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​Protect your children against Hand, Foot and Mouth Disease

Hand, Foot & Mouth Disease (HFMD) is present in Singapore all year round, and the seasonal outbreaks occurring in childcare centres, kindergartens and schools are generally mild. However, a certain type of the virus, EV71, can give rise to serious complications.  These complications, usually involving the heart and nervous system (e.g. encephalitis), have been known to cause fatality. HFMD is an infectious disease that is notifiable by law since October 2000.​

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How it is spread

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 of age are particularly susceptible.

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Signs & symptoms

A child with HFMD may suffer from some of the following common signs and symptoms:
  • Fever.
  • Sore throat.
  • Ulcers in the throat, mouth and tongue.
  • Headache.
  • 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 are very characteristic in appearance. The rash may also be present on the buttocks, arms and legs.
  • Poor appetite.
  • Lethargy.
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.

Related: Hand, Foot and Mouth Disease



Complications

Severe ulcers in the mouth can be very painful, interfering with the intake of food and drink. This could result in dehydration, as could persistent vomiting/diarrhoea, and a reduced fluid intake.

Occasionally, complications such as brain, lung or heart infections may occur. This is usually due to the EV71 virus and can be serious. Some signs and symptoms of complications include:
  • Severe headache, giddiness and neck stiffness.
  • Disorientation, drowsiness and/or irritability.
  • Fits.
  • Breathlessness or turning blue.

Screening & diagnosis

Laboratory testing is available to isolate and identify the causative agent. However, this is usually not necessary as diagnosis of HFMD is typically based on clinical grounds.


Treatment

There is no specific treatment for the infection other than symptomatic relief of symptoms. If you suspect your child has HFMD, please take him/her to your family doctor.

Take these steps to ease your child’s discomfort and help him or her recover:
  • Encourage your child to drink plenty of fluids.
  • Change to a soft diet (e.g. porridge, pureed fruit) if the mouth ulcers are a problem.
  • Give medications as prescribed by the doctor, e.g. paracetamol syrup to relieve fever and pain.
  • Ensure your child gets plenty of rest at home.
 

Keeping others safe

  • If your child has HFMD, minimise its spread to others with these following ways:
  • Keep your child at home, away from his school, kindergarten or childcare centre.
  • Keep your child away from all public places including restaurants, playgrounds and shopping centres.
  • Look out for signs and symptoms in other family members, both children and adults.
  • Keep your child’s toys, books, eating utensils, towels and clothes separate from others.
  • Inform your child’s school, kindergarten, childcare centre or enrichment classes as soon as possible so that they can monitor other children closely and take additional precautions to minimise the spread of HFMD.
  • Keep your child at home until all the blisters have dried up and he has fully recovered, after the expiry of the medical certificate (MC) given by the family doctor.


Preventing the spread of HFMD​

Protect your children from HFMD, by teaching them good hygiene practices such as:
  • Washing hands with soap and water before and after eating and after going to the toilet.
  • Covering the mouth and nose with a piece of tissue when coughing or sneezing.
  • Avoid sharing food/drinks, eating utensils, toothbrushes or towels with others.
  • Ensuring that toys or appliances that are contaminated by nasal or oral secretions are disinfected before they are used again.
  • Putting on a face mask when feeling unwell.

In addition, do these four steps before sending your child to the school, kindergarten or  childcare centre every day:

  1. Take your child’s Temperature (either orally or via the ear).
  2. Look for mouth Ulcers. Ask your child to open the mouth and say “Ah …”. Shine a torch in the mouth and look for ulcers on the tongue, inner sides of the mouth and on the lips. 
  3. Look for blisters on the Hands. Ask your child to hold out the hands and show his/her palms. Look for small pinkish/reddish bumps or tiny blisters with fluids. Then check for the same on the back of the hands.
  4. Look for blisters on the Feet. Check for bumps/blisters on the upper part of the feet first, then the soles.

If you observe any of the above, DO NOT send your child to the school, kindergarten or childcare centre. Instead, take him/her to a family doctor for a thorough examination. If your child is diagnosed with HFMD, please keep him/her at home, returning only after the expiry of the medical certificate (MC) and when fully recovered.