by Taurus on Mon 26 Jul, 2010 8:13 am 
Hand, Foot & Mouth Disease (HFMD) cases are on the rise again. Since the beginning of the year, more than 14,600 people have come down with HFMD - an increase of over 44 per cent from the same period last year.
Both adults and children can be affected by the disease, which causes rashes on the hands and feet, ulcers in the mouth, along with fever. Children - particularly those aged 5 and below - are particularly vulnerable, and childcare centres are hot spots for the infection.
What can parents do to protect their children from this highly contagious virus? Dr Sonal Singhal from the Youth Health Division of Health Promotion Board (HPB) shares some insight on the disease.
How is HFMD transmitted? Why is hygiene such an important issue in battling the transmission of HFMD?
HFMD is spread through direct contact with saliva, nasal discharge, faeces or the fluid from the blisters of an infected person. It can also be spread indirectly through things that have been contaminated by these secretions.
It is important to note that some infected people may not show obvious symptoms or signs, which is why good hygiene is so important.
By practising good hygiene, such as frequently washing your hands with soap and keeping an infected child's toys, eating utensils, towels, etc separate, the transmission of HFMD can be better controlled.
How long does the HFMD virus remain active on surfaces?
HFMD virus can remain active on surfaces such as toys, doorknobs, etc for weeks. Thus, it is important to regularly clean high-traffic areas and surfaces so as to curb the transmission of the virus to others. Child care centres should follow a strict schedule of cleaning and disinfecting all common areas, including shared items.
What happens if a child infected with HFMD does not observe good hygiene practices? Will other children still be infected due to contact with the sick child, despite washing their own hands regularly?
HFMD is highly contagious and a child affected with the disease can very easily spread it to other children around him or her. Therefore, it is imperative that a child with HFMD symptoms be isolated from the rest of the children and immediately sent to a doctor for diagnosis. As HFMD can be spread indirectly through contaminated objects, a sick child can continue to infect others if he or she is not isolated from the rest.
What can parents do to protect their children?
HFMD is highly contagious. Your child is also susceptible to other infections when they have HFMD. HPB recommends that, to protect children from HFMD, parents teach children good hygiene 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 cleaned thoroughly before they are used again.
What are HPB's recommendations for preventing the spread of HFMD?
If your child has HFMD, HPB recommends parents adhere to the following guidelines in order to prevent the spread to others:
-Keep your child home from 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 the adults
-Keep 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
-Keep your child at home until all the blisters have dried up and they have fully recovered, after the expiry of the medical certificate (MC) given by the family doctor
-Ensure that any siblings are well before sending them to the school, kindergarten or childcare centre.
What is the worst case scenario of HFMD? Can it result in death?
In most cases, HFMD is mild and has only occasionally been known to cause serious complications and even death in some instances. However, the few children who are infected with the EV71 strain of the virus can become very ill, with signs and symptoms such as:
-Disorientation, drowsiness and/or irritability
-Fits
-Severe headache, giddiness or neck stiffness
-Breathlessness or turning blue
-Dehydration - this can happen due to continuous vomiting, diarrhoea or poor fluid intake as a result of painful mouth ulcers. The child is very tired, has a dry tongue and may pass very little urine.
If you notice any of these symptoms please seek urgent medical help.
