During the rainy season the weather is generally hot, wet and humid. In other words, ideal conditions for incubating and spreading viruses. One such is Hand, Foot & Mouth Disease which can be a nightmare for parents as once one child catches it, they spread it to everyone they come in contact with.

Getting to know Hand, Foot & Mouth Disease             

Hand, Foot & Mouth Disease (HFMD) can occur in both children and adults. However, it's most common in young children under 5 years old and more severe in older children than adults. There are outbreaks of HFMD every year and it mostly spreads in schools and day care facilities. Fortunately, the symptoms are mild and very few people die from it. A contagious disease, HFMD is caused by infection with Enterovirus, of which there are over 100 strains. However, the Coxsackie A16 and Enterovirus 71 viruses are responsible for most infections.

Infection

HFMD has an incubation period of 3-6 days after infection. Patients are infectious from the onset of symptoms until about a week after recovery. The virus is transmitted through body fluids and wastes via coughing and sneezing or contact with an infected person’s urine or feces.

Symptoms of HFMD

Once infected, a person will have a high fever of 38-39 degrees Celsius. After 1-2 days of fever, they will start to have a sore throat and sore mouth. They will not want to eat which makes them tired. The reluctance to eat is due to the onset of red blisters on the tongue, gums and palate. The painful blisters will also appear on cheekbones, palms, soles and at the joints of fingers and toes. The red blisters become clear and are accompanied with inflammation and redness.

Parents must watch to see whether their young children develop a lot of little wounds. In the mouth, these may be ulcers that become so severe the child can’t eat anything. If your children shows such symptoms you need to take them to a hospital to get intravenous infusions until the wounds heal.

Usually, patients heal on their own within 5-7 days but there is a chance of complications arising.

Here are the symptoms to check for:

·       Dizziness, not playing, not wanting to eat or drink milk.

·       Bad headache.

·       Gasping for breath, rapid breathing, looking tired, pale face, sticky mucus.

·       Alternating between deliriousness and lethargy and seeing strange things.

·       Neck pain, stiff neck, confusion, vomiting.

·       Seizures, spasms, losing consciousness.

·       Being startled, trembling hands, trembling legs, staggering.

If your child has these symptoms, take them to a doctor immediately. They could develop the most severe complication which is encephalitis. Statistically it’s still unlikely: only 1-5 cases are found each year in Thailand. However, there are other less severe complications that are still concerning, including dehydration and loosening of fingernails and toenails.

HFMD vs Chickenpox

HFMD and chickenpox have similar symptoms. They both start with fever, loss of appetite and red and clear blisters around the body. However, chickenpox blisters are scattered in different parts, notably the face, chest, back, mouth, eyelids and genitals. By contrast, with HFMD very few blisters appear on the body. Rather the blisters are located in the mouth and on the palms and soles of the feet. Chickenpox afflicts children over 15 years and is caused by the same virus as shingles, which is not the same one as HFMD.

Treatment

There is no known cure for HFMD. So, if your child shows symptoms, you should keep them home to prevent spread and give them symptomatic treatment, as follows:

·       When they have a fever, they should be wiped periodically with a cool cloth to reduce the fever and have them take antipyretics and painkillers.

·       Give them oral gel to reduce pain in the mouth.

·       Have them eat light foods, drink clean water and get lots of rest.

·       Have them drink cold water and eat ice or ice cream to numb their mouth, reduce the pain and make it easier for them to eat.

·       Young children may need to be fed milk.

·       If they can’t eat enough, take them to a hospital for intravenous infusions to build their strength and treat other symptoms.

How to prevent HFMD

HFMD can be transmitted easily and quickly. There is no specific vaccine for it. The way to prevent getting it is as follows:

·       Avoid being in close contact or proximity with anyone infected. Taking young children into community areas such as playgrounds and shopping malls unnecessarily should be avoided during an outbreak.

·       Parents should maintain hygiene both for their own sake and that of their children. Make sure everyone who wants to touch the child washes their hands first. If someone close to you is sick in any way, stop them coming into direct contact with the child such as through hugging and kissing.

·       Avoid sharing of items such as milk bottles, drinking glasses, straws, handkerchiefs and towels. Always use serving spoons with help-yourself dishes.

·       Only eat clean, freshly cooked food and drink clean water.

·       Use a handkerchief or tissue paper to cover your mouth and nose every time you cough or sneeze.

·       After wiping your child’s nose or mouth, wash your hands immediately.

·       Wash diapers or clothes that are contaminated with urine or feces as soon as possible and pour the water directly into the toilet. Do not dispose of it into the sewer to prevent spread.

·       If your child shows symptoms of HFMD, they should be taken to a doctor immediately to diagnose symptoms and get treatment advice. Keep them home from school at least a week and until the ulcers have completely healed.

·       Keep the child's utensils and toys clean at all times.

Schools and nurseries are always at risk of being the epicenter of an outbreak of HFMD but this can be prevented by:

·       Providing hygienic sinks and toilets.

·       Training and supervising children to have their own personal items such as water glasses, milk bottles and handkerchiefs.

·       Disciplining children to wash their hands after going to the bathroom and before eating.

·       Always maintaining cleanliness of the space, equipment and toys as well as the personal hygiene of the caregivers.

·       Isolating sick children at the school entrance.

·       If a child is found to have HFMD, the school should be closed for at least 2 weeks and all classrooms and toys should be cleaned.

HFMD is nothing new. While it’s not that serious, infected children can suffer quite a bit. It crops up among them every year, and every time it not only affects children's bodies but also their schooling, not to mention their parents’ mental state.  It’s important that parents and teachers put cleanliness first and routinely monitor for symptoms as this will save children from getting sick if an outbreak occurs and stop it spreading.

Krungthai-AXA life insurance customers can consult an online doctor using the Krungthai-AXA Telehealth service by downloading Emma by AXA application, pressing “TeleHealth” and confirming your policy number the first time you use it. For more information, click https://www.krungthai-axa.co.th/th/telehealth.

References

·       Bumrungrad Hospital
https://www.bumrungrad.com/th/conditions/hand-foot-mouth

·       Corporate Communication, Faculty of Medicine, Ramathibodi Hospital
https://bit.ly/3xF3Pls

·       Faculty of Medicine, Siriraj Hospital
https://www.si.mahidol.ac.th/sidoctor/e-pl/articledetail.asp?id=828
https://www.si.mahidol.ac.th/th/tvdetail.asp?tv_id=419

·       King Chulalongkorn Memorial Hospital, Thai Red Cross Society 
https://chulalongkornhospital.go.th/kcmh/hand-foot-and-mouth-disease/

·       Pobpad website
https://bit.ly/3aWYU6x
https://bit.ly/3QgmCuk