The death toll from the ongoing outbreak of hand-foot-mouth disease (HFMD) rose to 28 yesterday, as the health ministry warned the number could still climb.

The two latest casualties were reported in Hunan and Guangxi, following 22 deaths in Anhui, three in Guangdong and one in Zhejiang.

Tests showed the latest victims had been infected with the EV71 virus, as in previous cases.

At an executive meeting of the State Council yesterday, Premier Wen Jiabao urged health authorities nationwide to go "all out" to prevent and contain the spread of the disease.

As of yesterday, the number of reported HFMD cases was 19,962 across at least 16 provinces, municipalities and autonomous regions.

On May 2, the Ministry of Health issued an order saying all cases of the disease must be reported, its spokesman Mao Qun'an said yesterday at a press conference jointly organized by the ministry and the World Health Organization (WHO).

Last year, China reported about 80,000 HFMD cases, including 17 deaths, he said.

"We are confident we can contain the spread of the disease," Mao said, adding the current situation is stable.

He said the cases will peak in June or July, as the disease thrives in warm weather.

"However, it won't affect the Olympic Games," he said.

WHO China representative Hans Troedsson agreed, saying: "China is sure to control the outbreak."

Despite the unusually high number of child deaths, there is no evidence to suggest the virus has mutated, Troedsson said.

"There is no indication the virus has changed or become more virulent," he said.

Outbreaks of the virus have also been reported in Singapore, Malaysia, Vietnam and Thailand, he said.

But it remains a mystery why so many cases have been reported in Fuyang, Anhui, Troedsson said.

"We usually don't see clusters like this ... so we have to investigate further in cooperation with the government," he said.

While the disease mainly affects children, in rare cases adults can contract it, Mao said.

However, adults with a sound immune system generally suffer nothing more than a rash on the hands and usually recover without medication, experts have said.

(China Daily 05/08/2008 page1)