Hand, foot and mouth disease: An epidemic

It first crossed the epidemic threshold of 780 in mid-February 2012. By June of the same year, the weekly number of hand, foot and mouth disease (HFMD) cases has more than doubled that.

With such alarming statistics, parents have become ultra-vigilant about keeping their little ones safe, by constantly checking their hands and mouths, and keeping themselves updated on fresh new cases at childcare centres.

But while focusing on their children, parents may not realise that they, too, need protection. They cannot assume that they are safe from HFMD. The reality is that adults and youth ove​r the age of 15 account for about one in 10 of the HFMD cases here. In most instances, parents catch it from their children who have got the disease.

HFMD: Symptoms

Dr Ng Chung Wai, Senior Consultant and Family Physician, SingHealth Polyclinics​​​ (Outram), and Chairman, SingHealth Polyclinics Infectious Diseases and Infection Control​​ Committee, a member of the SingH​ealth​ group said: “The symptoms of HFMD in children are similar to those in adults. The rash typically consists of red bumps and blisters which affect the palms and/or soles. In some cases, the rash may be just red spots or bumps without blisters, and may also appear on the buttocks, knees or elbows.”

Other symptoms include fever, ulcers in the throat and mouth and on the tongue, sore throat, loss of appetite as well as a general feeling of being unwell.

HFMD is endemic in Singapore, which means it can occur all year round.

The mild disease, which is easily spread among children through saliva, mucus or other bodily fluids, is caused by viruses that belong to the enterovirus group, such as the Enterovirus 71 (EV-71) and th​​e Coxsackievirus. EV-71, the more virulent of the two, is associated with brain and nervous system complications, and is responsible for most of the HFMD-related deaths recorded here. The current epidemic in Singapore is caused by the relatively milder Coxsackievirus.

HFMD: Are adults resistant?​​

While exposure to nasal discharge, saliva, faeces or bodily fluids of an infected person puts anyone at a higher risk of contracting HFMD, adults generally develop immunity to the virus. However, in adults who have an underlying medical condition that impairs their immune system, the risk is higher. There is currently no vaccine to protect against HFMD.

“There is no difference in the progression of the disease in adults compared to children, and the potential complications in adult HFMD cases are the same as those in children,” said Dr Ng.

The most frequent complication of HFMD is dehydration as mouth ulcers may sometimes be severe enough to interfere with the intake of fluids. Dehydration may also occur if there is persistent vomiting.

Click on page 2 to find out how HFMD can be​ ​treated and prevented.

Ref: M19​