Health Advisory

ADVISORY INFORMATION- (HFMD) HAND, FOOT AND MOUTH DISEASE

Hand, foot, and mouth disease is common in children under 5 years old, but anyone can get it even older children and adults may be affected. It is caused by Enterovirus genus, most commonly, strains of Coxsackievirus A6 & A16.

Mode of Transmission

Hand, foot, and mouth disease spreads easily through

• Person-to-person contact
• Respiratory droplets containing virus particles when an infected person coughs or sneeze
• Contact with contaminated surfaces and objects
• The virus can spread to others through an infected person’s nose and throat secretions, such as saliva,
  drool, or nasal mucus
• Fluid from blisters or scabs
• Feces (poop)
  People with hand, foot, and mouth disease are usually most contagious during the first week that they are sick. People can sometimes spread the virus to others for days or weeks after symptoms subside or if they have no symptoms at all. (Source: cdc.gov)

Signs and Symptom

• Fever
• Feeling unwell
• Drooling more than usual
• Only wanting to drink cold fluids
• Sore throat
• Malaise and loss of appetite
• Red blister like lesions around or inside mouth, palms, soles, hands, feet, knees, elbows, sometimes
  buttocks and genital areas.
• If a person has mouth sores, it might be painful to swallow

Consult a doctor in case any signs and symptoms appear.

Prevention and Control

Hand, foot, and mouth disease is very contagious. There is no vaccine to protect against the viruses that cause
hand, foot, and mouth disease.

A person can lower their risk of being infected by following the steps:

• Washing hands often with soap and water, especially after changing diapers and using the toilet.
• Cleaning and disinfecting frequently touched surfaces and soiled items, including toys.
• Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with
  hand, foot, and mouth disease.
• Avoid sharing cups, towels and utensils and disinfect premises and all infected materials such as cups,
  towels, utensils.
• Disinfect the classroom surfaces that people frequently touch.
• Teachers and Parents should check for symptoms of HFMD to prevent spread. Parents need to inform
  their respective class teacher if their child is diagnosed with the same. It is important for the school
  personnel to know so staffs and parents can be told to watch for symptoms.
• Parents, please refrain from sending your child to school until rashes have healed completely and no fever for
  at least last 24 hours (at least 7-10 days from onset of symptoms) and till your doctor permits it.

Prevention Guidelines given by MoHFW

• Avoid immediate contact with the infected person
• Educate your child about the signs and symptoms and its side effects
• Tell your child not to hug or touch children having fever or rash symptoms
• You should encourage your children about hygiene maintenance and stopping thumb or finger sucking
  habits
• Encourage the child to use a handkerchief in case of running nose or coughing to avoid the spread of the
  disease
• Don’t scratch or rub the blister and wash every time you touch these blister.
• Try to keep your child hydrated by motivating them to drink plenty of water, milk, or juice, whatever
  they prefer. If a person has mouth sores, it might be painful to swallow. However, drinking liquids is
  important to stay hydrated. If a person cannot swallow enough liquids, consult a doctor.
• If your child develops symptoms of tomato fever, immediately isolate them from other children to
  inhibit disease progression.
• All utensils, clothes, and other utility items (for e.g., bedding) should be separated and sanitized
  regularly. Always use warm water to clean skin or for bathing the child.
• Take a nutrition-rich, balanced diet to boost immunity.
• It is essential to get enough rest and sleep to promote healing.

Right Method of Washing Hands

• Wet your hands with clean, running water (warm or cold) and apply soap.
• Rub your hands together to make lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails.
• Continue rubbing your hands for at least 20 seconds.
• Rinse your hands well under running water.
• Dry your hands using a clean towel or air dry them.
  
  (Source: ncdc.gov.in)

How to you use hand sanitizers?

• Apply the product to the palm of one hand.
• Rub your hands together.
• Rub the product over all surfaces of your hands and fingers until your hands are dry
  (Source: ncdc.gov.in)

If the outbreak occurs in primary schools

Ensure that the infected children remain away from the institution for at least ten days after onset of symptoms and must be certified free from infection by a registered medical practitioner prior to returning to school.

Sources: cdc.gov, ncdc.gov.in, mohfw.gov.in