2 days ago
#HEALTH: Managing HFMD in children
BETWEEN April and May this year there was an alarming rise in Hand Foot and Mouth Disease (HFMD).
Penang, for example, saw a 409 per cent increase in cases between Jan 1 and March 22 compared with the same period last year, while in Johor, since the beginning of the year, the number of infections exceeded the total cases recorded in both 2023 and 2024. In Sabah there were already 4,385 cases up till April 19.
As is the usual pattern with this disease the most affected were children in daycare and kindergarten settings.
What causes this sudden spike in cases every year and what can parents do to protect their children?
The spike in cases during certain times could be related to environmental factors such as climate changes, the circulating virus type and the low population body immunity towards these viruses, says Pantai Hospital Klang paediatrician Dr Tay Chee Pin.
HFMD is a mild contagious viral infection which is caused by the human enterovirus, for example, the Coxsackie virus A and B and enterovirus 71, he explains.
The infection is commonly seen in young infants and toddlers aged less than 5 years.
In Malaysia, Enterovirus 71 tends to occur in a cyclical pattern, roughly every 2 to 3 years, says Dr Tay.
"Even though it is a mild viral infection, some individuals can develop neurological complications such as meningitis, encephalitis or paralysis."
Early signs of HFMD are fever ( temperature which is more than 38 degrees celsius), oral ulcers and skin rashes at the hands and feet. Others symptoms include body fatigue, poor appetite, diarrhoea and headache
"The rashes are flat , red spots, sometimes associated with blisters and they can extend up to the elbows, knees, buttocks or groin area. It rarely affects other body parts," says Dr Tay.
Since this infection spreads through nose and throat secretions like saliva, nasal mucus and fluid from its blister or the faeces of the patient, isolation of infected children is important.
Dr Tay says parents must prevent the infected child from indulging in close contact such as hugging, kissing, playing or sleeping together with other children. They must also not share food or utensils.
Parents themselves must be extra careful with hand hygiene, especially after cleaning the infected child's faeces so they don't pass the virus to others.
In addition, they should sanitise commonly touched surfaces at home such as furniture to prevent other children from coming into contact with these contaminated surfaces.
"Frequent cleaning and sanitising of the home including floors, surfaces of furniture, toys, bedsheets and utensils are important to prevent the virus spreading within the household."
Dr Tay adds that like with the common cold and flu, children can be reinfected with HFMD once their body immunity towards HFMD wanes. There are also chances that these children can be reinfected by other types of Coxsackie viruses that cause HFMD.
However, older, schoolgoing children with a stronger body immunity would be able to fight off the virus and hence not show signs and symptoms of HFMD.
MANAGING A CHILD WITH HFMD
*Provide regular ( every 4 to 6 hourly) fever medicine (paracetamol is safe to be given to children to control the fever).
*Conduct tepid sponging of the child with room temperature water.
*Make the child wear thin and soft clothing.
*Maintain hydration through small and frequent feeds of fluids.
*Throat sprays or drops can be used.
*A cold and soft diet is encouraged.
*Body lotion can be used to soothe skin rashes.
