Hand, Foot & Mouth Disease
Hand, Foot & Mouth Disease (HFMD) is caused by the Coxsackie virus and Enterovirus 71. The throat and tonsils develop small ulcers while the hands, feet, and diaper area are affected by a rash with characteristic vesicles (very small blisters). This is usually a mild illness with the rash healing in 5 to 7 days.
HFMD is spread from person to person by direct contact with the nasal discharge, saliva, faeces and fluid from the rash of an infected person. Both adults and children can be affected, but young children below five years are particularly susceptible.
   
Click to view a larger version of each photo.
(Courtesy of KK Women's and Children's hospital.)
- fever
- sore throat
- ulcers in the throat, mouth and tongue
- headache
- a rash with vesicles (small blisters-- 3-7 mm) on hands, feet and diaper area. The vesicles are typically on the palm side of the hands the sole side of the feet and very characteristic in appearance
- loss of appetite
There is no specific treatment for the infection other than symptomatic relief of symptoms.
Treatment with antibiotics is not effective and is not indicated. Acetaminophen can be used to treat fever. Aspirin should not be used in viral illnesses in children under age 12 years.
Salt water mouth rinses (1/2 teaspoon of salt to 1 glass of warm water) may be soothing if the child is able to rinse without swallowing. Ensure an adequate fluid intake because swallowing may be painful. Extra fluid is needed when a fever is present.
HFMD is present all year round in Singapore and there will be yearly seasonal outbreaks. Outbreaks do occur in childcare centres, kindergartens and schools. HFMD became legally notifiable on 1 October 2000. Although usually a mild disease, it has been associated with fatalities usually due to complications involving the heart and nervous system (e.g encephalitis).
Parents are advised to consult a doctor early if their child has fever, mouth ulcers and rashes on the palms, soles or buttocks. They should also be alert to any change in their child's normal behaviour, e.g. irritation and sleepiness. Should they refuse to eat or drink, have persistent vomiting or drowsiness, parents should bring their child immediately to hospital.
Parents should ensure that their children adopt the following good practices:
- Wash hands with soap before eating and after going to the toilet
- Cover mouth and nose when coughing or sneezing
- Do not share eating utensils
- Ensure that toys or appliances that are contaminated by nasal or oral secretions should be cleaned before they are used again.
- Keep him home from school, kindergarten or childcare centre
- Keep him away from all public places including restaurants, playgrounds and shopping centres
- Look out for signs and symptoms in other family members, both children and the adults
- Keep his toys, books, eating utensils, towels and clothes separate from others
- Inform the school, kindergarten or childcare centre as soon as possible. They can monitor other children closely and take additional precautions to prevent the spread of HFMD
- Children with HFMD should remain at home until all the blisters have dried up. Consult your doctor before sending him back to the school, kindergarten or childcare centre
|
|
Tell A Friend
Print friendly
