Protecting Your Child from HFMD

With an increase in the number of cases in the recent years, how can you prevent your child from falling victim to the dreaded disease?


HFMD. The worrisome acronym for parents. Any parent hearing this diagnosis upon their child would be anxious as how to treat and handle their little one without causing further pain and infection. Motherhood has some advice from these experts.


According to Dr Anita Menon, a consultant paediatrician from Dr Anita's Kids Clinic, the Hand, Foot and Mouth Disease (HFMD) is a viral infection caused by different strains of viruses in the Enterovirus family. The initial symptoms may be fever, lethargy, sore throat, runny nose, vomiting and diarrhoea. There may be drooling and loss of appetite too. Typical signs would include ulcers in the mouth, tongue and around the lips, flat or raised red/pink rashes and blisters on the hands and feet which may spread up the arms and legs. These rashes can also occur on the lower back, buttocks and diaper area. Dr Mary Varughese, associate consultant at Division of General Ambulatory Paediatrics and Adolescent Medicine in National University Hospital adds that children will usually exhibit signs of the disease three to five days after being infected.


Dr Varughese highlights that there have been increased cases of HFMD in the recent years possibly due to reasons such as heightened awareness of the illness following previous epidemics; parents seeking medical attention early for their children; compulsory reporting by doctors to the Ministry of Health which allows close monitoring of the situation; the virus altering itself over time to become more capable of growing, invading and producing disease in its host and more young children attending nurseries and day-care centres where outbreaks commonly occur. To make matters worse, sometimes parents inadvertently send their sick children to school, perhaps not realising that they may have HFMD, adds Dr Menon.



HFMD is very contagious and spreads by direct contact with an infected person. The virus is found in saliva, nasal secretions, fluid from blisters and in faeces. It can also live for some time on contaminated surfaces such as diaper change areas, playground equipment and toys.



The bad news is everyone who has not already been infected is at risk of infection, but the good news is not everyone who is infected becomes ill. In fact, if you are wondering whether the virus only affects a certain group of people, Dr Menon states that HFMD tends to affect infants and preschool children under five years old predominantly. Older children and adults may rarely get the infection. Young children are more susceptible to the virus because they tend to put their unwashed hands and toys in their mouths and their immune systems are not as strong as in adults. Dr Varughese adds that young children may not have acquired immunity to the various strains of HFMD compared to adults, who are likely to have had the exposure and/or the infection in their childhood. It is also more common with children attending infant and childcare centres, as the spread of the virus is most prevalent in places where children are in close proximity. HFMD is considered endemic in Singapore and occurs the whole year round.


Prevention of HFMD

In order to prevent or reduce the chances of your child or other family members contracting HFMD, Dr Varughese advises that parents ensure proper hygiene practices at home such as hand washing after going to the toilet, covering one’s mouth and nose when coughing or sneezing. Furthermore, there should be adequate disinfection of articles such as toys, eating utensils and towels which have been contaminated by the droplets, saliva or stools of those infected. Children also need to avoid places like childcare centres or playgrounds where an outbreak had occurred and avoid kissing, hugging, playing or sharing utensils with other children who may have HFMD. Basically, the risk of infection can be lowered by good, hygiene practices and prompt medical attention for children showing severe symptoms.



According to the World Health Organization (WHO), a person can be infected with HFMD more than once as infection only results in immunity to one specific virus and other episodes may occur following infection with a different virus type.



Pregnant women should also avoid close contact with anyone with HFMD and pay particular attention to measures that prevent transmission. Currently, there is no clear evidence that maternal enterovirus infection, including HFMD, is associated with any particular negative outcomes of pregnancy (such as congenital defects, miscarriage or stillbirth). However, pregnant women may pass the virus to the baby if they are infected shortly before delivery or have symptoms at the time of delivery.


Treatment for HFMD

As much as we wish for some magic healing potion against the HFMD virus, unfortunately, there are no specific antiviral drugs or vaccines available against non-polio enteroviruses causing HFMD, states WHO. Dr Menon mentions that the treatment is symptomatic. There is no need for the child to take any antibiotics or antiviral medication. The only medication possibly needed would be paracetamol for fever and pain. At this stage, it is important to keep the child well hydrated at all times.


Dr Varughese also recommends the following to help your child recover well:


  • Allow the child to take what he/she likes, even cold drinks, ice cream or popsicles
  • Apply ulcer gel or use a mouth spray to relieve pain from mouth sores
  • Salt water mouth rinses may help in older children
  • Small feeds with soupy or soft diet are preferable to minimise pain to the mouth ulcers
  • Calamine lotion may be applied on body rashes if they become itchy
  • Mittens are not advisable as they may irritate the blisters on the hands and feet
  • Stay in cool air-conditioned places to avoid sweating and further irritation to the rashes
  • Stay away from school and other children for one week after the rash appears to prevent further spread. At home, your child may have to be nursed in a separate room especially if there is a young infant or pregnant mother.
Thanks for sharing!