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How HFMD spreads
HFMD is a very common childhood illness caused by viruses that belong to the Enterovirus family. Some examples include Coxsackievirus and enterovirus.
It can be easily spread from one person to another when you come into contact with the body fluids of an infected person.
This can happen by
- touching something that has been sneezed, coughed or drooled on
- breathing in air droplets of the infected person when talking
- touching something that has been soiled with stool
- touching the fluid from a vesicle or sore of an infected child.
It is most common in young children under 5 years old, but older children and adults can get them too. The incubation period is 3-6 days, meaning symptoms may start to appear 3-6 days after you catch the virus.
Understanding the symptoms and diagnosis
Children often get a fever - typically in my experience for 2-3 days. Fever can be quite high in the first 2 days , sometimes up to 39-40 degree Celsius. They may be lethargic and tired and develop body ache and headache. They can complain of sore throat.
They may start to eat or drink less, drool more than usual. Some may even develop diarrhoea and vomiting
Thereafter you will start to see the appearance of multiple oral ulcers or blisters, typically at the palate, buccal mucosa or lips.
A classical skin rash may appear too. These rash looks like small red bumps, some may develop into small fluid filled bubbles. They can appear on the palms and soles, elbows, knees, buttocks and lower back typically.
The diagnosis of HFMD is a clinical one made by the medical doctor after examining the patient and also taking into account the age of the patient and their symptoms. No tests are usually necessary.
Treatment options for HFMD
Treatment of HFMD is usually symptomatic. No antibiotics is necessary. That means we treat whatever symptoms that appear.
You can give fever medications to control the temperature such as paracetamol or ibuprofen if the child is older than 12 months.
Feed them with plenty of cool liquid such as isotonic drinks, Ribena, even fruit juices. Popsicles are great too. Make sure they drink enough to stay hydrated. Offer soft diet like porridge and pureed fruits.
HFMD is very contagious. It can spread very quickly amongst children and even to adults.
To prevent the transmission to others, adopt these few steps
- When your child has contracted HFMD, try your best to isolate them. Avoid contact with others as the virus usually spread via touch and through their saliva.
- Clean and disinfect frequently touched surfaces and shared items, including toys and door knobs.
- For caregivers, do not hug or kiss the child. Wash your hands with soap and water often.
- No sharing of drinking cups, utensils, personal items like towels and brushes.
If your child has been diagnosed with HMFD, Do update the school so that the teachers and can inform rest of students to watch out for symptoms and only go back to class when all the ulcers and rash has resolved. If you are unsure, do check with your friendly family doctor.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)