Chinese and international health officials say they are working closely to combat a severe form of an intestinal virus that has already killed 28 children and infected thousands more.  Stephanie Ho reports from Beijing.

Chinese doctor checks boy for enterovirus 71 in Hefei, eastern China, 06 May 2008

Two more children were reported dead Wednesday, one in the central province, Hunan, and the other in the southwest region, Guangxi.

Both children tested positive for enterovirus 71.  The virus causes a severe form of hand, foot and mouth disease, which can lead to paralysis, brain swelling and even death.

Health officials across the country must now report all cases of the disease to central authorities.  State-run Xinhua News Agency says the reporting requirement has caused the enumeration of people in China infected with hand, foot and mouth disease to jump to near 16,000.

The World Health Organization's China representative, Hans Troedsson, says EV-71 is causing less severe problems in Singapore, Malaysia and Vietnam.  He says it is not unusual for thousands of children each year to be infected with what he says is normally a benign and mild disease.

"It could be unpleasant for the child because it has blisters, and blisters in the mouth, and so on, that could hurt," he noted.  "But usually, it's self-limiting within 10 days."

Most of the EV-71 cases in China have been centered around Fuyang, in central Anhui Province.  Troedsson says he believes doctors at first did not know what they were dealing with, because patients were displaying symptoms not typical for hand, foot and mouth disease.

"And, when the clinicians tried to diagnose it, they looked for other causes that could be severe, including avian influenza and SARS and so on, which was all negative," he explained.  "Just later, they could identify that this was actually enterovirus 71 and it was reported to the WHO."

The World Health Organization representative spoke at a joint news conference Wednesday with the spokesman for China's Ministry of Health, Mao Qun'an.

"I was told by the experts that some fatal cases occurred because of the late response time.  That is, they were sent to the hospital too late.  So, this increased the difficulty to treat them," he said.

The official China Daily newspaper reports the Anhui government has punished 10 doctors in relation to the outbreak.

In one of the cases, two doctors were given demerits for delaying the transfer of a patient with a fever to a larger hospital.  In another, a doctor was fined for giving 17 children an injection he claimed could prevent EV-71, although there is no vaccine for the virus.

And, despite the current attention, the Health Ministry's Mao says that this is not the first time China has experienced problems with this illness.  He said incomplete data from last year show 80,000 cases of hand, foot and mouth disease, including 17 cases that were fatal.