What You Must Know About HFMD In Preschool

Kids in child care are especially prone to getting Hand, Foot and Mouth Disease (HFMD). Find out how to protect your little ones from this contagious disease.

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Kids in child care are especially prone to getting Hand, Foot and Mouth Disease (HFMD). Find out how to protect your little ones from this contagious disease.

Hand, Foot and Mouth Disease is something you'll become very familiar with when your kid enters preschool, as children there are especially prone to catching it. Young Parents finds out more about this hot-topic illness with help from the Ministry of Health’s (MOH’s) website and Professor Paul Anantharajah Tambyah, senior consultant infectious diseases physician at the National University Hospital. 

1. What is HFMD? 

It is a common childhood viral infection caused by a group of intestinal viruses called enteroviruses. The most common culprit is the Coxsackie virus and, on rarer occasions, Enterovirus 71. While both adults and kids can be affected, young children – particularly those under the age of five – are more susceptible. 

2. How does HFMD spread? 

The illness is transmitted through direct contact with the nasal discharge, saliva, faeces or from the blisters of an infected person. In a preschool setting, this occurs when the saliva of one child is passed to another through shared toys or other common objects, and surfaces such as doorknobs. 

3. What happens if my child is infected?

Developing a fever, poor appetite and a sore throat are the usual beginning indicators. Small, painful spots will appear in the mouth a day or two later, which often turn into ulcers. A rash will also erupt on the palms of the hands and soles of the feet, and develop into painful blisters. Other symptoms may include vomiting or diarrhoea. 

HFMD can last anywhere from two days to two weeks, though the average incubation period usually ranges from three to five days. 

4. What treatment will my child's doctor prescribe? 

There is no vaccine for HFMD at the moment. Antibiotics are also not effective in treating it, though your doctor may prescribe medication for fever, pain relief or to soothe the itching. 

It’s best to make sure that your child gets lots of rest, and that she drinks a lot of fluids.

If her mouth ulcers bother her too much, try switching her to a soft diet of porridge or pureed fruit instead. 

5. Can it lead to more severe complications? 

Most of the time, HFMD is a mild illness that lasts only a few days. There have been rare cases in which the heart or brain is affected, however, such incidences are around one in 20,000 to 40,000. Citing MOH data, Prof Tambyah assures that no local cases of severe complications occurred in 2012 despite there being 37,000 reported cases. 

6. How long will my child be contagious?

According to the MOH’s website, children are most contagious for the duration of the illness. However, the virus may linger in your child’s stool for several weeks after the infection is gone, so it is important to continue implementing a good hygiene routine. 

7. What should I do if there's an outbreak of HFMD in my child's preschool? 

Childcare centres, kindergartens and schools are required to report any HFMD outbreaks to the relevant authorities. Those that have a transmission period of over 24 days with a number of cases greater than 16 or higher than 23 per cent are required to close for 10 days. Check MOH’s website for regular updates on the HFMD situation in childcare centres and kindergartens. 

According to a GP, the disease tends to come in waves, he said in a news report. If your child catches HFMD, keep her at home until the doctor gives the green light for her to return to school. And if her preschool reports a case in her class, you may choose to keep her at home for precautionary reasons. 

8. What are some good prevention methods? 

One simple step is to have your child wash her hands with soap and water after handling toys or playing with friends, before and after eating, before and after using the restroom, and after touching something dirty. Also routinely clean high-touch surfaces, especially in the kitchen and bathroom. 

Parents get it, too 

When your kid has HFMD, how can you protect yourself from getting infected, too? 


“Family members have multiple contact and thus exposure. More exposure means more opportunities for the virus to transmit,” says Dr Leong Hoe Nam, infectious disease physician from Rophi Clinic at Mount Elizabeth Novena Hospital.       

“A higher viral load is transmitted, resulting in more severe disease. This consideration is not unique to HFMD, but we see it in influenza, pertussis and chickenpox, too.” 


The virus is found in the infected child’s saliva. “So as the child speaks, the virus spreads,” he explains, adding that any surface that the infected child touches will also be exposed to the virus. 


Your only consolation is that the risk of an adult getting infected with HFMD is a low 1 to 5 per cent. 


Experts advise frequent and thorough hand- washing, too.