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In late March 2008, a hospital clinician was alarmed by the occurrence of 3 consecutive deaths of pre-school children presented with severe pneumonia and rapid deterioration in Fuyang City, Anhui Province. Up until mid-April, 15 children have died of similar severe illness. Through an investigation conducted by local and national experts, the disease was confirmed on April 23 as hand, foot and mouth disease (HFMD) caused by enterovirus 71 (EV71) based on epidemiological, clinical, laboratory and pathological evidence. Retrospective case investigation revealed that a simultaneous outbreak had occurred in the same area with children presenting. | ndia MDG Goal 4 and 5 indicators Under-five mortality rate males 87 females 95 per 1 000 live births Infant mortality rate 68 per 1 000 live births Proportion of 1 year-old children immunized for measles 67 MMR 407 per 100 000 live births Births by skilled attendant 42.3 O. Data source Basic Indicators Health Situation in South-East Asia World Health Organization South-East Asia Region 2004. India is the world s largest democracy and the largest country in South Asia covering over three million square kilometers from the Himalayas in the North to the Indian ocean in the South. The estimated population of India is 1028.6 million Table 1 . Not only is India the second most populous Table 1 Demographic trends - India Total population in millions 846.3 a 1028.6 c Sex ratio females 1000 males 927 a 933 c Crude birth rate per 1000 population. 29.5 b 25 d Crude death rate per 1000 population. 9.8 b 8.1 d Source a Census 1991 b SRS 1991 c Census 2001 d SRS 2004 country in the world but India contributes to around 20 of global births. Traditionally India has been viewed as having an agriculture-based economy but now with the advent of liberal economic policies is undergoing rapid urbanization industrialization and privatization. Currently the urban population is 28 . There are 40.6 million people living in slums in 607 cities towns. India is a country of great diversity with its 29 states and 6 union territories all varying in language social customs and traditions. There are regions in the country with health profile comparable to developed countries and there are others that lag well behind. Regional disparities in maternal and neonatal mortality are wide. For example maternal mortality is so low in such states as Kerala and Punjab that indirect estimates for these states could not be attempted. In contrast in as many as 10 of the 15 major states Assam Bihar Gujarat Haryana Karnataka Madhya Pradesh Orissa Rajasthan Uttar Pradesh and West Bengal where maternal mortality .
