HFMD (Hand Foot Mouth Disease) during the first week of childcare

We were feeling very excited for my girl was entering Nursery 1 in the childcare. We were also worried as we had heard of a lot of stories about children getting sick with HFMD once they entered school.

Everyone advised us to be prepared. We thought we were but fate had something else in store for us.

Day 1

I spent half a day with her in school. Everything went well. She was happy and was still excited to go school the next day.

Day 2

Hubby accompanied her to school and she enjoyed it very much! *Phew*

Day 3

She attended school herself as parents were not allowed to accompany their kids anymore. The teacher updated me on her progress via WhatsApp. She was slightly more emotional and cranky. We picked her up after her nap as she was crying non-stop looking for us.

Finally, Day 4

On the last day of school for the week, We thought we were almost there! But it did not turn out as well as we thought. She kept crying on and off that day. We had to pick her up immediately after nap. She was crying so badly when I saw her. To top it off, she was feverish. We went home and washed her up. She was cranky throughout. She was not eating well and her fever had shot up to 38.5 degree Celsius.

The nightmare started that night. Her fever went up to almost 39.5 degree Celsius in the middle of the night. I fed her paracetamol for the fever and kept sponging her.

Fever lasted for 2 days (Day 1 & 2). We were praying very hard that rashes and blisters should not appear but this dream was broken. Rashes, blisters and ulcers all came to visit her. They were on her hands, legs and bottom. We went to see a GP on Day 3 and he confirmed her symptoms.

So this concludes our first experience with our daughter attending childcare and getting HFMD the first week itself.

How serious is HFMD?

Most people with HFMD recover fully after the acute illness. HFMD is usually a mild disease, and most patients recover in 7 to 10 days without medical treatment and complications are uncommon. 

However, one common complication that occurs in HFMD is dehydration. It can occur if the intake of liquids is limited due to painful sores in the mouth.

How soon after exposure do symptoms appear?

The usual period from infection to onset of symptoms is 3–7 days. Fever, usually last for 24-48 hours. It is often the first symptom of HFMD.

What are the symptoms?

The disease usually begins with fever, poor appetite, malaise and frequently with a sore throat.

One or 2 days after the fever onset, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums and inside of the cheeks.

A non-itchy skin rash develops over 1–2 days with flat or raised red spots, some with blisters. The rash is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks and/or genitalia.

How do you get HFMD?

HFMD virus is contagious and infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters or the stool of infected persons. Infected persons are most contagious during the first week of the illness, but the period of communicability can last for several weeks (as the virus persists in stool).

Who is at risk for HFMD?

EVERYONE who has not already been infected is at risk of infection, but not everyone who is infected becomes ill. Yes, that includes children and also adults!

HFMD occurs mainly in children under 10 years old, but most commonly in children younger than 5 years of age. Younger children tend to have worse symptoms.

Can you be infected with HFMD more than once?

Yes, infection only results in immunity to one specific virus, other episodes may occur following infection with a different virus type. Doctor also mentioned to us that there are many types so it is possible to be infected again.

What about pregnant women (like me)?

Ideally pregnant women should avoid close contact with anyone with HFMD and pay particular attention to measures that prevent transmission. However, this may be difficult if you are the only caregiver. Just make sure to take extra precautions and get as many as help you can during the period.

How is HFMD treated?

Presently, there is no specific treatment available for HFMD. Patients should drink plenty of water and may require symptomatic treatment to reduce fever and pain from ulcers.

Can HFMD be prevented?

There are no specific antiviral drugs or vaccines available against non-polio enteroviruses causing HFMD. The risk of infection can be lowered by good hygiene practices and prompt medical attention for children showing severe symptoms.

Preventive measures include:

  1. Frequent hand washing with soap and water especially after touching any blister or sore, before preparing food and eating, before feeding your child, after using the toilet and after changing diapers.
  2. Avoiding close contact (kissing, hugging, sharing utensils, etc.) with someone with HFMD may also help to reduce of the risk of infection
  3. Keeping infants and sick children away from kindergarten, nursery, school or gatherings until they are well
  4. Monitoring the sick child’s condition closely and seeking prompt medical attention if persistent high fever, decrease in alertness or deterioration in general condition occurs;
  5. Covering mouth and nose when sneezing and coughing
  6. Disposing properly of used tissues and nappies into waste bins that close properly
  7. Cleaning contaminated surfaces and soiled items (including toys) first with soap and water, and then disinfecting them

Things that you need to do when your child goes back to childcare:

  1. Always wash your child’s hands and sanitised at the centre before bringing your child home
  2. Always wash up your child (bath and wear new clothing) once home
  3. Feed your child Vitamin C and Multi-Vit to build up their immune system

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