Enterovirus-71 has killed 23 children, sickened 4,000 others. Hong Kong, Taiwan, Singapore and Vietnam also have outbreaks. Beijing seeks to avoid coverup charges as Olympics near.

The Chinese Health Ministry issued a nationwide alert today over a virus that has killed 23 children and sickened more than 4,000 others, as it scrambled to fend off a potential scandal over a coverup.

The latest victim of enterovirus-71 was an 18-month-old boy in southern Guangdong province who died Friday. The death was the first outside the Anhui province city of Fuyang, 1,000 miles to the north.

Disease has also broken out in Hong Kong, Taiwan, Singapore and Vietnam, although no deaths have been reported there.

The virus is a perennial in the summer months in Asia, but the outbreak this year appears to be larger than usual. Because the disease usually peaks in June and July, more deaths are expected.

Kindergartens in Fuyang have been ordered closed until mid-May, and residents described an atmosphere of panic. One newspaper, the Liaoshen Evening News, printed a large headline reading simply, “Death,” next to a photo of a health inspection van parked in front of a kindergarten.

“There are noticeably very few children or infants on the street,” said a 24-year-old student from Fuyang who asked not to be quoted by name. “Even some adults are afraid to step out.”

Chinese health officials were quoted on state television Friday saying that as part of the nationwide alert, they would send doctors out in search of patients rather than waiting for them to come to the hospital.

The outbreak comes at a sensitive time for China, in the throes of preparations for the Summer Olympics, which will open here Aug. 8. Memories are still fresh from the 2003 epidemic of severe acute respiratory syndrome, or SARS, in which China’s reputation suffered from charges of a coverup.

In this latest case, parents in Fuyang have accused local health officials of lying about the disease. At a news conference, Fuyang officials admitted only “several deaths” and implied that the disease was not contagious. At one kindergarten where a child died, staff were reportedly told they would be fired if they leaked news of the death.

“The municipal government used lies to dispel rumors and ordered the departments concerned to shut up,” an editorial in the Beijing News complained.

Enterovirus-71 is characterized by a fever, sores in the mouth and blistery rashes. Sometimes known as hand, foot and mouth disease, it is not related to the similarly named disease that afflicts cattle. Most cases are not fatal, and the contagion can usually be controlled by hand-washing and improved hygiene, according to a notice posted Thursday by the World Health Organization about the outbreak in China. The agency said “it is not necessary to restrict travel or trade.”

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Gao Wenhuan in the Times’ Beijing bureau contributed to this article.