Hand Foot Mouth Disease (HFMD): Ordinary peak in Rainny

     Hand, Foot, and Mouth Disease (Hand Foot Mouth Disease : HFMD)  is a common illness in infants and young children in nurseries and kindergartens. It spreads easily, especially among children under 5 years old. It is caused by viruses in the Enterovirus group, which has many strains in Thailand.

 The most common strain with mild symptoms is Coxsackievirus A6. However, severe strains causing fatalities have been reported, specifically Enterovirus 71. (Enterovirus 71 or EV 71)  

Diagnosis of Hand, Foot, and Mouth Disease

     Physicians can diagnose the disease based on clinical symptoms and a physical examination. Additional tests are not necessary for all patients and are usually reserved for cases with severe complications depending on the physician's discretion. These tests include collecting secretions from the throat or nose (throat swab/nasal washing) or stool samples to detect the virus using PCR (Polymerase Chain Reaction) or viral culture.

This disease can be found year-round but is more prevalent during the rainy season, which brings cool and humid weather. Places where children gather cause crowding, and poor environmental and personal hygiene can easily lead to an outbreak.

How Hand, Foot, and Mouth Disease Spreads

• Transmission via consumption: The virus enters the mouth through hands contaminated with nasal secretions, saliva, or stool from an infected patient, or by inhaling airborne droplets from coughing or sneezing.
• Incubation period of 3-5 days: After exposure to the virus from an infected patient.
• Contagious period starts from the onset of symptoms for the first 7 days: Even after recovery, the virus can still be shed in the stool for a period of time (approximately 2-3 weeks).
• Reinfection is possible: Having had hand, foot, and mouth disease before does not prevent reinfection because the virus has multiple strains.

Symptoms of Hand, Foot, and Mouth Disease

• High or low-grade fever develops first. After 1-2 days, sores appear in the mouth, inner cheeks, tongue, and lips. Subsequently, red spots or clear blisters develop on the palms, soles of the feet, elbows, and around the buttocks. The patient may experience poor appetite and fatigue. Clear blisters can persist for 7-10 days.
• However, a severe infection caused by the enterovirus EV71 can lead to high fever, vomiting, encephalitis (brainstem inflammation), myocarditis (heart muscle inflammation), seizures, lethargy, and fatality.

Treatment of Hand, Foot, and Mouth Disease

• Currently, a vaccine against hand, foot, and mouth disease is available at the Well-Baby Clinic, Building 3, 2nd Floor. If interested, you can contact your child's pediatrician.
• Treatment is symptomatic, such as using antipyretics (fever reducers), topical anesthetics for mouth ulcers, and antipruritic medication (for itching).
• Consuming cold food and drinks is recommended, such as cold milk, ice cream, jelly, and pudding.

The most important prevention for hand, foot, and mouth disease is educating children and caregivers on personal hygiene.

• Eat food that is hot, freshly cooked: and free from flies.
• Use a serving spoon: and avoid sharing glasses, straws, or plates of food with others.
• Wash hands thoroughly with soap frequently: before and after meals, as well as after defecation and using the restroom.
• Stop the spread of the virus: by cleaning toys and avoiding crowded places or outbreak areas. Sick children should stay home to rest for at least 1 week.
• Hand sanitizers or alcohol gels: cannot kill this virus. Clean toys with soap, detergent, or household cleaners, then rinse with clean water and leave to air dry completely.

Children should be taken to see a doctor promptly for proper treatment and close monitoring of potentially severe complications.