.

Local health authorities were not required to report HFMD cases before the new order.

Zhejiang Province in east China said Monday that 1,198 children have been infected by HFMD this year, and that a five-year-old boy died on April 6.

According to the provincial health authority, nine of the reported cases were confirmed to have been triggered by enterovirus 71 (EV71), a highly contagious virus that preys on children usually aged between two and six.

Zhejiang registered 101, 793, and 1,607 cases of HFMD in 2005, 2006, 2007 respectively, said Zhao Feng, an official with the administration.

The worst-hit Anhui Province updated child infections to 5,840,including 689 new cases registered on Sunday, according to statistics from the provincial health administration.

In Fuyang City alone, where 22 children have been killed by the epidemic since March 20, 4,496 children have been infected and 1,314 are still hospitalized.

The coastal province of Guangdong reported 1,692 cases, an increase of 767 from Sunday. Three boys were killed in the outbreak of the disease.

Tests have confirmed 25 of the 26 deaths were triggered by EV71.

Children go through morning examination in a kindergarten in Zhengzhou, capital of central China's Henan Province, May 5, 2008. (Xinhua Photo)

In southwestern Chongqing Municipality, 42 sporadic cases have been detected since Thursday.

"No fatal or critical cases have been reported in Chongqing so far," said Liu Kejia, vice director of Chongqing health bureau. "The disease prevention and control center has sampled some cases and no enterovirus 71 has been confirmed."

Beijing has recorded at least 1,482 cases by Monday, of which 818 were reported in kindergartens.

The neighbouring Hebei Province reported 206 infections.

Outbreaks have also occurred in the provinces of Jiangsu, Hunan, Hubei, Shaanxi, Jiangxi and Henan.

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 A 16) 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.

The epidemic was first recorded on March 20. The Health Ministry issued a circular late last month requiring better management and surveillance of the disease, as it expects more cases in the next few months.

The ministry asked hospitals for daily reports on the disease, and for local health departments to report emergencies promptly and increase investment in research into the disease.

Editor: Yan