Hand, Foot and Mouth Disease oubreak in HCMC

HFMD is a viral infection with a typical rash and mouth lesions.
It is caused by coxsackie viruses’ infection. There are several subtypes that can cause the same disease, the most common is A16. (It is unrelated to “foot and mouth disease” of cattle). The most susceptible are infants and toddlers. Adults usually are only carriers.

After an incubation period of about 4-6 days the child may develop low grade fever, complain of sore mouth and refuse to eat or drink. The lesions in the mouth start as small vesicles (blisters) that turn into yellowish ulcers.
They involve mainly the palate but can appear anywhere in the mouth. Soon after, several red spots may appear on the hands, feet and sometimes the buttocks. They gradually change into grey – yellow small blisters. The disease last for a few days up to a week. The child develops neutralizing antibodies and re-infection is uncommon.
Herpangina – is a similar infection which involves only the mouth.

The main care for a sick child with HFMD is to make sure he drinks enough fluids during the day to treat pain and fever. Mouth wash with salty waters can alleviate pain. Soft and cold food are prefered (even ice cream) The most commonly used medications are the Paracetamol (e.g. Effergan, Panadol, and Tylenol) and Ibrufen (e.g. Advil, Neurofen). Both are very effective and very safe. While using Ibrufen, it is important to make sure the child drinks properly.

The coxsackie viruses spread through saliva and feces. Therefore, in order to minimize the spreading of the virus, good hygiene should be kept and children should avoid sharing same utensils or mouth to mouth contact. It is essential to wash hands thoroughly with water and soap after using the bathroom, especially in kindergardens and daycare centers.

The disease usually is mild with no long term complications.

Recently, there were some reports about epidemics of HFMD (Singapore, Taiwan, Malaysia) with the subtype E71. There were reports of neurological (encephalitis – infection of the brain) and cardiac complications leading to death. Most of the children with HFMD do not develop these complications but they are extremely rare.

When to seek medical help: If your child develops Lethargy, High fever, Headache, Recurrent vomiting, significant reduction in urine output - he should be examined by a pediatrician immediately.

You can download our information brochure on this disease here

Good health to us all!

Dr Jonathan Halevy
Pediatrician