To avoid an increase in the number of hand-foot-mouth disease (HFMD) cases in the state, the parents and caretakers of children should take steps to prevent the spread of the disease and protect their children from getting infected with the disease.
This is important in view of the coming holidays and the associated mass movement of people during that period. HFMD is endemic in Sarawak ever since the first outbreak in 1997; this endemicity is interspersed with outbreaks over the years.
The numbers of cases tend to increase following school holidays and festival seasons. Majority of the cases occur among children less than 10 years of age.
Usually, any closure of the kindergartens or child care centers due to clusters of HFMD were made under Section 8(1) of the Prevention and Control of Infectious Diseases Act 1988 or under the Protection of Public Health Ordinance, 1999 with a maximum period of 14 days of closure.
Among other things, the closures allow the disinfection activities to be carried out in the affected centers. Advice to parents It is important to maintain high standards of personal and environmental hygiene to minimize the risk of HFMD at all times.
Parents should ensure that their children adopt the following good hygiene practices:
• Frequently wash hands with soap and water e.g. before eating and after going to the toilet;
• Cover mouth and nose with tissue when coughing or sneezing, and throw the tissue away into a bin immediately;
• Do not share food or drinks, eating utensils, toothbrushes, toys or towels with others.
Parents should practise hand hygiene and to ensure that articles such as toys, appliances or surfaces that are contaminated by nasal or oral secretions are cleaned and disinfected before they are being used again. Parents should also 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, including siblings, should be avoided until the child recovers. The affected child should not be brought to any public or crowded places.
Parents are encouraged to inform the nearest district health office if their children especially pre-schoolers were infected with HFMD. Advice to person in-charge of school and child care centres.
To all people in-charge of school and child care centres would be advised for the following:
a) Where a case is observed or suspected to have unusual signs and symptoms e.g. seizures, weakness of limbs, profound lethargy, refusal to play, poor feeding or refusal to feed, the case should be immediately referred to a hospital.
b) Principals, teachers and supervisors of institutions or day care centres should be alerted to look out for children with fever, rashes or blisters on palms and soles and to isolate them immediately.
Screening before coming to class is recommended.
c) Ensure that the infected children remain away from the institution for at least ten (10) days after onset of symptoms.
d) Articles such as toys contaminated by infected cases need to be disinfected with 0.5% sodium hypochlorite solutions.
e) A high standard of food and personal hygiene, which includes proper waste and diapers disposal – should be maintained by the institution involved.
f) If closure is necessary, close only the affected class. Closure of the whole school is unnecessary as HFMD in older children is usually very mild and so far, no complication has been documented from this age group.
