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The Guam  Department of Public Health and Social Services (DPHSS) has received reports from Department of Education (DOE) school officials and healthcare providers of an increase in cases for Hand-Foot-and-Mouth Disease (HFMD) in the past several weeks.

Guam map

There have been 42 cases reported in January 2023 (as of February 1st) including fifteen (15) confirmed and twenty-seven (27) suspected cases of HFMD. All cases are among children of elementary school age or younger.

HFMD is a highly contagious viral infection common in children under the age of 10 years and is often spread in daycare centers. Infection in older children and adults can also occur and is usually asymptomatic.

HFMD is not a reportable illness, but due to the increased number of reported cases, the DPHSS is issuing this advisory.


* Contact with respiratory droplets containing virus particles after a sick person coughs or sneezes.

* Touching an infected person or making other close contact, like kissing, hugging, or sharing cups or eating utensils.

* Touching an infected person’s feces, such as changing diapers, then touching your eyes, nose, or mouth.

* Touching objects and surfaces that have the virus on them, like doorknobs or toys, then touching your eyes, nose, or mouth.


The first symptoms of HFMD are usually fever, sore throat, and loss of appetite. Other symptoms include feeling unwell, painful sores usually developed in the mouth (small red spots often a blister or ulcer), red rash on palm of the hands, feet, or buttocks, and maybe itchy. HFMD symptoms are usually mild and go away on their own in 7 to 10 days.

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There is no specific medicine to treat HFMD. For dehydrated patients, implement supportive treatment with correction of fluid and electrolyte deficits. Some cases may have difficulty swallowing due to painful mouth sores. There is no vaccine to protect against HFMD, but you and your children can lower your risk of becoming sick (or of spreading the infection if already sick) by observing the following preventive measures:

* Always clean hands with soap and water after using the toilet or handling diapers and other stool-soiled materials.

* Do not share towels or wash cloths, especially at nurseries and other facilities for infants.

* Cover nose and mouth while sneezing or coughing and dispose of nasal and oral discharges properly.

* Clean shared children’s toys and other objects thoroughly and frequently with diluted household bleach (approximately 1 part Clorox to 10 parts water). Allow to set for a few minutes and then rinse with clean water or wipe dry with a clean cloth. Regular disinfectants can also be used instead of Clorox.

* Avoid taking children to overcrowded places if they are sick; avoid exposing young children to crowds, especially when childhood diseases are prevalent in the community.

* Avoid close contact such as kissing, hugging, or sharing eating utensils or cups with people who may be sick or have been exposed to sick children.

* Children who are ill should be kept out of school or daycare centers until their fever and rash have subsided and any blisters have dried and become crusted.