What parents should know about hand, foot and mouth disease

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Hand Foot and Mouth Disease is prevalent among children under five. How much do you know about it, and how can you help to prevent this from spreading?

In Singapore, Hand Food and Mouth Disease (HFMD) has been legally notifiable by law since October 2000.

Due to its infectious nature and risk of fatality, the Singapore government and health authorities are paying extra attention to the outbreaks, as they predominantly affect young children, although adults are not sparred too.

As of August 2015, there has been over 18,000 cases of HFMD in Singapore in 2015.

Though HFMD is usually not fatal, the rashes and mouth sores bring great discomfort to children who contract it.


HFMD is a contagious viral infection common in infants and children under the age of five. It is characterised by rashes in the hand and feet and painful mouth sores.

Signs and Symptoms of Hand Foot and Mouth Disease

The first signs of HFMD usually involve:

  • Fever
  • Reduced appetite
  • Sore throat
  • Feeling of being unwell

These symptoms are then followed by:

  • Painful ulcers in the mouth, throat and tongue
  • Rash or small blisters on the palms of hands, soles of feet or buttocks
  • Bouts of vomiting and diarrhea 

However, these symptoms may not apply for everyone. Some people may show no symptoms at all, but it is still possible to pass on the virus to others.

Causes and Transmission

HFMD is commonly caused by Coxsackievirus, which part of the Enterovirus group.
Coxsackievirus can spread through direct contact with nose and throat discharge, saliva, fluid from blisters and the stool of infected persons.

Risk Factors

The disease is common in kids who attend school or play centers. Being in close quarters with other children–where common areas and items are shared and not always cleaned immediately–means viruses can be easily spread.

As children age, they usually build an immunity to Hand Foot and Mouth Disease thanks to developing antibodies. However, it is still probable for older kids and adults to contract the disease.

hand foot and mouth diseaseComplications

  • Dehydration is the most common complication of Hand Foot and Mouth Disease. The painful mouth and throat sores, that make swallowing a painful activity, can cause a child to refuse both eating and drinking. Thus, it is crucial to monitor a child’s liquid intake. As a preventative measure, talk to your pediatrician on how to avoid dehydration and what to do in case you suspect it.
  • Viral meningitis* causes the membranes and cerebrospinal fluids around the spine and brain to be inflamed. This leads to back pain, stiff neck, headache. The infected child may need to be hospitalized.
  • Encephalitis* is the inflammation of the brain caused by a viral infection. It may be life-threatening.
  • Nail loss for both fingers and toes, though temporary, has been reported. However, it is yet to be proven whether the disease, in fact, causes this.

*Note: Both rarely occur when a child has Hand Foot and Mouth Disease.

Continue reading to find out when to call the doctor if you detect your child has Hand Foot and Mouth Disease.

Child Health Health HFMD