An outbreak of hand-foot-mouth disease is affecting children in the Commonwealth of the Northerrn Marianas.
The Department of Public Health is warning parents to keep sick children at home and schools to enforce strict handwashing procedures following the clinical diagnosis of the disease in 20 Saipan children aged between two and eight.
The department's awaiting laboratory confirmation of the disease, which causes fever and blisters or sores.
The department's medical director, Dr Richard Brostrom, says although it's viewed as more of a nuisance than serious, it can result in severe illness.
"People can get viral or aseptic meningititis which can be very serious and cause brain damage, encephalytis can happen and they can almost get a polio-like paralysis even at times. We have not seen any of that here, we actually have no history of seeing it but it's something that our local medical providers need to be aware of and the parents as well."
Dr Richard Brostrom says the hand-foot-mouth disease outbreak has highlighted again the lack of laboratory resources in the territory.