What Parents Must Know About Hand Foot Mouth Disease (HFMD)
DR. ANG SIANG CHIE | CONSULTANT PAEDIATRICIAN | JESSELTON MEDICAL CENTRE
“My Kid’s school was recently instructed to close temporarily for 2 weeks as there is currently an outbreak of HFMD. He has had fever for the last 2 days and now is drooling saliva and refuses orally. I have just noticed a few red dots on his palms… May I know whether my kid has HFMD?”
Often parents get worried about kids contracting hand, foot, and mouth disease (HFMD), unfortunately basic hygienic care in our community is still largely neglected hence leading to the spread of bugs.
What is hand, foot and mouth disease?
Hand, foot and mouth disease (HFMD) is a common infectious disease of infants and children. It is a very contagious illness caused by viruses from the enterovirus family, most commonly caused by Coxsackie virus A16 which usually results in a mild self-limiting disease with few complications. However, HFMD can also be caused by Enteroviruses, including Enterovirus 71 (EV71) which has been associated with serious complications, and may be fatal.
How does it spread?
These viruses live in the patient’s digestive tract and spread from person to person usually through unwashed hands and surfaces contaminated by stool of the infected person. Transmission also occurs by direct contact with nose and throat discharges, saliva or fluid from blisters.
How soon after exposure do symptoms appear?
The usual period from exposure to onset of symptoms (Incubation period) is about 3–7 days. During this period, a child can remain well and asymptomatic.
Who is at risk for HFMD?
EVERYONE who has not already been infected is at risk of infection, but not everyone who is infected becomes ill. HFMD occurs most commonly in children younger than 5 -6 years of age. Younger children tend to have worse symptoms. Children who attend daycare centers, schools, shopping centers or even playgrounds are at risk of contracting HFMD. Intra-family spread is also another means of transmission.
Can you be infected with HFMD more than once?
Yes, infection only results in immunity to one specific virus, another infection may occur with another different virus type.
WHAT are the classical signs and symptoms and HOW serious is HFMD?
Fever : Lasting 24- 48 hours, is often the first symptom of HFMD. Children also experience malaise, poor appetite, and frequently have a sore throat.
Oral Ulcers : One or two days after fever onset, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the gums, tongue, and inside of the cheeks. That leads to drooling of saliva and often, children will have very poor oral intake, especially solids and semisolids.
Vesicle/Rashes : A non-itchy skin rash develops over 1–2 days with flat or raised red spots, some with vesicles typically with a red halo. The rash is usually located on the palms of the hands and soles of the feet; it may also appear on the buttocks.
A child with HFMD may not have symptoms, or some may have only the rash or only mouth ulcers which is also known as HERPANGINA.
How is HFMD treated?
Presently, there is no proven treatment available for HFMD. It usually goes away on its own within a few days to a week. Acetaminophen (Paracetamol) can be given to help a child who is achy or irritable, or to ease painful mouth ulcers or discomfort from fever.
A child who refuses solid food can be offered milk or even cold foods like ice cream and popsicles which help by numbing the area, and will be a welcome treat for kids who have trouble swallowing.
Besides, make sure children drink plenty of fluids to stay hydrated ( e.g: coconut water, barley water e.t.c). Discourage sour drinks as they contain mild acid which can cause more pain to the ulcers. Seek help if your child continues to be irritable, can’t be comforted, or seems to be getting worse or even looks dehydrated, with signs like a dry tongue, sunken eyes, or decreased urine output.
Children with blisters on their hands or feet should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and pat dry.
Can HFMD be prevented?
There are no specific antiviral drugs or vaccines available against HFMD. Fortunately, the risk of infection can be lowered by good, hygiene practices and prompt medical attention for children showing severe symptoms.
Hand washing is the best protection. Remind everyone in your family to wash their hands often. Frequent handwashing with soap and water especially after touching any blister or sore, before preparing food and eating, before feeding young infants, after using the toilet and after changing diapers is very important.
Regular cleaning of contaminated surfaces and soiled items, including toys, first with soap and water, and then disinfecting them using a dilute solution of chlorine-containing bleach would help.
Avoiding close contact (kissing, hugging, sharing utensils) with children with HFMD may also help to reduce of the risk of transmission.
Keep infants and sick children away from kindergarten, nursery, school or gatherings until they are well (at least 1-2 weeks). Maintain good cough etiquette (covering mouth and nose when sneezing and coughing) disposing properly of used tissues and nappies into waste bins that close properly; maintaining cleanliness of the home, child care center, kindergartens or schools are steps to reduce the spread of HFMD
Even after kids recover, they can pass the virus in their stool for several weeks, so the infection still can spread to others.
For the complete article about this subject can be read on this July to September issue of Parents Avenue Magazine. *Disclaimer: All information is for your general reference only. We do not accept any responsibility whatsoever in respect of such information.