CNMI Hospital Warns Of Viral Disease Outbreak

Pacific Islands Development Program, East-West Center With Support From Center for Pacific Islands Studies, University of Hawai‘i

News Release

Commonwealth Healthcare Corporation Saipan, CNMI Friday, September 20, 2013

The Division of Public Health Services of the Commonwealth Healthcare Corp. is investigating and advising the public on a viral disease outbreak that is circulating in the community.

This viral disease has the components of both the hand food and mouth disease, or HFMD, and chickenpox (varicella). So far the investigation suggests that most of these cases are HFMD, while only appearing to be chickenpox.

HFMD usually starts with a fever, poor appetite, a vague feeling of being unwell, and sore throat. One or two days after fever starts, painful sores usually develop in the mouth. They begin as small red spots that blister and that often become ulcers. The sores are often in the back of the mouth. A skin rash develops over one to two days. The rash has flat or raised red spots, sometimes with blisters. The rash is usually on the palms of the hands and soles of the feet; it may also appear on the knees, elbows, buttocks or genital area, occasionally on the trunk. The virus may be found in nasal secretions, saliva, and stool from affected individuals, and can be spread by coughing, sneezing, and touching contaminated surfaces or objects. Infants and children spread it commonly in daycare centers and schools. It usually takes three to six days for a person to show symptoms of HFMD after being exposed.

There is no vaccine to protect against the viruses that cause HFMD. A person can lower their risk of being infected by washing hands often with soap and water, especially after changing diapers and using the toilet. Cleaning and disinfecting frequently touched surfaces and soiled items, including toys, and avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with HFMD also help. If a person has mouth sores, it might be painful to swallow. However, drinking liquids is important to stay hydrated. If a person cannot swallow enough liquids, these may need to be given through an IV in their vein.

Chickenpox is also a very contagious infection caused by a virus. It is spread from person to person by direct contact or through the air from an infected person’s coughing or sneezing. It causes a blister-like rash, itching, tiredness, and fever lasting an average of four to six days. Most children recover without any problems. Chickenpox can be spread for one to two days before the rash starts and until all blisters are crusted or no new lesions appear within a 24-hour period. It takes between 10-21 days after contact with an infected person for someone to develop chickenpox.

Persons who received their chickenpox vaccination generally have only mild symptoms with shorter duration of illness and fewer than 50 lesions. The rash may be atypical with red bumps and few or no blisters.

The Centers for Disease Control and Prevention recommends two doses of chickenpox vaccine for children, adolescents, and adults. Two doses of the vaccine are about 98-percent effective at preventing chickenpox. When you get vaccinated, you protect yourself and others in your community. This is especially important for people who cannot get vaccinated, such as those with weakened immune systems or pregnant women.

HFMD usually clears up within four days while chickenpox is about a week.

Persons who are concerned about their foot, hand, mouth disease or chickenpox should contact their health care provider. If you are concerned about possible symptoms, contact your healthcare provider before visiting them at the clinic. This will help avoid exposing other individuals at the clinics. To get your chickenpox vaccination or should you have any questions about this matter, contact CHCC’s Immunization Program at 236-8745 or email at

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