According to the CHP’s latest surveillance data, HFMD clusters in schools and other institutions have increased over the past month. Reported outbreaks rose from 17 cases involving 50 people between October 26 and November 1, to 20 outbreaks (53 people) and 25 outbreaks (61 people) in the following two weeks. Between November 16 and 20, authorities recorded another 16 outbreaks affecting 40 people. Of the 78 outbreaks logged from October 26 to November 20, 82% occurred in child care centers, kindergartens and primary schools.

The CHP noted that consultation rates for HFMD at childcare centers, kindergartens, private clinics, and public hospital emergency departments have remained high since late October.

HFMD symptoms typically include fever, poor appetite, tiredness and sore throat, followed by mouth sores that may turn into ulcers. Most patients recover within seven to 10 days.

CHP Controller Dr. Edwin Tsui said HFMD is commonly caused by enteroviruses such as Coxsackie virus and EV71, and tends to peak in Hong Kong from May to July and again from October to December. He said parents should monitor their children closely as the current level of activity remains elevated.

While most cases are mild, he noted that three severe pediatric enterovirus infections requiring hospital treatment have been recorded this year, although all patients have since recovered.

He added that schools and institutions are more prone to outbreaks because young children are in close contact with one another. He reminded schools to follow the CHP’s Guidelines on Prevention of Communicable Diseases and to report outbreaks promptly. Operators of venues with play facilities were also advised to follow the CHP’s infection-control recommendations for activities involving children under six.

Dr. Tsui also pointed out that alcohol cannot reliably kill certain viruses that cause HFMD, including EV71. Alcohol-based handrubs should not replace washing hands with liquid soap and water.

To prevent HFMD, the public — especially school and institution administrators — are advised to observe the following measures:

• Maintain good air circulation.
• Keep hands clean and wash them properly. Handwashing should be done before meals, after using the toilet, after contact with respiratory secretions such as sneezing, and after handling diapers or stool-soiled materials.
• Cover the nose and mouth when sneezing or coughing, and dispose of nasal or oral discharges properly.
• Clean and disinfect frequently touched surfaces, including furniture, toys and shared items, using a 1:99 diluted household bleach solution (one part bleach with 99 parts water). Leave for 15–30 minutes, then rinse with water and keep dry.
• For visible contamination such as respiratory secretions, vomit or excreta, wipe the area with disposable absorbent towels, then disinfect with a 1:49 diluted bleach solution (one part bleach with 49 parts water). Leave for 15–30 minutes, then rinse with water and keep dry.
• Avoid overcrowded places.
• Keep sick children at home until fever and rashes subside and all blisters have dried and crusted.
– Info.Gov.Hk

In a statement, the health ministry said 10% of these cases (10,421) were related to outbreaks of HFMD, while the remaining 90% (89,180) were sporadic.

Selangor recorded the highest number of infections making up 27.2% of cases, followed by Johor (9.9%), Perak (9.4%), Kelantan (7.2%), and Kuala Lumpur and Putrajaya (6.9%).

Cumulatively, 2,649 HFMD outbreaks were reported this year, compared with 1,339 during the same period in 2024 – a 98% increase.

“Of these, 578 outbreaks (22%) occurred at childcare centres, 480 (18%) at kindergartens, 292 (11%) at nurseries and 251 (9%) at preschools.

“No deaths linked to HFMD have been reported to date,” the ministry said.

It said a total of 38,285 premises – including childcare centres, kindergartens, preschools and homes – have been inspected nationwide, with 1,140 of them ordered to close under the Prevention and Control of Infectious Diseases Act 1988.

Another 430 premises had closed voluntarily, it added.

The ministry urged parents and guardians to take preventive measures such as ensuring their children wash their hands before eating and after using the toilet, and to regularly clean frequently touched items and surfaces with soap, water or disinfectant.

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.

Health Minister Liow Tiong Lai (see insert photo) said that there was one patient related to the virus, but that person has been placed in quarantine and is under supervision.

“There is no cause for alarm as the situation is under control and so far, there is no spread of EV-71 in the country,” he said after closing the Kids Invent! program on Thursday.

EV-71 raised fears across Southeast Asia this week when it was detected in lab samples taken after 52 of 59 children in Cambodia died suddenly from a mystery illness.

A number of countries in the region have set up strict health procedures for anyone entering who had been in Cambodia recently in order to ensure the virus does not spread.

Health experts were initially uncertain as to what the virus was.

Since then, however, they have said the disease is in the same family as polio, mainly affects children younger than five, and spreads easily through sneezing, coughing and contact with fluid from sores or infected feces.

Other related news:

EV-71 in Thailand still under Control

Source: www.bikyamasr.com

Extraordinary surveillance measures were being implemented to keep Enterovirus Type 71 (EV-71), a strain of HFMD that has claimed the lives of more than 60 children in Cambodia, from spreading to Thailand, Dr Surawit said.

Parents are being advised to encourage their children to wash their hands often and avoid taking them to crowded places, Dr Surawit said.

If parents suspect an infection they should immediately take their children to a doctor to reduce the risk of complications of the disease which can affect victims’ brains, lungs, and hearts, he said.

Authorities have sent a communicable disease control unit to the Chong Jom-Osamach border crossing in tambon Dan of Kap Choeng district of Surin to screen Cambodian parents and their children for HFMD virus strains.

Any Cambodian travellers suspected of carrying the virus would be quarantined, the Surin provincial health office said.

Meanwhile, parents of 16 Cambodian children attending a pre-school child centre in Ban Dan in the same border district of Surin were asked to take their children back to Osamach in Cambodia.

Sirichai Tantiratananon, president of tambon Ban Dan administration organisation, said it was a temporary measure to prevent the children infecting their Thai peers.

Satawas Sinprasitkul, director of Kap Choeng district hospital, said no Cambodian patients with EV71 has been admitted to his hospital since the virus was found across the border three months ago.

Dr Apichart Rodsom, chief of the provincial health office in Kanchanaburi, said four new HFMD cases in children aged three to five which were reported this week were not the EV-71 strain.

EV71 is one of two pathogens commonly found in infected Thai patients, but it was a virulent form of the virus that was detected in recent Thai cases, the permanent secretary for public health, Dr Paijit Warachit, said. The other type of HFMD virus commonly found in Thailand is Coxsackie A 16, he said.

Source: Bangkok Post