Hand, Foot, and Mouth Disease (HFMD)

HFMD Information and symptoms

HFMD is a major headache for teachers and parents alike due to its rapid spread. Infected children suffer from high fever and painful mouth ulcers, while their hands and feet break out in itchy, sore blisters or red rashes.

Causes

It is caused by Human Enterovirus species A (HEV-A), most commonly Coxsackievirus A16 and Enterovirus 71 (EV 71). Other strains like Coxsackievirus A2-14 and Echovirus can also be responsible.

Crucially, EV 71 is linked to severe neurological complications and fatalities, particularly in children under 5 years old across the Asia-Pacific region.

Incidence and Transmission

When: Occurs year-round in tropical climates, with peak outbreaks during the rainy season.
Where: Common in nurseries, kindergartens, and crowded areas.
How: Spreads through mucus, saliva, nasal discharge, stool, and fluid from blisters. The primary route is oral (ingestion), and less commonly through respiratory droplets. The incubation period is 3–6 days.

Symptoms

Fever for 1–2 days.
Red spots that turn into shallow ulcers in the mouth (cheeks, gums, palate, uvula, and tongue).
A red bumpy rash or clear blisters on the hands, feet, buttocks, genitals, knees, and elbows.
Most cases resolve within a week, but severe cases (usually EV 71 in children under 5) can lead to critical symptoms.

Watch for Neurological Signs: Lethargy, extreme irritability, frequent vomiting, seizures, excessive sweating, rapid heartbeat, or high blood pressure. These can lead to pulmonary hemorrhage or heart failure.

Treatment

There is currently no specific antiviral drug to kill the virus. Most patients recover within 7–10 days with supportive care. Focus on hydration and preventing secondary bacterial infections.

Red Flags (Seek immediate medical help):

Fever over 39°C for more than 48 hours.
Frequent vomiting.
Drowsiness or extreme agitation.
Limb weakness.
Loss of balance (staggering while standing/walking).
Rapid, involuntary eye movements.

Prevention

Hygiene: Do not share utensils, plates, or cups. Emphasize frequent handwashing and covering the mouth when coughing or sneezing.
Vaccination: There is now a vaccine for EV 71. It is suitable for children aged 6 months to 5 years (2 doses, 1 month apart). Children who have already had HFMD can still be vaccinated 1 month after recovery to protect against other EV 71 strains.