HFMD: The Disease that Spreads Like Wildfire

July 18, 2022  

Parents, be cautious about Hand, Foot & Mouth Disease (HFMD) because it is a highly infectious disease and spreads very easily from one person to another. The disease is transmitted too easily by direct contact with the infected person’s nasal discharge, saliva, feces or fluid from the person’s rash.

It can also spread through indirect contact with contaminated toys, towels or eating utensils used by the infected individual. “If I were to rate the extent of its infectiousness, I would say it is a nine over 10,” says Consultant Pediatrician from Columbia Asia Hospital – Setapak, Dr Margaret Kannimmel.

A self-resolving disease

“Although it is highly contagious, HFMD very rarely causes death,” assures Dr Margaret. “This disease is a mild infection that self-resolves within five to seven days without treatment.

“However, having said that, rare complications as a result of HFMD such as meningitis, encephalitis (brain-swelling) and myocarditis (swelling of the heart muscle), can cause death.”

Are HFMD and FMD the same?

This disease was first reported in New Zealand in 1957. It is caused by Enteroviruses, the most common being the COXSACKIE Virus A16 and then the Enterovirus 71.

It is vital to note that HFMD is not the same as Foot & Mouth disease (FMD). The latter affects animals like cattle and sheep. The HFMD that happens in humans cannot be transmitted to animals. Likewise, FMD in animals cannot be transmitted to humans.

More children than adults

HFMD commonly affects children under five, but it can also affect older children and adults too. However, in the latter group, symptoms are less severe. In fact, even though adults may be carrying the HFMD virus, they are asymptomatic.

The reason why HFMD happens more in children than adults is because of their tendency to put their hands in their mouths. Most likely, they also do not wash their hands as often as adults. Children also have lower immunity compared to adults. As for the risk profile of children who are most likely to be infected with HFMD, Dr Margaret says, “Any child is at risk, but those who are immunocompromised are likely to have more severe HFMD.”

“Even if it is just one case at a nursery or daycare centre, the infected child should be quarantined at home, and a sanitization exercise of the nursery premises must be carried out to prevent other children from getting infected.”

The unpleasantries

Regarding symptoms of HFMD, Dr Margaret explains, “Commonly, the child who is infected may first develop fever and feel unwell. The mouth ulcers and rash may appear within two to five days later. The rash commonly affects the palms and soles but can also appear on the limbs and buttocks. Occasionally, HFMD may also be accompanied by flu and a loss of appetite.”

As for pain in HFMD, she says, “Pain can be caused by ulcers in the mouth causing poor oral intake leading to dehydration. Skin lesions on palms and soles can be itchy and painful at the same time.”

Steps to take

To summarize, Dr Margaret advises keeping children healthy with adequate fluids and nutritious food. “That is important,” she stresses and adds, “Always practice good hygiene such as washing hands with soap and water. Avoid sharing food or drinks, and eating utensils and towels with others.

“If there is more than one child at home and one of them contracts HFMD, separate the infected child as far away as possible and do not share food or toys. Where possible, stay in a separate room or send the uninfected children to a relative’s home. Disinfect surfaces and practice good hand hygiene. Look out for symptoms in other children who are not infected yet.”

If you suspect your child has HFMD:
  1. See a doctor to confirm the diagnosis especially if your child is unable to take anything orally or if he or she is vomiting. Admission to the hospital may be necessary to prevent dehydration.
  2. Make sure your child is well-hydrated and getting lots of rest.
  3. Offer a soft diet like soups or soft bread, as well as cold foods such as ice cream, jelly or pudding.
  4. Keep your child away from the nursery, schools, daycare centres and public places.
  5. Inform the school or daycare centre in case other children are also infected.
  6. Keep your child at home till all lesions have dried-up and your child has recovered. This may take five to seven days.
  7. Keep your child’s toys, books, eating utensils, towels and clothes separate from others.
Dr. Margaret Kannimmel A/P Benson Fernando
Consultant Pediatrician
Columbia Asia Hospital - Setapak



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  This article first appeared in BabyTalk.
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