by DR. LAI ENG MENG
Consultant Paediatrician
ParkCity Medical Centre,
Kuala Lumpur
 

Hand foot mouth disease (HFMD) is not an uncommon disease among children. It is a contagious disease that is caused by Enterovirus. There are more than 20 sub-types of Enterovirus. Coxsackie Virus A16 and Enterovirus 71 are the most common triggers of hand foot mouth disease amongst all.

 

Incubation period of hand foot mouth disease can range from 3 to 5 days. During first few days, the infected child may present with fever, tired easily, or reduced appetite. Later on, the child may develop mouth ulcers, painful lesions on the tongue, gum and around lips. Also parents will notice reddish rashes or skin lesions on the infected child’s palms and feet, or some around the buttock and groins region. Some of these rashes may become small blisters. Once you notice these, you are advised to bring the child to clinic for medical check up by your paediatrician.

 

Most children infected with hand foot mouth disease will experience mild signs and symptoms, and most of them recover well within 7 to 10 days. Parents are advised to feed their infected child with water frequently to ensure good hydration, they should prepare balanced nutritious soft diet for the child as well during the infection period.

   

Unfortunately, some infected children will experience severe symptoms. This happens to younger children especially infants below one year old. Infants tend to deteriorate faster, and get dehydration because of the poor oral intake. Some of them can progress to complications like viral encephalitis and meningitis. These are very dangerous and life threatening. Parents are advised to bring their child to hospital to get early medical assessment and treatment.

 

Hand foot mouth disease generally spread through close contact with the infected persons, for examples through their saliva, nasal secretion, coughing or sneezing droplets, skin lesions contact, or through the stool contaminated daily utensils etc.

 

During the hand foot mouth disease outbreak period, parents should let their young children stay at home, avoiding crowded public area like supermarkets or shopping malls. We should keep good hygienic home environment, wash and clean the dirties frequently, especially feeding bottles, pacifiers, cups and plates. Washing hands before and after handling the young children, changing their diapers, cleaning their bodies. We should discard the contaminated wastes properly, sterilising the contaminated items with detergent, ensuring the children only take clean water and properly cooked food.

 

China has created a vaccine against Enterovirus 71, however, it does not provide broad full coverage protection to all hand foot mouth disease viruses. Thus, a lot of countries, including America and Malaysia, are not ready to formalise and legalise the usage of this vaccine.

 

Prevention is always better than treatment. We should emphasise good hygienic practice in our daily living to prevent infections.
 

 

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作者：黎行明（儿科专科医⽣） 

ParkCity Medical Centre,

Kuala Lumpur

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手足口症是常见的儿童疾病。它主要是由肠道病毒（Enterovirus）所引起的传染病。造成手足口症的肠道病毒（Enterovirus）有多达20多种类型，当中以柯萨奇病毒A16型（Coxsackie Virus A16）和肠道病毒71型（Enterovirus 71）最为常见。

 

手足口症从感染到病发的潜伏期通常是三至五天。前期会出现发烧，容易疲倦，食欲不振，慢慢地就会出现口腔溃疡，手足皮疹或者臀部皮疹。一旦出现相关症状，建议父母要带孩子到儿科诊所去确诊。

 

大部分的手足口症患者都不严重，他们的轻微症状都会很快好转，在七到十天内恢复健康，父母在这期间应该要让孩子多喝水，为他们准备营养均衡的软食和饮料。但是重症的手足口症患者就比较严重了。由于重症手足口症的发病年龄多集中在一岁以下的孩子，他们发病快，容易脱水，有的可能会导致脑炎、脑脊髓炎、脑膜炎等严重的并发症，因此会有生命危险，需要重视，父母应该尽早带孩子到医院去确诊并接受治疗。

 

手足口症的感染过程通常是因为和患者有密切接触，譬如接触患者的唾液、鼻涕、咳嗽打喷嚏的空气飞沫、皮肤疱疹液、或者是患者粪便污染的生活用品等渠道而传播。

 

当新闻资讯报道发生手足口症高发期间(outbreak period)，父母应当降低孩子的外出频率，尽量避免前往超市、商场等人群聚集、空气流通差的公共场所。平时父母应该保持家庭环境卫生，居室要经常通风，勤晒衣被。奶瓶、奶嘴、杯子和碗碟在使用前后应充分清洗。家长在接触儿童前、替幼童更换尿布、处理粪便后要洗手，并妥善处理污物。孩子用过的一切东西都要经常消毒处理。饭前便后、外出后要用肥皂或洗手液给孩子洗手，孩子所饮用的食物和水都要煮熟以及确保干净卫生。

 

虽然中国已经研制了针对肠道病毒71型(Enterovirus 71)的疫苗，但是对于其他手足口症病毒类型所引起的感染症状没有什么效果，只能在一定程度上降低一些感染的概率，并不能完全预防手足口症。因此很多国家，包括美国和马来西亚，还没有正式地批准这类疫苗产品的使用。

 

所谓防范胜于治疗，我们应该在生活习惯多注意卫生以预防疾病。

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手足口症是常見的兒童疾病。它主要是由腸道病毒（Enterovirus）所引起的傳染病。造成手足口症的腸道病毒（Enterovirus）有多達20多種類型，当中以柯薩奇病毒A16型（Coxsackie Virus A16）和腸道病毒71型（Enterovirus 71）最為常見。

 

手足口症從感染到病發的潛伏期通常是三至五天。前期會出現發燒，容易疲倦，食慾不振，慢慢地就會出現口腔潰瘍，手足皮疹或者臀部皮疹。一旦出現相關症狀，建議父母要帶孩子到兒科診所確診。

 

大部分的手足口症患者都不嚴重，他們的輕微症狀都會很快好轉，在七到十天內恢復健康，父母在這期間應該要讓孩子多喝水，為他們準備營養均衡的軟食和飲料。但是重症的手足口症患者就比較嚴重了。由於重症手足口症的發病年齡多集中在一歲以下的孩子，他們發病快，容易脫水，有的可能會導致腦炎、腦脊髓炎、腦膜炎等嚴重的併發症，因此會有生命危險，需要重視，父母應該儘早帶孩子到醫院去確診並接受治療。

 

手足口症的感染過程通常是因為和患者有密切接觸，譬如接觸患者的唾液、鼻涕、咳嗽打噴嚏的空氣飛沫、皮膚皰疹液、或者是患者糞便污染的生活用品等渠道而傳播。

 

當新聞資訊報道發生手足口症高發期間(outbreak period)，父母應当降低孩子的外出頻率，盡量避免前往超市、商場等人群聚集、空氣流通差的公共場所。平時父母應該保持家庭環境衛生，居室要經常通風，勤曬衣被。奶瓶、奶嘴、杯子和碗碟在使用前後應充分清洗。家長在接觸兒童前、替幼兒更換尿布、處理糞便後要洗手，並妥善處理污物。孩子用過的一切東西都要經常消毒處理。飯前便後、外出後要用肥皂或洗手液給孩子洗手，孩子所飲用的食物和水都要煮熟以及確保乾淨衛生。

 

雖然中國已經研製了針對腸道病毒71型(Enterovirus 71)的疫苗，但是對於其他手足口症病毒類型所引起的感染症狀沒有什麼效果，只能在一定程度上降低一些感染的機率，並不能完全預防手足口症。因此許多國家，包括美國和馬來西亞，還沒有正式地批准這類疫苗產品的使用。

 

所謂防範勝於治療，我們應該在生活習慣多注意衛生以預防疾病。