Singapore health authorities are reporting an increased number of hand, foot and mouth disease (HFMD) so far in 2015, according to local media sources. Since the beginning of the year, health officials have reported 609 HFMD cases, approximate double 2014 numbers for the same period.

Image/CIA
Image/CIA

The contagious virus has affected several child care facilities in the city prompting the Department of Health to stress the importance of maintaining high standards of personal and environmental hygiene to minimize the risk of HFMD.

Parents should consult a doctor early if their child has fever, mouth ulcers and rashes on the palms, soles or buttocks. Children with HFMD should remain at home until all the blisters have dried up. During this period, contact with other children should be avoided until the child recovers. The child should not be brought to any public or crowded places. Proper hygiene should also be practiced at home so as to prevent transmission to other family members.

In Okinawa, health officials at Kadena AB say they have reported several cases of HFMD in the military and dependent population. In addition, HFMD has been reported in the local Japanese community.

HFMD is typically a benign and self-limiting disease. Most common in young children, it presents as fever, oral lesions and rash on the hands, feet and buttocks. The oral lesions consist of rapidly-ulcerating vesicles on the buccal mucosa, tongue, palate and gums. The rash consists of papulovesicular lesions on the palms, fingers and soles, which generally persist for seven to 10 days, and maculopapular lesions on the buttocks.

Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.

  • Coxsackievirus A16 is the most common cause of hand, foot, and mouth disease in the United States, but other coxsackieviruses have been associated with the illness.
  • Enterovirus 71 has also been associated with hand, foot, and mouth disease and outbreaks of this disease.
Okinawa/CIA
Okinawa/CIA

EV-71 has been implicated in HFMD outbreaks in Southeast Asia over the several years. EV 71 is a non-polio enterovirus.

Complications associated with HFMD caused by the more pathogenic EV-71 strain include encephalitis, aseptic meningitis, acute flaccid paralysis, pulmonary edema or hemorrhage and myocarditis. Most deaths in HFMD occur as a result of pulmonary edema or hemorrhage.

According to the US Centers for Disease Control and Prevention (CDC), 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

  • 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.