Hand, Foot and Mouth Disease

What is Hand, Foot, and Mouth Disease (HFMD)?

HFMD is a common childhood disease that is generally mild and self-limiting. HFMD is endemic in Singapore and can affect all ages but young children are more susceptible, especially those below 5 years of age who constitute the at-risk population. HFMD is caused by viruses in the Enteroviruses group (e.g. coxsackieviruses, echovirus, and enterovirus A71).

What are the symptoms of HFMD?

A person with HFMD usually presents with the following:

• Fever

• Sore throat

• Rash (flat or raised red spots) or small blisters on palms of hands, soles of feet, or buttocks

• Mouth ulcers

• Poor appetite

• Lethargy

The clinical presentation may vary between individuals, and at different stages of the disease (e.g. some may only have a rash or some individuals may show no symptoms at all).

Young children are at higher risk of serious infection. If you suspect your child has HFMD, and symptoms are accompanied by changes in their normal behaviour, like drowsiness, persistent vomiting or refusal to eat/drink, take your child to visit a medical practitioner.

What are the potential complications of HFMD?

Most cases of HFMD are mild and self-limiting. Serious complications involving the nervous system, respiratory system and heart can occur, but are rare.

How does HFMD spread?

HFMD is transmitted via the faecal-oral route, direct contact with respiratory droplets, saliva, vesicular fluid or indirectly via contaminated surfaces.

The incubation period is about 3 to 5 days, ranging from 2 to 14 days.

How do I prevent HFMD?

To prevent the spread of HFMD, one is strongly encouraged to:

• Observe and practise good personal hygiene at all times.

• Wash your hands regularly with soap, especially before handling food or eating, after going to the toilet, or when hands are dirty from coughing or sneezing. If water is not available, use an alcohol-based hand sanitiser that contains at least 60% alcohol.

• Cover your mouth with a tissue when coughing or sneezing, and dispose the soiled tissue into the bin immediately. Avoid touching your face, including eyes, nose and mouth with unwashed hands after coughing or sneezing.

• Avoid sharing of food/drinks or eating utensils.

• Wear a mask and seek medical attention promptly when unwell.

In high-risk settings such as childcare centres and preschools, HFMD outbreaks can be prevented by:

• Early identification and isolation of cases. Unwell staff or children should be sent home and seek medical treatment immediately.

• Parents should inform their child’s school immediately if their child has HFMD, so that other children can be closely monitored for symptoms and additional precautions can be taken.

• Unwell children and staff should stay at home until blisters have dried up, or until they have fully recovered, or after the expiry of the medical certificate (MC) given by the medical practitioner.

• Proper cleaning and disinfection of communal areas and potentially contaminated items (e.g. toys or appliances) should be conducted regularly.

How is HFMD treated?

HFMD is usually mild and self-limiting. No specific treatment is available; however, treatment can be given to relieve the symptoms of the disease.