TODDLERS are notorious for putting everything in their mouths, an age-related habit for sure, but one which puts them at high risk of infections, including hand, foot and mouth disease (HFMD).
This highly infectious disease is showing a spike in Malaysia with 170 clusters identified.
According to the Health Ministry, the number of HFMD cases exceeded the national alert level of 1,150 cases per week during Epidemiological Week 19 from May 7 to 13.
Up of May 13, Selangor had the highest number of cases, followed by Sabah, Kuala Lumpur and Putrajaya.
Having an active HFMD case at home means being extra careful about limiting contact with the infected individual and practising good hand hygiene — similar to the preventive measures practised during the Covid-19 pandemic, says International Medical University Paediatrics Department head Dr Erwin Khoo.
"Parents and caregivers should wash or disinfect hands regularly, wipe down common areas with disinfectant, avoid sharing food and utensils, and avoid touching the eyes or nose."
These measures should continue for up to 10 days. More importantly, a child with confirmed HFMD should stay home to prevent passing the infection on to others, says Dr Khoo.
However, he says that extreme measures such as room isolation might be excessive and unnecessary because the disease is not typically spread through the air like some respiratory infections.
KEEP CLEAN
The virus can remain contagious for several days on hard surfaces.
The usual incubation period is between three and seven days, but can go up to two weeks. This allows HFMD to spread easily among those in close contact and in circumstances, where toys or utensils are shared, or when hand hygiene is not practised after routine childcare tasks like changing diapers.
Dr Khoo says while most people think of HFMD as a childhood disease — as most cases affect children under 6 — it can affect adults, too.
"Some people think that adults get worse HFMD symptoms, but studies show that adults usually experience milder symptoms."
Affected adults could still pass the virus to others though. For example, adults working in a childcare centre that has HFMD cases could carry the virus home, where it could infect their spouse, children or elderly parents.
Dr Khoo says it is also possible to get HFMD more than once, as there are different strains and immunity towards enteroviruses is only temporary.
HFMD is caused by viruses, with the most common being Coxsackie A16 and Enterovirus 71. These viruses can be found in the respiratory tract and faeces, and in the fluid-filled blisters that form on the hands and feet.
HFMD and chickenpox are examples of viral exanthems, says Dr Khoo. However, unlike chicken pox, the rashes are not usually on the trunk of the body, but on the hands and feet, and sometimes on the knees, elbows and buttocks.
In most cases, recovery at home with over-the-counter treatment is sufficient to relieve symptoms, which include fever, rash or red spots on the palms and soles, as well as ulcers in the mouth.
Though the spots are usually not itchy, but ulcers in the mouth can be painful and prevent children from drinking, eating and swallowing normally. This can lead to dehydration, which, in serious cases, requires medical attention.
HFMD — What parents can do
• Treat fever with paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the pain and inflammation of mouth ulcers. But, get the advice of a paediatrician before giving your child NSAIDs.
• Give the child foods that are easy to swallow, such as soups and porridge, in place of solid foods that require chewing.
• Prevent dehydration by regularly offering the child their favourite drinks or juices.
• Soothe mouth ulcers with cold treats like ice cream, yoghurt and jelly. Alcohol-free mouth rinses and oral gels can also help.
• Shower or bathe regularly to soothe the sores and towel dry gently to avoid breaking the blisters (if any). Avoid harsh soaps and scrubs that irritate the skin.
• Avoid using air-conditioning at night (where possible) because mouth ulcers may hurt more due to reduced saliva production because of the drier environment.
• If air-conditioning is needed during hot weather, using a humidifier or leaving out a bowl of water to keep the air moist may help.
• If pain prevents rest, speak to a paediatrician about using a pain reliever at night, even when there is no fever.
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