The recent deaths of six children in Miri have sparked public fears that the Coxsackie outbreak in 1997 is making a comeback.

Health Ministry director general Dr. Abu Bakar Sulaiman today said that after studying the deaths of the children, all of whom under five years old, two showed a similar pattern to the deadly outbreak two years ago where they succumbed to heart failure.

All the six deaths had occurred since last month in Miri Hospital.

"From the information we have so far, there are indications of a virus causing the illness but this is still waiting to be confirmed," said Dr. Abu Bakar.

He added that it is not clear whether this virus is related to the periodic hand, foot and mouth disease outbreak or whether this is a sporadic, unrelated event.

However, Sarawak Medical Department director Dr. Yao Sik Chi told malaysiakini that the deaths of the six children had no connection with the hand, foot and mouth disease.

He said that the six cases were related to "something else" which required further study.

The six children died in between the mid-February and mid-March, and had suffered fever, vomiting, body weakness and fainting spells before they passed away.

In his press statement, Dr. Abu Bakar said that there has been an increase in hand, foot and mouth disease cases in Sarawak, especially in Bintulu, Marudi and Miri for the last two months.

He reassured the public that so far, no deaths have been reported from hand, foot and mouth disease, which can only be spread from human to human, through direct contact with people having the illness, hand to mouth and inhalation of droplets spread by coughing and sneezing.

He urged the public, especially those with young children, to avoid all crowded places, wash their hands thoroughly before eating and handling food, ensure cleanliness in their homes and children's toys and used items.

Dr. Abu Bakar said that the public are advised to pay attention to personal hygiene and to bring sick children, especially those under five years old, to see a doctor. Doctors have been advised to admit children early who have difficulty in breathing, fits, drowsiness, poor feeding and vomiting.

In mid-1997, the Coxsackie outbreak took the lives of 31 children under five years old, with 911 treated at hospitals and clinics.

A total of 3,334 children were treated nationwide for this viral infection. The outbreak also put the country on medical alert, forcing the temporary closure of nurseries and swimming pools in Sarawak.