Outbreaks of Hand, Foot and Mouth disease is relatively common in Malaysia. Early detection makes all the difference.
In 1997, the first outbreak of Hand, Foot and Mouth disease occurred in Malaysia. Since then, outbreaks have been reported from time to time. In fact, early this year, a child in Johor Bahru succumbed to this deadly disease. There were times when the Ministry of Health (MOH) Malaysia had to order several schools and childcare centres to shut down to contain the disease.
Paediatrician at KPJ Johor Specialist Hospital, Dr. Kate Chan Sook Cheng talks about Hand, Foot and Mouth disease — a viral medical condition that is highly treatable with early detection and appropriate treatment.
1. Urban Health: What is Hand, Foot and Mouth disease?
Dr. Kate Chan Sook Cheng: Hand, Foot and Mouth is an infectious disease. It is usually caused by enteroviruses and may lead to multiple oral ulcers, vesicles (small blisters) on the palms, soles of the feet or buttock area.
2. UH: Who is most susceptible to Hand, Foot and Mouth disease? Why?
DKCSC: Children who are under 5-years-old are more likely to be affected, even though adults or teenagers may get infected too. However, younger children are likely to have more severe manifestations and are vulnerable to suffering from severe dehydration.
3. UH: What are the signs and symptoms of Hand, Foot and Mouth disease?
DKCSC: The child may have high fever, refuse to eat or drink, drool heavily, have multiple vesicles or red dots over the forearms, legs or buttocks. In some severe cases, the child may have multiple chickenpox-like vesicles all over the body including the forehead, back and trunk or torso. Young children who suffer from dehydration, may have other symptoms including decreased urine output, lethargy and dry oral mucosa which is dry mouth.
4. UH: How is this condition treated?
DKCSC: Anti-pyretic medication, which is usually available in the form of syrup, is used not only to control the fever but also to relieve pain. Topical sprays and cataflam drops may relieve a painful throat. For those with severe dehydration, intravenous hydration via a drip may need to be considered. Hence, hospitalisation is recommended.
5. UH: What are some the home remedies to manage Hand, Foot and Mouth disease?
DKCSC: Parents or guardians need to encourage the child to drink more fluids, such as coconut water, juices and isotonic drinks. The child can also consume semi-solid food or a soft diet, such as yogurt, jelly and so on. Solid foods or hot beverages need to be avoided as it may trigger a painful sensation (for children with blisters in the mouth) and reduce the appetite.
6. UH: What are the preventive steps parents can take to protect their children?
DKCSC: Personal hygiene is very important in preventing the spread of this disease. Encourage your child to wash his or her hands before every meal, avoid physical contact with the person who is infected by the disease and reduce public exposure during the peak season of an outbreak.
If your child is infected, isolate him or her at home. Your child must be restricted from entering public spaces and should not mingle with other children, especially at the nursery or kindergarten. This should continue until the ulcers and vesicles have completely disappeared.
7. UH: If a child is diagnosed with Hand, Foot and Mouth disease and has other siblings at home as well, what are the steps parents should take to prevent the spread of this disease at home?
DKCSC: Mostly, isolation is a protective measure to reduce transmission of the disease. The virus is spread via human contact so clean up the patient’s room, common areas and all toys that are shared. Make sure the other children avoid close contact with the infected sibling. The caregiver must also wash their hands frequently while taking care of both the infected child and other children.
8. UH: What should parents do if there is a Hand, Foot and Mouth disease outbreak in the school?
DKCSC: The infected child must be restricted from attending school. Common areas and objects, especially tables, toys and books, should be cleaned and sanitised. Closely monitor the medical condition of all the children in the school. If a child is found to be unwell, send the sick child to a medical facility as soon as possible. The incubation period for the disease is about three to five days.
9. UH: If this condition is left untreated, what are the consequences?
DKCSC: Dehydration is the most common issue and the child may show some symptoms of lethargy, tachycardia or low blood pressure in cases of severe dehydration. There are some rare complications that can also occur such as a nervous system infection or a severe respiratory or circulatory decompensation. These conditions may lead to severe morbidity or even death.
10. UH: What is your advice to parents with regards to Hand, Food and Mouth disease?
DKCSC: Be aware of your child’s symptoms and always consult a medical specialist as soon as the symptoms appear. Encourage your child to drink lots of fluids and closely monitor your child’s hydration status.