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An increase in the prevalence of Hand, Foot and Mouth Disease (HFMD) has been observed in recent months at clinics in Singapore. This is most prevalent in children, and parents are recommended to understand the causes and symptoms so that they can appropriately protect their children.
Hand, Foot and Mouth Disease is a mild but highly contagious infection in infants and children under ten years. It is spread from person to person through close contact with infected respiratory secretions or contaminated surfaces. As a result, children in childcare centres are particularly susceptible to outbreaks of HFMD.
HFMD is not related to Foot-and-Mouth disease found in farm animals and cannot be contracted from pets. It is commonly caused by the coxsackie virus and humans are generally immune after a single infection. Adults and teenagers are much less vulnerable, as they should have developed immunity earlier. However, HFMD can be contracted again if it is caused by other enteroviruses.
The child with HFMD typically shows symptoms three to seven days after exposure, with symptoms including fever, sore throat, irritability and loss of appetite. One to two days after fever begins, painful ulcers or sores may appear in the mouth or back of the throat. The typical raised spotty rash on the palms and soles of the hands and feet then appear a day or two later. A rash can also be found on the posterior or groin areas. Doctors make the diagnosis from symptoms and no laboratory tests are needed to do so.
Although symptoms are generally mild and usually clear up within seven to ten days, swallowing during the illness can be painful and difficult in young children. As a result, the most common complication is dehydration. It is important to prevent dehydration during the illness by ensuring that infected child drinks plenty of fluids. Far rarer are cases of viral meningitis due to coxsackie virus, which leads to inflammation of the membranes and fluid around the brain. Viral meningitis is generally mild and clears without problems.
HFMD does not require any specific treatment and clears up after running its course. The mainstay of management is hydration with plenty of fluids such as water or milk, adequate rest, and pain relief and fever control using paracetamol or ibuprofen (products Panadol or Nurofen). Rinsing the mouth with warm salt water may also provide pain relief for older children.
Families can help to prevent the spread of HFMD through careful and frequent hand washing, disinfecting common areas and shared toys, and isolating infected children from others. HFMD is most contagious during the first week of illness but children should not return to school or childcare until the fever, rash and mouth sores have disappeared.
HFMD in pregnant mothers does not pose any risk to the foetus. However, women who contract the illness just before delivery may pass it on to the newborn.
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