Hand, Foot and Mouth Disease

HFMD is a viral infection caused by a group of enteroviruses, most commonly the Coxsackie virus. It is a common childhood infection.


HFMD in Singapore

HFMD is endemic in Singapore and became legally notifiable in Oct 2000, i.e. medical practitioners, childcare centres, kindergartens with HFMD outbreaks must notify the Ministry of Health.

For the latest HFMD situation, you may refer to HFMD: Updates.

For updates on local infectious diseases, please refer to the MOH Weekly Infectious Diseases Bulletin.

Definition and Characteristics

HFMD is a viral infection caused by a group of enteroviruses, most commonly the Coxsackie virus.

The incubation period of HFMD is 3 to 5 days (with a range from 2 days to 2 weeks). Both adults and children can be affected, but young children below 5 years old are more susceptible.

HFMD is usually mild and self-limiting. Occasionally, serious complications involving the nervous system and heart can occur.

Common signs and symptoms

A child with HFMD may suffer from some of these common signs and symptoms:

  • Fever

  • Sore throat

  • Mouth ulcers on the inside of the mouth or sides of the tongue

  • Rash (flat or raised spots) or small blisters on palms of hands, soles of feet, and/or buttocks

  • Lethargy

  • Poor appetite

However, symptoms may vary between individuals, and at different stages of the disease. E.g. some may only have a rash or some individuals may show no symptoms at all.

How HFMD Spreads

HFMD is spread from person to person by direct contact with the nasal discharge, saliva, faeces, and fluids from the rash of an infected person.

A person infected with HFMD is most contagious during the duration of the illness. Although the virus may continue to persist in the stool for several weeks after infection, the person generally becomes much less contagious when the illness resolves. Nonetheless, good personal and environmental hygiene must continue to be maintained.

Treatment of HFMD

There is no specific treatment besides relief of symptoms.

There is no HFMD vaccine currently available.

What to Do If Your Child Has HFMD

If you suspect your child to have HFMD, please seek medical attention.

If there are any changes in the child’s normal behaviour, e.g. irritation and sleepiness, refusal to eat/ drink, persistent vomiting or drowsiness, bring your child to the A&E Departments of either KKH or NUH, whichever is nearer.

If your child has HFMD, help to minimise the spread of HFMD to others by:

  • Informing your child’s school, kindergarten or childcare centre immediately, so they can monitor other children closely and take additional precautions.

  • Keeping your child at home and away from public places.

  • Ensure that your child has no more symptoms of HFMD (refer to the ‘four checks’) and that the medical certificate issued by the doctor has expired before your child returns back to school, childcare centre or kindergarten.

  • Looking out for signs and symptoms in other family members.

  • Having good hygiene practices such as:

    • Frequent and proper handwashing e.g. after going to the toilet and before eating.

    • Covering the mouth and nose when coughing or sneezing.

    • Not sharing food/drinks, eating utensils, toothbrushes or towels with others.

    • Proper disinfection of articles such as toys or appliances contaminated by nasal or oral secretions.

Four checks to ensure that your child is fit for school:

  • Check for fever (to take temperature)

  • Check for blisters on hands and arms

  • Check for mouth ulcers

  • Check for blisters on soles of feet, legs and/or buttocks


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