Hand, Foot and Mouth Disease (HFMD)

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Hand, Foot and Mouth Disease (HFMD) is a common disease in children caused by enteroviruses such as coxackieviruses and enterovirus 71 (EV71). The EV71 infection is of particular concern as it more likely associates with severe outcomes and even death.

The disease is mostly self-limiting and resolves in 7 – 10 days. It usually begins with fever, poor appetite, tiredness and sore throat. Painful sores which begin as small red spots with blister, develop in the mouth after fever. They may then become ulcers. There may also be skin rash on palms and soles that is non-itchy and some with blisters. It may also appear on the buttocks and/or genitalia. A person with HFMD may not have symptoms, or may have only rash or mouth ulcers. The disease is most contagious during the first week of the illness and the viruses can be found in stool for weeks.

The disease mainly spreads by contact with an infected person’s nose or throat discharges, saliva, fluid from vesicles or stool, or after touching contaminated objects. The incubation period of HFMD is about 3 – 7 days.

There is no specific drug treatment for HFMD. Patients should drink plenty of water and take adequate rest, and may receive symptomatic treatment to reduce fever and pain from oral ulcers. Sick children should stay away from school or gatherings till all vesicles have dried up to avoid spreading the disease. If infection is caused by EV71, the patient is advised to stay at home for two more weeks after recovery from the disease (i.e. fever and rash have subsided, and vesicles have dried).

Parents should monitor the child’s condition closely and seek medical advice immediately if there is persistent high fever, decrease in alertness or deterioration in general condition.

There is no effective vaccine at the moment. Good personal and environmental hygiene are the mainstay of prevention. Wash hands with liquid soap and water especially before touching nose and mouth; before eating or handling food; after touching blister; after using the toilet; after changing diapers or handling soiled articles; and when hands are contaminated by respiratory secretions e.g. after coughing or sneezing. Cover nose and mouth with tissue paper when coughing or sneezing. Do not share towels and other personal items. Regularly clean and disinfect frequently touched surfaces such as furniture and toys.

(Source: Department of Health)