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Hand, Foot And Mouth Disease (HFMD)

What Is Hand, Foot And Mouth Disease (HFMD)?

It is an illness caused by intestinal viruses, the most common being coxsackie virus and enterovirus-71 (EV71). A person with HFMD usually has the following symptoms:

  • Fever for two to three days.
  • Sore throat and runny nose.
  • Rashes (flat or raised red spots, some with blisters) on palms, soles or buttocks.
  • Mouth ulcers.
  • Poor appetite.
  • Vomiting and diarrhea.
  • Tiredness and weakness ("feeling sick").

What Is The Incubation Period Of HFMD And How Is It Transmitted?

The incubation period is three to seven days. It spreads from person to person by direct contact with nasal discharge, saliva, faeces and fluid from the rash of an infected person, and indirectly by contaminated articles. A person is most contagious during the first week of the illness. HFMD virus is spread in the following ways,

  • Through mouth and nose secretions, which include tiny droplets from an infected child's nose and mouth when he breathes. They also include mucus from a runny nose or saliva. Healthy children can catch HFMD from eating with an infected person or sharing his toys.
  • From faceces, HFMD virus can spread if the caregiver does not wash her hands after tending to an infected child in the toilet or after changing a child's diaper.
  • From the blisters, especially when they pop open, releasing the liquid inside.

Does It Affect Only Children?

No. Both adults and children can be affected, but young children, particularly those under the age of five, are most susceptible. Two in three infected are under five.

What Is The Treatment For HFMD?

HFMD is usually mild and self-limiting. Treatment can be given to relieve the symptoms, but there is no vaccine for the prevention or treatment of HFMD.

Is HFMD Fatal?

Most cases of HFMD are mild. Occasionally, serious complications involving the nervous system (encephalitis) and heart (myocarditis) can occur.

What Is EV71?

EV71 was first isolated in 1969 and is often associated with outbreaks of HFMD. The virus is closely related to coxsackie virus A16 (CA16), the other major virus that causes HFMD. However, unlike CA16, EV71 also causes other acute neurological diseases, including encephalitis and aseptic meningitis. Public concern over this virus has increased because of deaths in Sarawak in 1997, Taiwan in 1998, and Singapore in 2000 and 2001. It is not known why EV71 sometimes causes more severe HFMD than other viruses.

What Should Parents Do If Their Child Has HFMD?

Consult a doctor early if the child has symptoms of HFMD. Parents should also be alert to any change in normal behavior, for example, irritation and sleepiness. Children who refuse to eat or drink, and have persistent vomiting or drowsiness, should be taken to hospital immediately. Children infected with HFMD should:

  • Stay at home and avoid contact with other children until they have recovered 
  • Not swim until six weeks after the onset of illness 
  • Stay away from school until the fever is gone and a doctor says they are well enough to go back

Are There Precautions Parents Can Take To Prevent Transmission Of HFMD?

Children should be kept away from crowded public places if they show signs of infection. Families are advised to adopt the following hygiene habits:

  • Wash hands with soap and running water before eating and after going to the toilet.
  • Cover mouth and nose when coughing or sneezing.
  • Clean premises and anything handled by the infected child or contaminated by his nasal or oral secretions with diluted bleach (if the bleach contains 5.25 per cent of sodium hypochlorite, dilute one part with 10 parts water).
  • Do not share eating utensils.

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