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Q&As on HFMD (Hand, Foot and Mouth Disease)

The following Q&A has been compiled in August 2018, after collecting commonly asked questions from the parents of Trinity Kids Malaysia, and presenting it to a group of scientists and medical professionals* during a Q&A video session hosted by SmartCoat Malaysia.

* The group consists of:

- Dr. Lai Chin Wei, Nanotechnology Expert, University of Malaya

- Dr. Ng Yi-Ki, Paediatrician, Baby & Beyond Child Specialist Clinic, Publika branch

- Dr. Tay Feng Huai, Chemical Engineer (representative role as parent)

- Ms. Daisy Ng, Chief Educator Officer, Trinity Kids Malaysia (moderator)

1. What is Hand, Foot and Mouth Disease (HFMD)?

Hand, Foot and Mouth Disease is an infectious, viral disease caused by the Enterovirus.

Upon exposure, the disease has an incubation period of 2-5 days before the first symptom shows. HFMD generally starts with fever, followed by ulcerated mouth and throat, rash on palms and feet. The disease usually self resolves in a week. An infected person is febrile/infectious post fever until the ulcers and rash/blisters have completely dried off.

2. How does it spread?

HFMD spreads from person-to-person through direct contact (hands) or indirect contact (surfaces). Direct contact and exchange of bodily fluids with a person with HFMD will result in exposure to the disease. Indirect contact to HFMD is usually through touching a surface (high chair, changing station, handles of supermarket trolley, toys, playground, etc.) that an infected person has physically touched and possibly left bodily fluids behind.

MOH requires a person infected with HFMD to be quarantined at home for 7-10 days. A school child has to be examined by the doctor (ideally the doctor who diagnoses the child) to be certified free of HFMD before returning to the school environment. The letter of certification has to be presented and kept on record by the school.

3. How long does the virus live on the surface? How do we kill the virus?

The virus can live on surface for up to a month, even after the fluids have dried off. The Enterovirus is particularly hardy and requires special handling to get rid of.

The most effective way to minimise HFMD exposure in public areas is to practice good hygiene. Wash hands often, especially before eating and drinking. Wipe down surface as best as possible before use.

4. If my child gets in touch with another child who has HFMD, does it mean my child will fall sick with HFMD?

It is important to note that exposure to the virus does not mean falling ill to HFMD immediately. There is probably always exposure to HFMD in the environment. A good immune system is our best defense against HFMD. Our body learns to fight the virus, builds anti-bodies that guards against HFMD.

5. How do we guard against HFMD? What can I do to protect my child from HFMD?

In general, factors such as good nutrition enhanced with immune boosting supplements (Vitamin C, Probiotics, Echinacea, Garlic oil, Fish oil… Check with your local pharmacy for more options), adequate sleep, sunshine, good water and food intake contribute to good immune system.

When a child has been exposed to another child with HFMD, it is important to boost the immune system during the incubation. The exposed child may not become susceptible to HFMD.

6. What brand of sanitizer or wet wipes is recommended?

As mentioned previously, HFMD is particularly hardy and not easy to eradicate. For most sanitizers, germs multiply in minutes to hours post sanitizing. SmartCoat utilizes nanotechnology to coat the surfaces and continuously kills the Enterovirus among other viruses.

7. Can I use the same piece of wipe for my child’s hands, face and the table surface?

Avoid commingled use of wet wipes. Use a piece for each purpose – wiping faces/ hands and wiping surfaces. This avoids transferring germs from one surface/person to another.

Consider a milder and gentler wipe for the child’s face and hands, a stronger anti-bacterial method of spray and wipe for the surface top.

8. If my child is diagnosed with HFMD, how do I protect my other children from getting infected?

In a family of more than one child, try as best as possible to separate the children as further apart as possible. Adults should wash hands thoroughly after contact with one child and before interacting with another child.

9. What should I do after my child is infected with HFMD?

When a child is suspected to have HFMD, always see a doctor to confirm as the child would require a letter of clearance before returning to a school environment. Do what you can to aid the child’s recovery (as in above paragraph). Separate the unwell child from healthy children.

Adult caretakers should take the same precaution to boost immune system and practice good hygiene when interacting with the child(ren). Deep clean and sanitize the toys, books, bed linen etc. Avoid spending time in public.

10. How do I aid my child’s recovery from HFMD?

When a child is infected with HFMD, continue to boost the child’s immune system through nutritious food and supplement before the ulcers set in. This may mitigate the symptoms and/or aid recovery.

A numbing mouth spray or fever medication can provide pain relief from ulcers so the child can drink and eat. It is important for the child to stay hydrated. Avoid food and drinks which are acidic (painful to eat and drink). Consider chilling or freezing milk, water as the coldness numbs the pain and makes it easier for the child to ingest.

11. Is it safe for my child to attend school during the HFMD season?

In a school environment, children congregate and contact is unavoidable. This is why schools with diagnosed cases (exposure) close for a short period (incubation period or more) to break out of a transmission cycle.

During the closure, a child either falls ill to HFMD or remains healthy. When the school reopens, healthy children return to the school environment. For best practice, parents should rest their child at home for observation within 24 hours of a fever.

12. What should a school do to protect the children from HFMD?

A school that practices good hygiene standard operating procedure and a transparent communication style reduces the risk of HFMD transmission. In a school environment, the school takes measures to reduce chance of transmission through direct and indirect contact.

Direct contact is reduced by stringent checks at entry (temperature, body checks) to ensure the child is healthy, sanitizing and washing hands often, reducing water/cookery/other sensory play during sensitive period. Indirect contact is reduced by engaging deep sanitization such as SmartCoat that continuously provide a layer of protection over surfaces.

13. Does wearing socks or mitten guard against HFMD?

Wearing socks or mittens do not protect against HFMD. While they may protect our feet or hands from general dust, the child may still touch his/her own face with the gloved hands and be exposed to the virus.

14. Where are the public areas to avoid?

Conventionally, children zones such as playgrounds, public high chairs, public changing stations are avoided. When the HFMD epidemic occurs in Penang, the authority finds that the Enterovirus is present on many public spots such as the handles of supermarket trolleys, benches, tables etc. In truth, the virus is omnipresent and each of us would have some degree of exposure to it.

The best defense is hence good personal hygiene: wash hands with soap as often as possible, particularly before eating and drinking.

15. Can I visit a clinic that has diagnosed cases of HFMD?

As with a school, a well-managed clinic would adopt good hygiene practice in regular sanitization and cleaning, providing a separate quarantined waiting area for suspect HFMD cases. Doctors and other personnel would sanitize/wash their hands between patients. The risk of contracting HFMD through a clinic might be more controlled than in a public place that is unaccounted for.

Brought to you by SmartCoat, Powered by Trinity Kids.

Link to HFMD Q&A video on SmartCoat's Facebook page:

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