This is an infectious disease caused by a family of viruses called Enteroviruses -- the commonest being the Coxsackie virus and Enterovirus. It can occur in people from various age groups, especially pre-schoolers. It is a very common disease in Singapore and has been in existence for many years. It is not a rare or new disease.
Children with HFMD will have blister-like or pimple-like rash on their hands, feet and buttocks, mouth ulcers and fever. In addition, the child may have a sore throat, runny nose, experience vomiting and diarrhoea, and may feel tired.
You may bring your child to the polyclinic or see your family doctor. There is no need to rush your child to the Children's Emergency just to confirm the diagnosis of HFMD.
HFMD can be easily spread through direct contact with nose discharge, saliva, faeces and fluid from the blisters.
The disease is usually mild and most children will recover in about a week’s time. Only very rarely do certain rare strains of the virus cause complications such as inflammation of the brain and heart.
There is no specific treatment for HFMD. The symptoms are usually mild and children usually recover well as their own immune system fights off the virus. Your doctor will give medication to control the fever.
You should encourage your child to take as much oral fluids as possible. Your child may not have a good appetite because swallowing may be painful. However, ensure that your child has adequate fluid to prevent dehydration. Offer your child small amounts of fluid (about 10 – 30 mls each time) such as diluted juices, rice or barley water every half hourly and about 10 - 30 mls each time throughout the day. Antibiotics are ineffective because this is a viral, not a bacterial infection.
Specific immunity can occur, but a second episode is possible from a different strain of virus belonging to the enterovirus family.
Infected children should not be allowed to go to school, childcare centres and other crowded places until he is fully recovered and for at least 1 week after the start of the illness.
Practise good general hygiene. Wash your hands immediately after contact with the infected child or handling diaper changes, and before handling food. The virus can continue to be shed in stools up to 12 weeks in an infected child so practice good hand hygiene when changing diapers for the infected child. Prevent other children from contact with toys, books, eating utensils, towels, clothes and other personal items used by the infected child.
Most children with HFMD are relatively well and active despite their illness. Your family doctor or the polyclinic will be able to manage the majority of the cases.
However, you should bring your child in to the Children’s Emergency if you notice any of the following:
Pregnant women who get HFMD may experience miscarriage, stillbirth or severe disease in the newborn (if she acquired the infection close to delivery).
Pregnant women should practise good hand hygiene by washing their hands after each contact. If the infected child suffers from severe runny nose and cough, it is advisable to wear surgical mask when in close contact (less than 3 feet). Do not prick the blisters as the fluid can be contagious. Do not share toothbrushes etc, as saliva contains the virus.
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