What is Hand, foot & mouth disease?

The Straits Times, September and October 2000

Hand, foot and mouth disease (HFMD) is an infectious disease caused by viruses. It affects children under five years old, and less often, older children and adults.

While the disease is usually mild and most patients recover within seven to 10 days, complications such as brain and heart inflammation may occur among young children.

The first reported outbreak was in 1970. Another happened in 1981 in which 742 people were affected.

There are about 70 HFMD-causing viruses. Common ones are coxsackievirus A16 and enterovirus type 71.

Warning signs

The ministries say: Keep your child away from crowded places and consult a doctor if your child suffers from:

• Fever lasting two to three days
• Sore throat and runny nose
• Mouth ulcers that begin as small red spots that blister. They are usually located on the tongue, gums and inside of the cheeks
• Blister-like rashes over hands, feet and nappy areas that forms over one to two days. These are flat or raised red spots, some with blisters, that do not itch
• Vomiting
• Diarrhoea
• Tiredness and weakness

How is the disease spread?
By direct contact. Infection is high among those who are in close contact, especially children in the same household and in a group or institutional setting. The disease can spread through: Direct contact with nose discharge, saliva, faeces and fluid from blisters Inhaling air droplets containing the virus Handling toys, books, utensils and other items used by infected people The disease takes three to five days to surface

Precautions
Keep children away from places like shopping complexes and swimming pools Cover your mouth when sneezing and wash your hands with soap after going to the toilet Sterilise eating utensils and other items frequently used by children

Can adults pass the disease to children?

Transmission by adults is not common, said Dr Wong Sin Yew, a Gleneagles Hospital consultant physician. Children usually transmit it to children.

And is it possible to suffer a second bout of the disease?

It is possible to get the disease again.

Does HFMD occur more often in this part of the world?

No, said Dr Wong, adding that in the past few years however, the big outbreaks have occurred in this region. For example, in Malaysia in 1997 and Taiwan in 1998.

Is HFMD notifiable?

Since 1987, childcare centres have had to tell the Environment Ministry of any HFMD outbreaks. From Oct 1, 2000 GPs have to do so too.

[Sources: Epidemiological News Bulletin, Singapore; Dr Wong Sin Yew; Journal of the American Podiatry Medical Association and Communicable Disease Report, UK.