What is hand, foot and mouth disease (HFMD)?
HFMD is an illness caused by intestinal viruses, the more common strains being Coxsackie virus and Enterovirus 71. Someone with HFMD usually has the following symptoms:
Fever for two to three days;
Sore throat and runny nose;
Rash (flat or raised red spots, some with blisters) on the palms of hands, soles of feet, or buttocks;
Mouth ulcers;
Poor appetite;
Vomiting and diarrhoea; and
Tiredness and weakness.
Patients are infectious for the duration of the illness.
Does HFMD affect only children?
No. Both adults and children can be affected, but young children, particularly those under the age of five, are most susceptible.
What is the treatment for HFMD?
No specific treatment is available, except medication to relieve the symptoms of the disease.
HFMD is usually mild and self-limiting. There is no vaccine for the prevention or treatment of HFMD.
Can you die from HFMD?
Most cases of HFMD are mild. Occasionally, serious complications involving the nervous system, heart and brain can occur, leading to death.
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.
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 behaviour, 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
This article was first published in The Straits Times.
