Hand Foot and Mouth Disease on the rise!
My colleagues and I have in recent weeks seen a significant number of cases of Hand Foot and Mouth Disease in Male’. Viral illnesses like HFMD easily spread and have the potential to cause epidemics. I will therefore present some general information which could help people understand the disease better and take preventive measures.
What is Hand Foot and Mouth Disease?
It is a viral illness of children, usually less then 5 years of age, that is characterised by fever and a vesicular rash occurring over the hands, feet, mouth and buttocks. It is usually a mild disease that the body would clear on its own. This is not the same as Foot and Mouth Disease!
How does one get HFMD?
The infections is mainly spread by drop-lets. Infected children release micro droplets of saliva when they sneeze, cough or speak. These saliva droplets carry the disease causing virus. If inhaled by a another child these droplets could cause infection.
Inanimate objects that are soiled with saliva from an infected child could also be the source of infection for other children. Toys and other objects could therefore spread the infection if they are not cleaned after an infected child handles it.
Recently there have also been reports of the infection spreading by feco-oral route. Food and drinks contaminated by feces of affected children could therefore spread the infection. Safe drinking water, good hygiene in handling food and improved personal hygiene, especially after using the toilet could be effective prevention steps. Children should also be made to wash their own hands before feeding and after bowel movements.
What happens to infected children?
The virus takes about 3-6 days from time of infection to show its first signs of illness. Following this incubation period most children develop a mild to moderate fever which could last for a day or 2. It is documented that some children do not have this classical primary symptom of fever. During this period some children would have generalised malaise, decreased appetite and a sore mouth.
This phase of the illness is followed by the appearance of classical HFMD vesicular rash. The rash are about 5 mm in diameter, is filled with a clear fluid and has a narrow ring of redness surrounding each lesion.
The rash usually begins in the mouth; over the inside of the cheeks, inside of the lips, tongue and gums. The rash may then appear over the hands, palm, arm, legs, feet, sole and buttocks. Some kids also have the rash appear over their genitalia.
How is it diagnosed?
No special tests are required to diagnose HFMD. The diagnosis is made on history and examination of the lesions. The disease in moderately contagious and will need to be notified to Department of Public Health for purposes of epidemic surveillance.
Can the disease be managed at home?
Yes, the disease preferably should be managed at home. Infected children should be kept at home and allowed to rest. Plenty of oral fluids not restricted to just plain water should be encouraged. This is because many children may refuse to eat solids for a few days because of a sore mouth.
Appropriate doses of Paracetamol should be used to manage fever and pain. Local applications in the mouth to relieve pain have also been used in cases with severe sore mouth.
Keeping infected kids away from school, play groups and other children is an important preventive measure that should be practiced in each and every case until all lesions clear.
When should you see a doctor?
For purposes of diagnosis and notification it is important to have your child seen by a doctor during the phase of vesicular eruption. The child may also need subsequent reviews if unable to consume adequate amounts of fluids or has any unusual symptoms.
The treatment is supportive in all cases. Antiviral agents have no proven role in its management and their use should be discouraged. The lesions and the illness usually resolves within 1 week.
