Protecting Your Child from HFM Disease – Risks and Prevention Tips

November 27, 2024

By Dr Wong Weng Keong, Consultant Paediatrician at Bukit Tinggi Medical Centre (BTMC)

Hand, Foot, and Mouth Disease (HFMD) is a common and highly contagious viral illness that primarily affects children under five but can occur in people of any age. The disease, often caused by viruses from the enterovirus family, particularly Coxsackievirus A16, Coxsackievirus A6, and Enterovirus 71 (EV-A71), typically manifests with mild symptoms, including fever, sore throat, and a distinctive blister-like rash on the hands, feet, and mouth. Most children recover within a week; however, in rare cases, HFMD can lead to severe complications, such as neurological or cardiopulmonary issues.

In Malaysia, Hand, HFMD remains a significant public health concern, with 35,043 cases reported in 2022 alone. The Ministry of Health continues to monitor and address outbreaks, which typically surge every alternate year. Globally, the incidence of HFMD has varied, ranging from 98.81 cases per 100,000 population in 2020 to 435.63 cases per 100,000 in 2018. These statistics underscore the need to better understand the broader implications of HFMD and to implement effective preventive measures to curb its transmission.

Recurrent infections and immunity

One of the critical concerns surrounding HFMD is the possibility of recurrent infections. HFMD can be caused by different strains of viruses, meaning that a child who recovers from one infection can be reinfected by another strain.

While recurrent infections are possible, there is no concrete evidence to suggest that children who have had recurrent or repeated HFMD infections are more susceptible to other viral infections. He emphasises that each infection helps the child’s immune system develop antibodies to fight off future exposures, but the risk of reinfection still exists due to the various viral strains involved.

To help strengthen a child’s immune system after recovering from HFMD, parents should ensure their child gets sufficient rest, follows a balanced diet rich in vitamins and minerals, and stays well-hydrated. Adopting a healthy lifestyle is essential for supporting the immune system, especially after recovering from a viral illness.

Why children with HFMD may feel isolated, lonely

HFMD is not only physically challenging for children but also emotionally taxing for them and their families. Children with HFMD often experience discomfort from painful sores and confusion during the isolation required for recovery. Dr Wong explains, “Children quarantined due to HFMD outbreaks often struggle with feelings of loneliness, frustration, or anxiety, especially if they don’t fully understand why they must be separated from their friends and normal routines.”

For parents, balancing work responsibilities and caregiving during an HFMD outbreak can be overwhelming. Dr. Wong advises parents to prioritize their own well-being during this time by ensuring they get enough rest, eat healthily, and seek support from family or friends who can take turns caring for the sick child.

Food do’s and don’ts; Hydration is important

One of the main complications of HFMD is dehydration, as the painful mouth sores can make it difficult for children to eat and drink.

Parents can offer cold or lukewarm liquids, which may be more soothing for children. Soft foods that do not require much chewing, such as puddings, jellies, and even ice cream, are often recommended. Saltwater gargling or numbing sprays may also help older children manage the pain from mouth ulcers. Avoid spicy or acidic foods, as they can make mouth sores more painful. Parents should be creative in encouraging their child to drink fluids, whether by using fun cups or offering ice pops.

How to prevent infection; manage outbreak

Preventing the spread of HFMD requires strict hygiene practices, especially in homes, schools, and daycare centres. Since HFMD is highly contagious and can spread through contact with saliva, stools, or blisters, it is important to implement hygiene measures even after recovery.

The virus can still be shed in a child’s stools for several weeks after recovery, so maintaining hygiene is critical to prevent further spread.

Proper hand washing, hygiene – At home, parents should ensure regular handwashing with soap for at least 20 seconds, especially after using the toilet, changing diapers, or blowing noses. Shared items like toys and utensils and towels should be washed or changed frequently. . Schools and daycare centres must also implement strict hygiene protocols, regularly cleaning high-touch surfaces

Rest and recuperation– Children with HFMD should be kept away from school or daycare until they have fully recovered, typically within five to seven days, to minimise the risk of transmitting the virus to others. Moreover,  schools and day care centres must ensure that affected children remain in quarantine.

Sufficient hydrated – Keep children well-hydrated to aid recovery and avoid complications. Dehydration is a common issue with HFMD, as children may refuse to eat or drink due to the discomfort caused by the mouth sores.

Empathy – A child with HFMD may experience a range of emotions, from discomfort to confusion and frustration. Parents can help alleviate their child’s emotional distress by offering comfort, explaining the situation in simple and reassuring terms, and providing engaging distractions such as favorite books, games, or activities.

Raising public awareness about HFMD is essential for preventing its spread. Parents can play a key role by educating their communities about the importance of good hygiene practices and staying alert for common symptoms of HFMD, such as fever, rashes, and mouth sores.

HFMD continues to be a major concern for parents and healthcare providers, particularly with the rise in cases across Malaysia. While HFMD is generally a mild illness, its potential for complications and recurrent infections highlights the need for preventive measures and public education.

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Category: MJN enews

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