Hand Foot and Mouth Disease: A Firsthand Account

Image credit: University of Maryland  Medical Center

Hand, foot and mouth disease (HFMD) has recently gained its notoriety when news about the outbreak of a deadly epidemic showing HFMD symptoms hit Cambodia. It claimed the lives of at least 60 children since April this year according to the Department of Health (DOH).  The last time I remember HFMD this popular in the Philippines, was way back 2010 when Kris Aquino and her sons were reported to have been diagnosed with this disease. Imagine my horror when my daughter was diagnosed with HFMD just this weekend!

Cramming the feeling of rising panic down my throat, I immediately called the pediatrician when I noticed sores in my daughter’s hands, feet and around her mouth. The baby sitter was insisting that its chicken pox. However, my   daughter was already given the chicken pox vaccine so I was pretty sure she must be mistaken. I have no firsthand experience with HFMD so I deemed it best to consult the matter right away to the person of authority.

We were advised to bring her to the clinic after I reported all the symptoms that were ailing my child. I detected low grade fever during the wee hours of the first day of illness as well as lack of appetite. In the early evening of the same day, she had high grade fever and vomited twice. The next day, sores developed around her mouth, on her hands and soles of her feet. Although the sores were very few, it was alarming to me.

During the check up, the pediatrician confirmed that it is indeed hand, foot and mouth disease. We were advised to give plenty of fluids to my daughter and she was prescribed to take Immunosin (an immunostimulant). There is no vaccine to prevent HFMD and no specific treatment as it is a viral disease. We just have to let it run its course.  To relieve pain and fever, over-the counter medications may be taken.

The Pediatrician assured us that the HFMD cases that were reported in the Philippines to date are mostly the mild, non-fatal forms. And I am so relieved that it is what my daughter was diagnosed with. According to the Department of Health (DOH) update, "the Cambodian Enterovirus 71 (EV-71) was of the encephalitis type and not HFMD as earlier reported."  They said that the cases in Cambodia generally involved fever followed by rapid respiratory deterioration and impaired consciousness resulting to death 24 hours from hospital confinement and clarified that EV-71 infections do occur in the country but are reported with irregularity. Fatal EV-71 infection is still very rare in the Philippines.  Furthermore, DOH assistant Secretary Dr. Eric Tayag, state that enterovirus and mild HFMD occur in the country but in mild form and not fatal or self-limiting illness.

Hand, foot and mouth disease (HFMD) acquires its name from its dermatologic manifestations, specifically, sores or blister-like lesions around the mouth, on the tongue, gums, inside the cheek or on the palate as well as on palms of hand and soles of feet. Symptoms also include:

• Fever
• Headache
• Vomiting
• Malaise
• Sore Throat
• Loss of appetite
• Irritability in infants and toddlers

Initial symptoms are mostly fever and often followed by the loss of appetite, sore throat and sometimes malaise. The appearance of the sores happens within a day or two after the onset of fever. The incubation period (the time between infection and start of symptoms) of HFMD is about three to seven days.

HFMD commonly affects infants and children. It can sometimes be transmitted to adults especially those who have immune deficiencies. During the initial week of the disease is when children with HFMD are said to be most contagious. However, the disease can still be contagious long after the symptoms have disappeared because viruses that cause it can remain in the feces for weeks.  Some people who are also infected may unknowingly be spreading the virus, including most adults, as they may how no symptoms. (Source: Centers for Disease Control and Prevention).

The DOH is urging the public to ensure proper disposal of baby diapers or human waste. Observance of strict personal hygiene and frequent hand washing is of outmost importance in order to prevent viral spread. Nasal or throat emissions (such as saliva, sputum, or mucus), blister fluids, and feces of infected persons contain the viruses. Items that were handled or touched by infected persons may also transmit the virus.

To lessen the risk of infection to other family members, the following may be observed:

• Isolate an infected member of the family by having him/her sleep in a separate bed room.
• Aside from frequent hand washing, use of face masks by other members of the family if direct interaction such as playing with the infected child is unavoidable.
• As much as possible, avoid close contact such as kissing, hugging or sharing eating utensils or drinking glasses with the infected member of the family.
• Proper washing of hands after changing baby’s diapers and using the restroom. This should be thoroughly explained to the Yaya (baby sitter) so that she will be able to fully appreciate the importance of observance of strict hygiene.
• Disinfect unclean surfaces and dirty objects, including toys.

Since HFMD is highly contagious, it is best to practice preventive measures to protect others from catching it. For parents like me who are concerned about their symptoms, it is most prudent to immediately contact the doctor or health provider for proper diagnosis and guidance on HFMD management during the entire period of the illness.