Hand foot mouth disease

HAND foot mouth disease (HFMD) is not an uncommon disease among children. It is contagious and caused by enterovirus.

There are more than 20 sub-types of enterovirus. The Coxsackie virus A16 and Enterovirus 71 are the most common triggers of HFMD.

The incubation period of HFMD ranges from three to five days. During the first few days, the infected child may have fever and reduced appetite, and tire easily. Later, the child may develop mouth ulcers, and painful lesions on the tongue, gums and around the lips.

Parents will notice red rashes or skin lesions on the child’s palms and feet, or around the buttocks and groin. Some of these rashes may become small blisters. Once you see these, you are advised to take your child to the paediatrician.

Most children infected with HFMD will show mild signs and symptoms, and a majority will recover within seven to 10 days.

Parents are advised to get the child to drink water frequently to ensure hydration. They should prepare a soft diet for the child during the sick period.

Some children with HFMD have severe symptoms. This happens to younger children, especially infants below one year old. Infants tend to deteriorate faster and get dehydrated because of the poor oral intake. Some can develop complications like viral encephalitis and meningitis which are very dangerous and life threatening. Parents are advised to get early medical assessment and treatment for their infant child.

HFMD generally spreads through close contact with infected persons – via saliva, nasal secretion, cough or sneeze droplets, skin lesion, or stools. Sharing of contaminated utensils is a hazard.

During an outbreak of HFMD, parents should keep their young children at home. Crowded public areas like shopping centres are to be avoided.

The home environment should be kept clean and hygienic. If there is a case of HFMD at home, items such as feeding bottles, pacifiers, cups and plates should be washed thoroughly. The child should be fed cooked food and clean water.

Parents and minders need to wash their hands after handling the sick child – after a diaper change or cleansing the child. Ensure that contaminated wastes, such as soiled diapers, are properly disposed of, and reusable items sterilised.

While China has created a vaccine against Enterovirus 71, it does not fully protect against all HFMD viruses. Thus, many countries including the United States and Malaysia are not ready to implement the usage of this vaccine.

Prevention is always better than treatment. We should adopt good hygienic practices in our daily lives to avoid HFMD. – By Dr Lai Eng Meng, consultant paediatrician
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