Tackling HFMD in 5 Easy Steps

HFMD (Hand Foot Mouth Disease) is a very common ailment in Singapore, and faced with worry by parents frequently. Even in the COVID-19 era, HFMD continues to infect many children in childcare centers!

From infants, to toddlers, primary school kids and even teenagers and adults, this contagious infection spreads rapidly and easily.

Is your child down with HFMD? Are you frantic and wondering how to treat HFMD? Let our experts and nannies at MEIDE provide you relief with these 5 easy steps to handle HFMD:

1) Hydrate, hydrate, hydrate

Always keep your children and yourself well-hydrated when fighting HFMD. This is because the virus often causes symptoms that prevent one from eating or drinking sufficiently. Patients with HFMD tend to become lethargic and have poor appetite. Ulcers and blisters in the mouth and lips further contribute to cause decreased fluid intake.

Nonetheless, it is extremely important to hydrate because it will enable your body to keep fighting the infection, and protect your internal organs from damage.

Here are a list of recommended foods and fluids to counter the fussiness and irritation from kids and adults enduring HFMD:

• Plain water – it doesn’t matter whether it is hot, warm, or cold – just gulp it down!
• Ice Creams
• Yogurts
• Smoothies, popsicles and jellies
• Porridge and soups
• Softened fruits, pureed fruits, or fruit juice
• Mashed Potatoes / Carrots / Vegetables
• Milk, Milo, Horlicks or Ovaltine

2) Monitor for RED FLAGS

Again, HFMD does not often cause severe disease. It is self-limiting and most children infected with it can recover by themselves over time.

How long does HFMD last?

In general, HFMD symptoms can last between 7 to 10 days. However, it is not unusual to see patients suffering from symptoms for 2 weeks or more before completely recovering. Moreover, the virus can stay in your body for many weeks!

Danger Signs

Thus, it is recommended for parents and patients to monitor themselves for the less common, but potentially life-threatening signs and symptoms:

• Lack of hydration (eg. <5 wet diapers a day, or >50% reduction in fluid intake)
• Persistent fever for 3 or more days
• Severe diarrhea or vomiting
• Severe headache, giddiness and neck stiffness.
• Disorientation, drowsiness and/or irritability.
• Fits.
• Breathlessness or turning blue.

(Courtesy of https://www.healthhub.sg/live-healthy/631/HFMD)

These happen when the HFMD virus unfortunately starts to cause trouble with vital organs like the brain, heart, lungs, kidneys and so on. For your information, Enterovirus 71 (EV71) is one of the specific strains of virus that causes such severe complications of HFMD. Seek immediate emergency medical attention if you or your children experience these red flags during HFMD!

3) Enforce contact precautions

The Coxsackie A16 virus (a family of the Enterovirus) that causes HFMD is pretty virulent. That means, it spreads easily to others. The mode of transmission is often via droplets and close contact. That means when your child contracts HFMD, there is a really high chance that the virus will spread to all those in close proximity.

Even though not all individuals who get the HFMD virus will become symptomatic or sick, it is still best to reduce the chance of spread. Of note, the virus is more dangerous in individuals who are at high risk:

• Pregnant Ladies, particularly those nearing delivery date, as the virus can pass on during delivery to the newborn and cause severe diseases like multi-organ failure;
• Immunocompromised – such as those undergoing chemotherapy, or with poorly controlled Diabetes Melitus or HIV
• Elderly and Frail Persons

Prevent yourself and others from getting HFMD by enforcing these contact precautions:

• Wash hands frequently and with soap if soiled;
• Wear a mask all the time;
• Do not share saliva or food or drinks;
• Minimize talking or interacting in close proximity and wear N95 (properly fitted) if required;
• Sanitize commonly touched areas like door knobs, toys, play areas, and so on with child-friendly sprays and wipes;

4) Treat Symptomatically

Sometimes, HFMD may not cause any symptoms. In that case, there is no need for any specific medicine yet. However, if it does cause symptoms, it is advisable to take some medications to lessen the symptoms.

Signs and Symptoms of HFMD and How To Treat Them?

• Fever – take paracetamol, and if required, add on stronger medications like diclofenac and ibuprofen with your doctor’s advice!
• Runny Nose – get a suitable antihistamine or nasal spray from your medical provider
• Sore Throat – gargle water with some salt in it, use painkillers as mentioned below, and suck lozenges (eg. Strepsils) where appropriate
• For any Pain, Body or Muscle Aches – take paracetamol, and if required, add on stronger medications like diclofenac and ibuprofen with your doctor’s advice!
• Rashes – Mild moisturizing cream or no cream is best
• Blisters – try thin cotton cloths that are damp with clean cool water, and anti-histamines like cetirizine/Zyrtec, and prevent scratches by trimming your baby nails and using mittens
• Ulcers – ice chips, ice cream, or soothing gels like Medigel or Bonjela helps

5) Seek Help!

This may seem like common sense, but many anxious parents whose kids are down with HFMD forget about it.

Especially in a modern country like Singapore, there are plenty of available resources to help your family when stricken with HFMD.

As a general overview, MEIDE recommends that you seek help via these methods:

• Read about HFMD information online – you can use Google, HealthHub, official hospital websites for patient information, and many other useful links;
• See a doctor (refer to details below);
• Get help from a nanny or sitter or extra carer (see below too);

When to See Doctor for HFMD

If your child is sick with HFMD but has mild to no symptoms, there is no need to rush to the Emergency department, or even to the doctor’s office! Perhaps, you’d only need to visit your family doctor for an “administrative reason” to get medical certificate. Or, when all the lesions and ulcers have cleared, you would need to return for a follow-up visit and get a memo from your GP stating that your kid is “fit for school” again and no longer has contagious HFMD.

However, as we listed above, if your kid has RED FLAGS, do not hesitate to rush to the emergency and get early attention, or even dial 995 for the ambulance. Life-threatening complications from HFMD are rare, but not totally non-existent. Importantly, you WILL need to seek medical attention if you suspect your child is getting dehydrated and you are unable to cope!

Lastly, you may not have all the available medications at home and some may have expired. Although you can get many suitable alternatives from the pharmacy, certain prescriptions like those for NSAIDS (diclofenac and ibuprofen), lignocaine gels, and antihistamines may be best obtained via a physician’s prescription and recommendation.

Hence, see your doctor too, for such advice to prevent unnecessary side effects or incorrect dosing of medications!

Get Help from A Nanny, Babysitter or Relative

Release some burden and stress by enlisting help from others for your sick child. The more capable carers available, the easier it is to care for a sick child. If you are handling it all alone, be very wary that you may end up burning out and posing physical danger for yourself and your kid!

Your first line of help should be from a family member or relative. Get someone dependable, and not at health risks from HFMD (see above under “enforce contact precautions”).

If you require, enlist help from a babysitter or nanny like one from MEIDE too.

Then, if you really still need help, and are at wits’ end, you can always head down to the Children Emergency. That is a last resort, but a life-saver because that is where the medical workers will definitely assess and provide you proper advice on how to cope with the HFMD and stresses!

Remember, avoid overtaxing yourself because it would lower your immunity and render you less capable of helping your child recover! Indeed, the last thing you’d want is for yourself to fall sick too alongside your children!