Hand Foot and Mouth

What is Hand Foot and Mouth?

Hand foot and mouth disease (HFMD) is a common childhood infection caused by a group of enteroviruses and the most common virus known is Coxsackie virus.

What are the symptoms? When is the patient most infectious?

HFMD is usually mild and self limiting. The infected child may have fever, sore throat, poor appetite, lethargy, ulcers inside the mouth, on the cheeks or on the tongue, rash (flat or raised small spots) or small blisters on the palms of hands, soles of feet and/or buttocks. There is no specific treatment besides the relief of symptoms. Symptoms vary between children, some may only have a rash while others may have fever and other associated symptoms. The incubation period for HFMD is between 3-5 days but this can range from 2 days to 2 weeks.

How does it spread?

Patients are most infectious during the duration of the illness. HFMD is spread from person to person by direct contact with nasal discharge, saliva, faeces and fluids from the rash of an infected person. The virus may also continue to persist in the stool for several weeks (up to 12 weeks) after the infection. Thus it is important to maintain good personal and environmental hygiene during and after the illness.

Is it notifiable? What should I do if I suspect my child has it?

HFMD is endemic in Singapore and it is a notifiable disease. Doctors, childcare centres, kindergartens with HFMD outbreaks must notify the Ministry of Healthy. If you suspect that your child has HFMD, you should seek medical review. You should isolate your child and keep them away from public places including school, childcare centre and kindergarten. You should inform the childcare centre, kindergarten or school immediately so that they can monitor other children closely and take additional precautions. Your child is fit to go back to normal activities when their fever subsides, they no longer have mouth ulcers and blisters or lesions on the hands, palms, feet and buttocks have cleared. Your child will need to have a medical clearance letter from your doctor before returning to childcare centre, kindergarten or school.

Can adults get it?

Yes. Both adults and children can be affected but young children below 5 years of age are more susceptible.

How can it be prevented?

Infected children should be isolated at home and kept away from public places, schools, childcare centres, kindergartens and crowded places until the lesions are cleared.   HFMD can be minimized by practising good hand hygiene such as

  • Frequent hand washing eg. After going to the toilet, before eating, after changing of diapers
  • Covering the mouth and nose when coughing or sneezing
  • Not sharing food/drinks, eating utensils, towels or toothbrushes with others
  • Proper disinfection of articles such as toys or appliances contaminated by nasal or oral secretions.

Written by Dr Monika Tasani, MBBS (Melbourne, Australia), FRACP (Australia).

IMC Paediatric, Camden Medical Centre, #11-06, Singapore, 248649. Tel: 6887 4440



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