Hand Foot Mouth Disease

[didiez]

My daughter was noted with symptoms yesterday... Panic I and although we already got it confirmed at a GP, mu hubby insisted we go to KKH to get a confirmation. 
My best friend's daughter is in hospital cos of HFMD but the girls did not get it from each other but from school.  I checked the MOH website and there were 490 cases last week up from 300+ the week before...

Can anyone share their experience dealing with HFMD?

[blitze]

This maybe useful.

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise ("feeling sick"), and frequently a sore throat. One or 2 days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.


Is HFMD the same as foot-and-mouth disease?

No. HFMD is often confused with foot-and-mouth disease of cattle, sheep, and swine. Although the names are similar, the two diseases are not related at all and are caused by different viruses. For information on foot-and-mouth disease, please visit the web site of the US Department of Agriculture.

What causes HFMD?

Viruses from the group called enteroviruses cause HFMD. The most common cause is coxsackievirus A16; sometimes, HFMD is caused by enterovirus 71 or other enteroviruses. The enterovirus group includes polioviruses, coxsackieviruses, echoviruses and other enteroviruses.


Is HFMD serious?

Usually not. HFMD caused by coxsackievirus A16 infection is a mild disease and nearly all patients recover without medical treatment in 7 to 10 days. Complications are uncommon. Rarely, the patient with coxsackievirus A16 infection may also develop "aseptic" or viral meningitis, in which the person has fever, headache, stiff neck, or back pain, and may need to be hospitalized for a few days. Another cause of HFMD, EV71 may also cause viral meningitis and, rarely, more serious diseases, such as encephalitis, or a poliomyelitis-like paralysis. EV71 encephalitis may be fatal. Cases of fatal encephalitis occurred during outbreaks of HFMD in Malaysia in 1997 and in Taiwan in 1998.


Is HFMD contagious?

Yes, HFMD is moderately contagious. Infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.


How soon will someone become ill after getting infected?

The usual period from infection to onset of symptoms ("incubation period") is 3 to 7 days. Fever is often the first symptom of HFMD.


Who is at risk for HFMD?

HFMD occurs mainly in children under 10 years old, but may also occur in adults too. Everyone is at risk of infection, but not everyone who is infected becomes ill. Infants, children, and adolescents are more likely to be susceptible to infection and illness from these viruses, because they are less likely than adults to have antibodies and be immune from previous exposures to them. Infection results in immunity to the specific virus, but a second episode may occur following infection with a different member of the enterovirus group.


What are the risks to pregnant women exposed to children with HFMD?

Because enteroviruses, including those causing HFMD, are very common, pregnant women are frequently exposed to them, especially during summer and fall months. As for any other adults, the risk of infection is higher for pregnant women who do not have antibodies from earlier exposures to these viruses, and who are exposed to young children - the primary spreaders of enteroviruses.

Most enterovirus infections during pregnancy cause mild or no illness in the mother. Although the available information is limited, currently there is no clear evidence that maternal enteroviral infection causes adverse outcomes of pregnancy such as abortion, stillbirth, or congenital defects. However, mothers infected shortly before delivery may pass the virus to the newborn. Babies born to mothers who have symptoms of enteroviral illness around the time of delivery are more likely to be infected. Most newborns infected with an enterovirus have mild illness, but, in rare cases, they may develop an overwhelming infection of many organs, including liver and heart, and die from the infection. The risk of this severe illness in newborns is higher during the first two weeks of life.

Strict adherence to generally recommended good hygienic practices by the pregnant woman (see "Can HFMD be prevented?" below) may help to decrease the risk of infection during pregnancy and around the time of delivery.

When and where does HFMD occur?

Individual cases and outbreaks of HFMD occur worldwide, more frequently in summer and early autumn. In the recent past, major outbreaks of HFMD attributable to enterovirus 71 have been reported in some South East Asian countries (Malaysia, 1997; Taiwan, 1998).


How is HFMD diagnosed?

HFMD is one of many infections that result in mouth sores. Another common cause is oral herpesvirus infection, which produces an inflammation of the mouth and gums (sometimes called stomatitis). Usually, the physician can distinguish between HFMD and other causes of mouth sores based on the age of the patient, the pattern of symptoms reported by the patient or parent, and the appearance of the rash and sores on examination. A throat swab or stool specimen may be sent to a laboratory to determine which enterovirus caused the illness. Since the testing often takes 2 to 4 weeks to obtain a final answer, the physician usually does not order these tests.


How is HFMD treated?

No specific treatment is available for this or other enterovirus infections. Symptomatic treatment is given to provide relief from fever, aches, or pain from the mouth ulcers.


Can HFMD be prevented?

Specific prevention for HFMD or other non-polio enterovirus infections is not available, but the risk of infection can be lowered by good hygienic practices. Preventive measures include frequent handwashing, especially after diaper changes (see "Handwashing" in: An Ounce of Prevention: Keeps the Germs Away), cleaning of contaminated surfaces and soiled items first with soap and water, and then disinfecting them by diluted solution of chlorine-containing bleach (made by mixing approximately ¼ cup of bleach with 1 gallon of water. (See more about cleaning and disinfecting in general in CDC's Prevention Resources). Avoidance of close contact (kissing, hugging, sharing utensils, etc.) with children with HFMD may also help to reduce of the risk of infection to caregivers.

HMFD in the childcare setting

HFMD outbreaks in child care facilities occur most often in the summer and fall months, and usually coincide with an increased number of cases in the community.

CDC has no specific recommendations regarding the exclusion of children with HFMD from child care programs, schools, or other group settings.  Children are often excluded from group settings during the first few days of the illness, which may reduce the spread of infection, but will not completely interrupt it.  Exclusion of ill persons may not prevent additional cases since the virus may be excreted for weeks after the symptoms have disappeared.  Also, some persons excreting the virus, including most adults, may have no symptoms.  Some benefit may be gained, however, by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands.

If an outbreak occurs in the child care setting:


Make sure that all children and adults use good handwashing technique, especially after diaper changes.


Thoroughly wash and disinfect contaminated items and surfaces using diluted solution of chlorine-containing bleach.

[didiez]

this is from the MOH website right?  sigh... seems that there is a spike of cases last 2 weeks...

my friends recommended that I give ice cream to the child to help deal with the pain in the mouth...

[lyn1404]

Hi didiez,

Here’s my experience. Both my children had it during the September school hols last year. It started with my first daughter who is being infected in school. She had fever and red sports all over her hands and bodies. We tot at first tat she had chicken pox or measles but then later we confirmed it with our family doctor that it was HFMD. Her fever was on and off and she was not cranky at all as hers is very mild.

Few days after my daughter had it, my son pun dpt. Masa tu, he was like only 8mths. His fever shot up almost to 39degress. There were red sports all over his bodies and the worst part of all, his whole mouth began to turn red and swollen and drooling all the way as the whole of his mouth get infected with ulcer. Imagine kalau org tua dpt ulcer, apatah lagi to a 8mths old baby…. Sedih bila Lyn ingat2 kan balik the time he get HFMD. No matter how we prevent, pun dpt jugak.

We rush him to see our family doc and the they gave him Brufen  and cream to apply. The doctor advise us to monitor his temperature and to make sure that he takes lots of liquids, or else we have to bring him to KK. The whole day he was crying and crying as his whole mouth hurts. Nak minum susu pkai botol pun susah and we hv to feed dia slowly with spoon as there was ulcer in his mouth.We sponge him frequently to bring down the temperature and keep feeding him with liquid. Anything, as long as its liquid. Whole day, me, my hub and my maid take turns dokong dia. Tido pun on our shoulders and air liur dia meleleh tak stop2. He was like crying in pain the whole day.

Alhamdullilah, the fever subside later at nite and the ulcer reduce as he’s able to drink his milk slowly from the bottle. But still we monitor him very closely the whole nite to make sure his fever turun.

my friends recommended that I give ice cream to the child to help deal with the pain in the mouth...

true, my doctor told us that too. infact, I also feed my son ice cream to reduce his pain in the mouth kerana tak tahan tgk dia in pain & he was like so hepi sipping bit by bit of the ice cream. Tat was his first time eating ice cream tat time.

[blitze]

this is from the MOH website right?  sigh... seems that there is a spike of cases last 2 weeks...

my friends recommended that I give ice cream to the child to help deal with the pain in the mouth...

Not sure where I got it from.. but is a foreign website, I thk.

My nephew is having HFMD but alhamdulilah he is getting better.  Semlm he could talk and there isnt any fever. The day b4, he has blisters all over his mouth & couldnt speak. Kesian tgk dia, dah lah kurus.. semakin lidi jadi nya.  :-\

[aUra]

ouch... can feel ur pain..  :-[ :-[ i cant help much pasal tak pernah go thur.. mudah2an ur children will recover soon :-[

[didiez]

my elder girl's dun seem so bad... her ulcer is at her gums so she is not able to take solid food but she drinks lots of milk... i'm now worried for my younger girl who has started showing signs... she is the more demanding sort so not sure how she is going to cope

[blitze]

Like to update that my nephew dah baik and start going back to school pun. Syukur, alhamdulilah. 

[mayang]

this is so scary.. Rian been having fever since tuesday.. and since thursday he start to have ulcer in his mouth.. makan, minum, susu semua dia tak nak.. always complaining mulut dia sakit.. risau dibuatnya.. nak kasi makan obat pun punya lah susah.. but when i check his leg and hand, no rash or blisters.. now my hubby and mum on the way to see GP.. since PD tutup on weekend.... i just hope he's not infected by this disease.. 

[petite mum]

my son ada ulcer in his mouth since wed. but wen i asked him..dia kata dia tergigit mulut dia. den i juz put bonjela. den on Thurs, mulut dia banyak nah ulcer...i takut jugak cos i sent him to playgroup. takut HFMD. tanya hubby..he said better dun take d risks. tangan n kaki dia tak ada apa2.

on Thurs..bawak gi poly. Lucky, doc kata takde apa2. its not HFMD. juz normal sakit. he was given antibiotic n cream to rawat his ulcer. nangis jugak bila nak makan cos ulcer keliling mulut dia n even lidah. pity him. but den now dah start minum susu kat cawan. taknak botol lagi cos he said sakit.

i tanya doc pasal HFMD.. dia kata usually budak tu ada fever. lucky my son tak demam. but she asked me to monitor je.. check his hands n feet. so far alhamdulillah.. nothing. 

[girlnani]

my son pun baru baik frm this hfmd.. pasal mulut dia ada bintik bintik merah i thought normal ah pasal nak tumbk gigi..but my hubby noticed his palm pun ada... time to fri..pukul 9pm decided to go 24-hr clinic..doctor suspect it hfmd... another is maybe chicken pox..pasal he say penyakit nie mcm chickenpox ah.. check ada fever 38degree. kasi ubat and cream. susah nak minum susu and malam jgn ckp tido sekejap bangun and cry cry..kesian tgk budak budak mcm nie...monday nyapegi followup ah yup betul my son kena hfmd... but doc say tak serious penyakit nie . i think my son main kat playground ah kena..then i say to hubby jgn  bawak pegi playground ah lagi..takut seh..he say usually take one week to baik..nowalhamdulilah dah baik pun...

[nina nin]

It's still on the rise.. now at epidemic level.
you can check weekly status at MOH website.

as of CW18:

http://www.moh.gov.sg/mohcorp/uploadedFiles/Statistics/Infectious_Diseases_Bulletin/2007/2007_week_18.pdf

[Ain Wahira]

Kalau salah seorang anggota keluarga ada yang terkena HFMD, anggota serumah yang lain pun boleh kena jangkit jugak tak?

So far, ada tak forummers kat sini yang mana anak terkena HFMD, tapi tak lama lepas tu, adik beradik yang lain kena jangkit juga?

Baru tadi dapat tahu dari my sis that one of her 4 yr old twin daughters (younger twin) kena HFMD. Doktor dah sahkan dan beri anak dia MC 1 minggu dari childcare nya. My sis pun kena amik cuti keja 1 minggu untuk jaga dia. My sis pun risau juga kalau2 kembar yang satu lagi (elder twin) will get it too. This is becos the elder twin suka usap2 the younger twin and very concern about her sis.

[lyn1404]

Kalau salah seorang anggota keluarga ada yang terkena HFMD, anggota serumah yang lain pun boleh kena jangkit jugak tak?

So far, ada tak forummers kat sini yang mana anak terkena HFMD, tapi tak lama lepas tu, adik beradik yang lain kena jangkit juga?

Baru tadi dapat tahu dari my sis that one of her 4 yr old twin daughters (younger twin) kena HFMD. Doktor dah sahkan dan beri anak dia MC 1 minggu dari childcare nya. My sis pun kena amik cuti keja 1 minggu untuk jaga dia. My sis pun risau juga kalau2 kembar yang satu lagi (elder twin) will get it too. This is becos the elder twin suka usap2 the younger twin and very concern about her sis.

Yes, after my daughter got it, few days later, mu son pulak

[Ain Wahira]

Really??? Hmm...macam ni, nampak gayanya my sis nak kena standby lah takut kalau2 her two elder boys age 6 and 7 kena jangkit jugak.  :