Every parent would be all too familiar with their young child’s habit of putting everything in his or her mouth. Unfortunately, this puts them at high risk for hand, foot and mouth disease (HFMD).
In spite of its high rate of infection, many remain unclear about what HFMD is and what to do about it. Dr Erwin Khoo, head of paediatrics at a medical university in Kuala Lumpur, shares three essential facts about this disease, and useful tips for mums and dads.
1. Highly contagious, 14-day incubation
HFMD symptoms include fever, mouth sores, and rashes on the hands and feet, and sometimes on the knees, elbows and buttocks. Unlike chickenpox, rashes do not usually appear on the trunk of the body.
“HFMD is commonly caused by the Coxsackie A16 and Enterovirus 71 viruses, which can be found in the respiratory tract, in faeces, and in the fluid-filled blisters that form on the hands and feet,” Khoo said.
On hard surfaces, these viruses can remain contagious anywhere from three to five days, with incubation of up to two weeks. This allows HFMD to spread easily among those in close contact, in situations where toys or utensils are shared, or when proper hygiene is not practised after tasks such as changing diapers.
While most people think of HFMD as a childhood disease, the truth is that it can infect adults, too. Affected adults can then pass the virus on to others – for example, if they work at a childcare centre, they could carry the virus home to their spouse, children, or elderly parents.
Given that there are different strains, it is also possible to get HFMD more than once, and immunity towards enteroviruses is only temporary.
What parents can do:
- Be extra vigilant about limiting contact with an infected child, and practise good hand hygiene – similar to preventive measures taken during the pandemic.
- Parents and caregivers of an infected child should wash or disinfect hands regularly; wipe down common areas with disinfectant; avoid sharing food and utensils; and avoid touching the eyes or nose. These measures should continue for up to 10 days.
A child with HFMD should stay home to prevent passing the infection on to others, but extreme measures such as isolation is unnecessary as it is not typically spread through the air like some respiratory infections.
2. No prevention or treatment options
Unfortunately, there is no way to medically prevent HFMD as there is no specific treatment or cure, only ways to alleviate the symptoms.
Khoo cautions against certain purported remedies such as bathing in coarse salts or soaking in enzyme water, as these could irritate the skin with no evidence of efficacy.
What parents can do:
- Treat the fever with paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), which also help reduce the pain and inflammation of mouth ulcers. Seek the advice of your
- paediatrician before giving your child NSAIDs.
Give your child easy-to-swallow foods such as soups and porridge in place of solids. Prevent dehydration by regularly offering them their favourite drinks or juices. - Soothe mouth ulcers with cold treats like ice cream, yoghurt, and jelly. Alcohol-free mouth rinses and oral gels can also help.
Shower or bathe regularly to soothe the sores and towel dry gently to avoid breaking any blisters. Avoid harsh soaps and scrubs that further irritate the skin. - Avoid using air-conditioning at night (where possible), when mouth ulcers may hurt more due to reduced saliva production. If air-conditioning is needed, use a humidifier or leave out a bowl of water to keep the air moist.
- If your child is in too much discomfort to sleep, speak to a paediatrician about using a pain reliever at night, even if there is no fever.
3. HFMD can lead to serious complications
Most of the time, recovery at home with over-the-counter treatment is enough to relieve symptoms. But, in extreme cases, HFMD can lead to complications such as viral meningitis.
“Although the spots are usually not itchy, ulcers in the mouth can be painful and prevent children from drinking, eating and swallowing normally. This can lead to dehydration which, in serious cases, requires medical attention,” Khoo also pointed out.
What parents can do:
- Take note of poor urine output, dry mouth, or lack of tears when your child cries, as these are signs of severe dehydration that would require medical treatment.
- Seek immediate medical attention for symptoms such as rapid breathing, disorientation, drowsiness, giddiness, neck stiffness, seizures, fever for more than three days, or if your child does not eat or drink.