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That Scary Thing Called HFMD

Wednesday, July 25, 2018-The friendly people at Me Books Asia

“HFMD outbreak ‘beyond the danger level’ in Penang”

The Star Online, 19th July 2018.

Over the next few days, more and more reports appeared highlighting staggering increases in HFMD cases in numerous states across Malaysia. Almost immediately, most pre-schools sprung into action promising additional steps will be taken to ensure the safety of our little ones. But is this enough? Parents need to be vigilant and proactive to ensure the spread of this contagious disease is minimised.

Picture: Both adults and children are susceptible to HFMD.

What is HFMD and what are the symptoms?

HFMD is known as Hand, Foot and Mouth Disease and is commonly caused by coxsackievirus and enterovirus pathogens.

As its name suggests, a child can show symptoms of rashes, which start off as flat, discoloured spots and bumps that may be painful. These progress to water-filled vesicles over the hand, foot and mouth. Fever may or may not be present, while restlessness and irritability for babies and toddlers may also suggest HFMD. Children will typically have poor appetite and refuse any form of food and water, causing dehydration.

Symptoms vary as some may just have skin rashes or mouth ulcers, while some may not show any symptoms at all! 

While HFMD is deemed as a mild viral infection, there are some severe forms of HFMD that can affect the body and heart. Should a child show the following symptoms, he or she needs to be admitted to the hospital immediately:

  • Headache, giddiness or stiffness of the neck

  • Irritability, drowsiness or disorientation

  • Fits or abnormal jerky movements

  • Fast breathing or turning blue

  • Lethargy

Who gets HFMD?

Anyone can get HFMD but it usually infects children below the age of 5. Although rare, adults can also be infected. More importantly to note is that adults may be carriers and will infect children when they come in contact. However, an adult may only experience a simple viral fever instead of a full fledge manifestation. Once infected, there will be an incubation period of 3-6 days before the clinical manifestation occurs.

How can my child be infected?

Once a child is diagnosed with HFMD, he or she will remain in infectivity period for 14 to 16 days. The virus is highly contagious and is transmitted by direct contact with saliva, nasal mucus or by faecal-oral transmission. In other words, the sharing of food, toys or even a touch or a sneeze can result in infection.

I’m going to wrap my child in a bubble. Would that help?

With HFMD being a major cause of concern, the bubble sure sounds like a good idea, but if only that were possible. What we can do is to educate and enforce these steps with our little ones:

#1: The art of hand washing

Don’t just get them to wash their hands; teach them the 7 steps of washing hands.

  • Step 1 - Wet your hands and apply enough soap.

  • Step 2 - Rub your palms together.

  • Step 3 - Rub the back of each hand.

  • Step 4 - Rub both your hands while interlocking your fingers.

  • Step 5 - Rub the back and the tips of your fingers.

  • Step 6 - Rub your thumbs and the ends of your wrists.

  • Step 7 - Rinse hands properly with water.

#2: Keep nails short

Younger children tend to unknowingly place their little digits near their mouths all the time! Their nails can be a playground for a whole lot of nasty stuff. Let’s reduce the risk of them contracting different diseases by keeping their nails trimmed.

#3: Stock up on immunity boosting foods

Boost your child’s immunity with fruits and products rich in Vitamin C, B and E. This includes citrus fruits, nuts like almonds and hazelnuts, fish, eggs and vegetables such as broccoli, tomatoes and spinach.

If your child is still being breastfed, you may want to up your intake of immune-boosting foods as well. While it does not decrease the risk of infections, studies have shown that babies that are fed breast milk have a lower rate of contracting severe HFMD.

#4: Keep extreme temperature changes at bay

We know, the heat is back! While we can’t quite negotiate with Mother Nature, what we can do is to minimise extreme temperature changes. Blasting the air-condition at 16 degrees celcius after a sweaty bout of playground adventures is only going to do your child more harm than good. The occasional “hardening and tempering” actually helps boost a child’s immunity, but it should be done with natural resources. Let them cool down without any ‘cooling aids’ so that their body temperature stabilises naturally.

What are my treatment options for HFMD?

Well, here’s the bad news. There is none.

As we are dealing with a virus strain, antibiotics would be of no help. Currently, as the virus is deemed as a fast mutating one, there is also no vaccination available.

Treatment for HFMD is just mainly symptomatic relief. The disease does not typically cause any mortality; however, extra care needs to be in place. A child with HFMD needs to be kept hydrated. Calamine lotion will also help relieve symptoms of the rashes, while paracetamol may be administered to children with fever.

Usually HFMD is self-resolving without complications. However, if the child develops breathing difficulty, it’s wise to bring to the nearest clinic. This may be due to hydration status of the child or vesicle formation within the mouth cavity.

I’ve done all I can, but my child is infected. What do I do now?

Isolate your child and do not send your child to school or bring them out to public spaces!

We understand that this can be tough especially when both parents are holding full-time jobs, but this is crucial to ensure that the disease is contained. Some relief is given for parents who are civil servants as they are eligible for 5 days of ‘cuti kuarantin’ (or quarantine leave), totalling 10 days, as both parents are not permitted to take them together.

Inform your childcare provider or your child’s school that he or she has been infected so that extra precaution can be taken by the schools to ensure the disease does not spread further.


  • http://docs.jpa.gov.my/docs/pp/2016/pp112016.pdf

  • https://emedicine.medscape.com/article/802260

  • http://www.moh.gov.my/images/gallery/Garispanduan/Guidelines%20HFMD%202007.pdf

  • http://www.myhealth.gov.my/en/hand-foot-mouth-disease-hfm





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