Malaysian health officials said today they would shut more kindergartens if necessary to prevent an outbreak of hand, foot-and-mouth disease in eastern Sarawak state from spreading nationwide.

Four children have died and thousands of others have received medical attention so far this year because of the virus, which mostly affects young infants and is not related to foot and mouth disease.

Malaysia's Health Minister Dr Chua Soi Lek said the government was on alert for the spread of the disease from Sarawak, located on Borneo island, into Peninsular Malaysia, where most of the country's population live.

"In Peninsular Malaysia, the health ministry will take a clear line of action to prevent the spread of HFMD," Chua told the official Bernama news agency at a hospital in Sarawak.

"If more than two children in a kindergarten are infected, it will be shut down automatically to break the chain of transmission," he said.

The health ministry on Friday ordered the immediate closure of 488 Sarawak kindergartens for two weeks to curb the spread of the disease.

Chua warned that kindergartens that failed to shut could risk having their licences revoked, or face fines or jail terms.

Sarawak health director Dr Yao Sik King said as many as 200 new cases were being reported daily.

Yao told AFP that a total of 3,087 cases had been recorded since January 1. Some 80 percent of the patients were children aged below six years, he added.

As of Tuesday, at least 55 children remained in hospital, he said.

Under control

But Yao said the state government was taking all the action necessary to prevent the outbreak from becoming worse.

"The situation is under control," he said.

Sarawak Deputy Chief Minister Dr George Chan was quoted as saying by the Star daily today that parents were not taking the matter seriously.

"The people should not take this lightly, as the consequences can be serious," he said.

The disease mostly affects infants and young children. Symptoms include fever, mouth ulcers and rashes.

Sarawak had a major outbreak of hand, foot-and-mouth in 1997, which resulted in 31 fatalities. The state also suffered outbreaks in 2000 and 2003.